The eldercare dilemma

A few years ago, I vowed I would care for my elderly mother in her Hurstbourne apartment as long as it was safe. On Valentine’s weekend, after looming risks reached a critical mass, I passed the torch to my beautiful, dutiful sister — a Taylor County nurse practitioner whose husband is a surgeon.

Mom remains very much herself — charming, cheerful and generous to a fault. But beset by vertigo, she is prone to falling. Memory loss means that she sometimes forgets to use her walker or cane — or remove her reading glasses, which wreak havoc with her depth perception and sense of balance. Hypersensitive to side effects, she resists taking three medications — one of which keeps her from lapsing into atrial fibrillation.

Life gets increasingly confusing at 96. Is it dawn or dusk? Can the people on TV hear and see us? Are callers friends or con artists? Even caregivers struggle for clarity. For example, Mom attributes her longevity to coffee and routine movement. But now caffeine seems more toxic than therapeutic. It can play a role in “sundowning” episodes ranging from confusion to violent hysteria — and urinary tract infections, which can deepen dementia and trigger delirium, “a temporary state of extreme mental excitement, marked by restlessness, confused speech and hallucinations,” according to Webster’s New World Dictionary.

If resting begets rusting, frequent mobility seems like a high, holy virtue — unless you’re apt to stumble, drop and roll. Those “I’ve fallen and I can’t get up” ads don’t amuse those who know that a broken old hip foreshadows mortality on par with heroin addiction.

Eldercare isn’t rocket science; it’s far more complicated. Every day is a blessing filled with curses. Last weekend, the curses got unacceptably deafening.

Mom’s transition is a mixed blessing. Our longtime hope — her lifelong hope — was for her to live and die in the comfort and privacy of her home. Any mention of an institutional setting prompts her to spit fire and nails. We duck and run as she bellows, “I don’t want to be around a bunch of old people!”

I never thought it would come to this until recently. I never thought Mom would long survive the death of our dog three months ago (see “A best friend‘s merciful exit“). Fortunately, she has — but with collateral cognitive deficits. It’s taken a toll on both of us.

If pseudo-dementia (deepened by depression) is the issue, the obvious solution would be to get another dog. But the risk of her falling over — or atop — a small dog obviates that option.

Mom hoped to bequeath her hard-earned life savings to the neediest survivors — another dream I’ve been struggling to keep alive. But my health has been suffering as I’m haunted by the prospect of Mom surviving me.

Assisted living appears imminent. But what once seemed like nuclear winter increasingly seems more like spring — for both of us. Mom is supremely a people person. A transition from quasi-independent to assisted living would close the door to her home but would open an iron curtain of isolation to interaction with kindred spirits.

Change is daunting at any age, but the status quo is unsustainable. In the tragedy of aging, time is no compassionate bystander; it’s an indifferent participant.

The signs are as clear as the hands of a clock: it’s time to try something different in a protected, secure environment. Moreover, it would be selfish of me to preserve her estate if it might buy her a better, longer life in the face of threats to our health and safety.

A family decision — hopefully a consensus — is pending.

In the meantime, my bypassed heart is filled with gratitude for three outstanding health professionals who optimize MomCare with unwavering patience and kindness.

Audiologist Mark Clark of Advanced ENT and Allergy keeps Mom’s ears and hearing aids in the best possible condition. Life is hellish when Mom can’t hear, so Archangel Mark is a godsend for our mental health as well. He’s eligible to retire — but not without our permission.

My family’s faith in Charles Barrett, who presides over a Disneyland of dentistry, spans decades. Don’t take my word for it; Charlie is a frequent favorite among LEO’s Readers Choice Awards.

I trust internist Stephanie Altobellis, Mom’s primary care doctor, completely because I’ve known her since 6th grade. What’s more, she’s the daughter of retired Dr. Charles Smith, a living legend of internal medicine. That Mom is 96, alive and kickin’ speaks volumes for the Jennifer Lawrence of MomCare.

This article appears in February 17, 2016.