Breaking Out of the Nursing Home?

Image by infomatique via FlickrBreaking Out? Yesterday I went to see my mother at the nursing home. She was sitting out by the aviary, and when she saw me she glanced over, gave me her worst gaze of contemptuous fury, and said, grimly, "This will cost you... this will cost you more than you know... " She has no memory of having agreed to go into the nursing home, when she left the hospital.

She was all up and dressed, and looked better than she has looked, before. I told her that it was probably time to consider where she should go next... how about an apartment (assisted living) there at the elder-care facility? "NO," she said. "I have my own house." I asked her what about some help around the house [something she definitely needs, but has never before permitted]? She said, "I'll get a nig." (This was while she was no more than 2 feet away from two aides, both of them black women, who were working on the med carts... They did not display any response to this, and I admire them, cannot imagine all that they must put up with.)

So, I left, and thought about it... She is walking, she is swallowing OK, she is getting up and getting dressed on her own now. She is pretty much where she was just before she went into the hospital... and I am not her guardian. Nobody has actually said she is not competent to make her own decisions. So I called the Director of Nursing and said, "Let's let her go home." I said that I really don't think we can keep her in the nursing home any longer, against her will, now that she has done everything anyone asked her to...

I spent the rest of the afternoon working on all that, working with the staff to get the discharge planning done, getting home health care lined up, etc. Then, when I went back to her room with the person from the home health care agency, I found Mother in bed, in her pajamas. She said: "Oh, I can't possibly go home tomorrow. I don't have any groceries in the house, and I have a sore throat." And, for good measure, she accused me once again of stealing her money.

I feel as if I am held hostage to insanity. It's one of those situations in which there is no clear and correct path; there is only an ever-shifting array of bad choices, and the task is to try to keep choosing the least-bad choice, at every turn of the road. A few days ago, Jane Gross wrote a piece in the NYT Wellness blog called "What I Wish I'd Done Differently." She describes several of the decisions that she made while her mother was becoming increasingly sick and disabled, and then points out:

"All of these mistakes would have mattered less if the trajectory of my mother’s decline had been different. But that trajectory, alas, is unknown and unknowable but for its certain ending. So every decision we made — residential, medical, financial — was a crapshoot that changed the landscape for the next decision, usually by limiting options I didn’t even realize we had. There’s no way around this uncertainty, no way of knowing what’s going to happen next so you can plan accordingly... " [emphasis added]

Gross suggests consulting or retaining geriatric specialists, social workers, lawyers, financial planners... And that is a good suggestion, in theory, for those who have the time and the means to do all that. I have been scrambling around for weeks now, looking for and talking with various of these people, and (as of yet) I have very little to show for it.

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