Waiting for other outcomes

Bird watches the berries   by the lampost
photo taken on one of my walks

Two days ago, Thursday, MIL appeared to be on the recovery trail.  The SNF nurses had determined that Tramadol, the pain meds were making her worse, more confused,  we agreed that they discontinue and within two days she was improved, color better,  up in a wheel chair, able to eat and being herself, which is not all that pleasant under normal circumstances but we are all used to it.  However yesterday and today is another story. This is the second day she has refused to eat.  She continues to need oxygen, her lungs will not work without it, she is very delusional with out constant oxygen, yet it  dehydrates her.  She sits in her wheel  chair when they get her up and simpers.  It is not even a whimper, but a simper, it makes no sense, it is a noise a  very high pitched whining of sorts.  It is pitiful.  Once in a while she says, "97 years old!" she is 96.  She knows who we are, "Jerry  and Pat"  but otherwise, she knows nothing, cannot remember  she has broken her hip, had surgery let alone what day it is, she cannot communicate.  The  pros say, "  Mortality and functional outcome in hip fracture patients are significantly related to the presence of neuropsychiatric comorbidities. The most frequent ones in elderly are delirium and depression."  Yes indeed MIL has both delirium, depression and pulmonary episodes.  If this is her final stage of life it is miserable, a bad way to die, nothing peaceful.

Her daughter does not care, obviously and will not come to visit her mother, big deal she lives in another state, there are planes today, shame on her, someday she may regret her neglect.  Her younger son, I believe, feels he did his duty by appearing this past August with his family.  Well at least he made an effort after four years.  These are my simple opinions, very sad for them, they have not a clue what lies ahead.  Maybe I selfishly want them to participate for our relief, they have not and will not now. Jerry ignores it, says, " why would they change now?"  and he reminds me I  expect too much. 

I have a friend in PA who said caring for her elderly mom that she was an only child until the will would be read.  Well here is a flash to Florence's other children, the cost of the care in the SNF has all but diminished your mother's money.  We have bought  her personal care items and clothes the last years while you were never interested nor asked us what she needed.  You went along your merry  way. Do not appear with your hands open and out when she passes to collect your share, there is nothing $$. And beware the cold winds of karma that blow your way.  I find these people most irritating.  What goes around comes around, something like that, I don't know if the Hindus, Buddhists or whoevers have it right. 

"  .. As my life today....has been determined by the way I lived my yesterday,......
So my tomorrow is being determined by the way I live my today.        Ralph Waldo Trine

The daily SNF visits leave us both very tired.  It takes a hunk out of our days, but what else can we do?  So until something  very unusual happens or MIL passes on, we are tied to a circular duty, one that was not our choice, but one that we assumed,  catch, here comes another curve ball in the game of life.

If it's not one thing it's your mother

December 13, Christmas Party
Florence looking at Santa's baby

So goes a pop culture quote that includes books, TV shows, magazine articles, t shirts, even Robin Williams' sayings and some reach back to Freud blaming it on your mother.  But that it has been the mother again here, a siege for us beginning with the phone call Sunday afternoon:  Jerry's 96 year old mother, Florence,  (aka MIL=mother in law) fell  in her room at the  skilled facility where she has resided for two years.  She has been  our responsibility since 1980 when her husband passed away and we acquired the task of looking out for and  putting up with the demands and annoyances of this dependent, manipulative woman as her other two younger children opt out.  Truth, Jerry's full sister, dead since 2004 but who was alive at the time would have stepped up but she had her own siege of medical and financial problems and was not really able to do much.  So it has been that we got the Old Maid.  At 96, you think there is not much  time left but they live long lives in her family and she is the last of the 5 sisters, the youngest, the baby and the less stable  mentally and the nastiest.  All this has been told before, our lives whirling along and finally we have had some degree of freedom with her in the nursing home.  We have been concerned about this potential, she had a walker to use for stability but with her dementia and  bull headedness she often neglects to use it in her room.  The orthopedic surgeon wondered if she had previously fallen.  How does anyone know, her hearing is almost non existant, she does not communicate, she attempts to be secretive, to hide things, much as the hoarding we cleared from her room.  That is another story we filled 4  big trash cans with old  napkins, boxes, paper plates, old newspapers, old church bulletins, envelopes, and the worst used disposable underwear.  The  facility staff try to not  intrude on a resident's privacy but after I discovered the garbage upon garbage, some other protocol must be followed. 

Who knows how it happened, they found her on the floor near her bed, and in pain.  She has a high pain threshold and an ability to ignore aches so when she complained, they knew it was serious.  An ambulance transport to emergency at the Gunderson hospital in La Crosse and ever since  4:00PM Sunday it has been a tilt a whirl; her partial hip replacement surgery at 11:00PM, being up out of bed Monday morning, standing yesterday and declared medically stable and dischargeable back to the SNF today.  Medically stable says nothing about mentally unstable and there's not much to be done about that.  She convinced the hospital attendants to call her son and when she got Jerry on the phone she was belligerent and demanded he come get her.  We requested they not connect a phone, but they try to do what a patient wants or what makes their life easier.  I wish her daughter had interest and would come and sit at the facility, taking care and be pushed to  frustration but that is not going to happen and so we make do.  I watch my own tongue and attitude because I do not want to be mean to an old lady, someday I'll be old too, but what a predicament.  Long discussions with the therapists and nurses at the home this morning about protocols and a new level of care for her. Will she comply, will she attempt to do something she should not and reinjure herself, what next?  All questions to be answered as we look toward Easter.    I'll not be Easter decorating this year, too much else to deal with.  

Full healing may take 6 months.  This is a time of instability when anything can happen.  A cousin reminded me that Aunt Berniece died of complications from a broken hip, but Florence has a strong heart and  body in ways unbelievable for a 96 year old.  Many  nurses marveled at how good she looks for 96 and then they marveled at how nasty she could be,  how she could be foul in disposition and demeaning, I am not surprised.  We hope progress continues.  Such is life.