The unimaginable
No, I don’t refer to death. I refer to the incredible amount of time and effort helping your elders recover will cost you. I have FMLA, but even that won’t cut it for an extended medical episode. Before I took care of Pop, it never occurred to me how disruptive and invasive recovery periods would be. I was completely unprepared for the time, effort and overall exhaustion involved.
So, I’ll try to help you get ready…as if that’s possible.
Your House Becomes The Elders Recovery Room
Mom had a seizure in 2018, fell in 2019, and was hospitalized due to an infection in 2021. Not really a bad history for a 92 year old lady. Before the seizure, she had not been hospitalized since I was born in 1965. The hospital staff didn’t believe her when she said that—I had to confirm it.
These three events had something in common: She eventually came home.
Home had to change to be safe for her after each event. We were the ultimate recovery room. Planning for that eventuality was incredibly important, and helped lead Mom to a faster, more complete recovery each time. You need to prepare.
What Happened?
The three hospitalizations highlighted above were extremely different from each other. They represent three different reasons your loved one might be hospitalized—a neurological event, a common fall, and an unchecked infection. Each of the three required different tests and treatment, and were handled very individually by the hospital staff. However, they also represent various stages in Mom’s dementia journey, so how I responded to each of these situations was not only important, it was different.
All three events were emergency-level events. Not expected, and very frightening, also. I happened to be with her—in a public place with my youngest son—when the seizure occurred, but the other two events I was at work. I actually found her on the floor after the fall, and it was her nurse that made the decision to call 911 with the illness in 2021.
My message to you is this: You never know. Always be thinking. Always be prepared.
Planning during the hospital stay
So your loved one is in the hospital…
First things first: Verify that this is not a cataclysmic, life-threatening event. If that is the case, you simply live in the moment, and do everything you can to keep them calm and comfortable until the initial crisis has passed. This has only happened to me once, with Pop, and all I did was sit in the hospital talking. I didn’t do any preparations for when he came home. I didn’t even think about him coming home. In fact, I was simply there to bear witness to the event, and wait for what might happen next. It’s sobering, but that event passed—as hopefully it will for you—and I moved into preparation mode for the future.
Helping Elders In The Hospital
For Pop, I visited every day, and tried to be there when I anticipated doctors visits and tests. Pop, however, was completely coherent and in control, so I knew he would be fine to report to me later.
Mom, however, needed me to be present as much as possible. So, I stayed in the hospital as much as they would allow, and accompanied her to all tests being done. I spoke to the doctors, or had them call me while in her room. It was much more stressful and exhausting than with Pop, but the dementia forced my hand. She was a difficult patient if I wasn’t there—pulling out the IV and refusing to let nurses do their job. So, sometimes helping elders recover happens before you even leave the hospital.
What Happens Next
Immediately upon her admission to a room in the hospital, I questioned the staff about “what’s next?”. I knew she would probably go to a rehab facility, and I wanted to do as much research as I possibly could in advance of that eventuality. Start “shopping” right away, looking to find somewhere that has dementia experience, and a very liberal visiting policy, so you can help out as much as possible. While she was still in the hospital, I visited numerous facilities, to make the best decision possible. You absolutely can’t just send your dementia patient to the closest facility, so use this time to get out there and visit.
After the fall, we had no idea how much mobility Mom would regain. So we evaluated her rooms in our home. Could you get a wheelchair bedside for her to transfer? Where should we move the coffee table out of the way? These are things that could absolutely be considered and handled long before she comes home. It is important that you be proactive in as many details as you can.
Helping Elders Recover When They Get Home
Rehab facilities have a time limit under Medicare, so you know your loved one is eventually coming home. What’s your plan?
Deal With Her Physical Space
As mentioned above, we went through her rooms from several different perspectives: Fully mobile, walker or wheelchair accessibility. We traced all of her steps in our home from the front door, and made sure that she would be able to navigate everything on her own. The tightest and toughest was the bathroom. Frankly, if she had ended up in a wheelchair, it would be a problem.
Deal With Her Emotions
She spent a week in the hospital with the hip replacement from the fall, then four weeks in a rehab facility. Coming home after that was quite emotional for her. And helping elders recover is both physical and emotional. She cried walking in. She cried at dinner. Then, she cried multiple times in the days that followed. She cried because she was happy to be home, for sure. But…she also cried out of confusion.
The dementia was just taking hold of her at that time, and going from one location to another was extremely difficult for her, and she found herself quite discombobulated several times. She went into the laundry room instead of the bathroom, for example. Be prepared to deal with very strong emotions as your loved one becomes reacquainted with your home.
Deal With Her Paraphernalia
We also needed to find workable solutions for her walker, which she uses to this day, and always will. Where does it go while she watches tv? Eats dinner? These practical matters can become an issue that leads to more frustration and anxiety for her if you aren’t careful. Even worse, we found that if her walker isn’t in immediate reach, she will simply get up and walk around without it!!!! Not acceptable!!!
Dealing with home health
While you’re dealing with all of this, your home is about to be bombarded with strangers offering help and assistance. That sounds great…but it really isn’t easy. After the seizure, I was required to stay at home 24/7 for quite a while. Fortunately for me, it was during summer vacation, or I would have blown through at least half of my FMLA dealing with her recovery. By the time of the fall, we already had a part-time caregiver. We simply moved her to full-time after that, so she was able to deal with the doctor’s appointments and home health issues.
Mom was ordered nursing care, physical and occupational therapy for about six weeks after she returned from the rehab facility after the fall. After the seizure, she also had speech therapy for a visit or two to be sure. These people will visit once to several times a week, at a wide variety of times. It’s simple—you need someone at the house at all times following a medical episode.
Home health is great. They are extraordinary people doing fantastic work during a difficult time. It’s just scheduling that crushes you.
When you’re alone again
Eventually, all of the additional, Medicare-covered services will end. You need to be prepared. Just because all of the extra nursing came to an end didn’t mean Mom could walk normally anymore, nor did the dementia—exacerbated by anesthesia—ever get better.
You need a long term plan.
For us, we converted her incredible, fantastic part-time caregiver into a full-time employee. She covers the 40 hours while I am at work, and I cover the other 16 hours a day. It is still stressful for us every single day, but it is a strong, functional plan to make sure Mom is safe, happy and maintains her standard of living.
The most important thing for us, particularly following the fall in 2019, was to make sure Mom continued with the physical therapy. Assuming your loved one has a physical accident, physical therapy will be paramount. In the months following the fall, medical professionals worked with Mom to build up the strength in the legs, as well as teaching her how to navigate with the walker. That muscle-building and practice with the walker is an ongoing event for us now, with exercises and practice. For her to recover as much as possible of her mobility, it is imperative that we take over where the professionals left off.
It’s a job that will not end. Kind of like The Job, anyway.
No next time allowed
Wouldn’t that be awesome? One and done and we continue on with regular life! I wish I could find a way to make sure nothing bad happens to Mom again, but that just isn’t the reality of it.
What I can do, however, is make sure I’m ready. Helping elders recover requires preparation. Whatever comes next, we will meet it head on with resolve and a strong infrastructure in place. We may not be “ready” for the accident itself, but we will be ready to deal with it.
That’s about all we can do, really.
THANK YOU FOR READING THIS FAR
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