Saturday afternoon, my mother was transferred from Atrium Hospital in Corinth to Rambling Oaks, a senior rehab facility north of 407 between Morriss and 2499. It was her fifth transfer in the past six weeks. With each change, she became increasingly confused, anxious, and paranoid.
I was suffering from the flu and didn't want to infect either parent. Pam soldiered up, taking Dad to see Mom on Saturday and Sunday at Rambling Oaks. When Pam and Dad weren't present, Mom became uncooperative and verbally abusive to the staff.
On Monday morning, at 11:00 a.m., I received a phone call from the social worker at Rambling Oaks to tell me they wanted to transfer her ASAP to a psychiatric facility. I was still pretty sick and told the social worker I couldn't okay a move and my father couldn't get there until 2:00 p.m. She was pressing for immediate action.
This is before her doctor had seen her, before any evaluations, before any therapy assessments, etc. I was appalled and concluded the decision makers at Rambling Oaks simply didn't want to deal with a difficult patient and wanted to get rid of her as expediantly as possible. Thus, things were couched around my mother's "safety," stressing that she was at risk of walking out. If she could "walk out" she wouldn't need to be there in the first place. If she could walk to the bathroom she wouldn't need to be there.
I held them off until Pam could get Dad over to the facility and got out of bed to meet with them at 2:00 p.m. We met with the social worker and head nurse. They talked a lot about what was "best" for Mom.
Look, in my opinion, transferring her to a psych facility where the would sedate her into tranquility is the worst thing that could happen. If that happened, I doubted Mom would ever leave. I didn't think this was about what was best for Mom. I thought it was about what was easiest for them.
I also find it unacceptable that they were pushing this on us before we had the opportunity to even speak to Mom's doctor (who makes routine calls at Rambling Oaks). We raised the possibility that the behavior could be partially or mostly pharmacological since she had been given a lot of Xanax over the past few weeks, was on a number of other drugs that no one had really evaluated for some time, and thought it important to have a psychiatrist review her meds.
None of this mattered to them. The only way they wouldn't discharge her on the spot was if Pam or I agreed to stay with her 24/7. Dad didn't count (i.e., we couldn't bring Dad over during the day and leave for a few hours).
With no acceptable option, we agreed. I called my sister, who was scheduled to come out in June and said we needed her now. Through all of these years, I've never asked her to come out and help with my parents before now. She said she couldn't come out until Monday because she wanted to drive down to Tampa to celebrate my niece's 30th birthday. I explained the situation, that we were hanging on the edge, but it wasn't as important. Later, she started asking me, "Would it be so bad" if Mom was sent to a dementia facility?
We couldn't hire a "sitter." The challenge is we needed someone with whom Mom had long term memories. Of the possibilities, the only other person I could think of was a cousin who had come out to see Mom a few weeks ago. I called and asked her. She wanted to come and tried to work it out, but for a number of reasons, couldn't make it work. That left Pam and me, 24/7.
Pam has been spending every night with Mom. Typically, I come over sometime in the morning to relieve her and stay until it's time to take Dad back in the evening. Yeah, Pam is spending the night there, but at least Mom's asleep and Dad's home. When they're awake, they only demand attention every 15 seconds or so and ask the same set of questions every few minutes.
On Tuesday, we finally got a nurse practicioner working for Mom's primary care physician to examine her (the physician still hasn't been by). We pushed for a change in her meds, which we thought might be contributing to the behavior problems. An anti-anxiety drug was added and was given to her starting Thursday morning.
On Wednesday, we attended the staff meeting where Mom's case was discussed. There was general acknowledgement among the staff that Mom was doing much better, was certainly calmer, and that the change in meds might be positive. However, when we asked if we could plan on Mom remaining in the facility, we were told her status remained tenative.
Since Monday, we've been trying to get a psych evaluation of her meds. Due to facility bureaucracy, we essentially had to use the facility's people. We asked about this and were told by the end of the week. Through Thursday, no one had shown up (remember, she was sooo bad they needed to discharge her within hours, but it takes a week to get someone out for a psych evaluation).
Mom had a good day on Thursday. She was cooperative, even with physical and occupational therapy. Add the change in meds and we began to be optimistic that we might be able to leave her for a few hours.
I asked the social worker if Pam could sleep at home Thursday night as long as she returned early Friday morning. I noted that Mom had slept through the night every night, which the nurse acknowledged. I also explained that Madison was in a play that was important to her and we really wanted to be able take off for three hours on Saturday to see it together, while remaining on call if there were any problems.
The nurse seemed to indicate that it wouldn't be a problem. The social worker seemed open to the concept of a trial, but wanted to talk to the head of nursing. The response was no change would be allowed until, possibly, Monday.
Having hung around the facility for the better part of a week, Pam and I could point out half a dozen patients who are more challenging than Mom the past few days. However, there's no apparent recourse besides pulling Mom for a different facility, complaining to the state, and letting lots of people know about the callous indifference we encountered. Pulling Mom is not a good option.
On Friday, I'm going to Madison's play. On Saturday, Pam's going. On Monday, my sister appears and we're planning on disappearing until she leaves. Last night, Pam posted the following on Facebook...
Okay folks...I'm still "living" in the nursing home with my mother-in-law & nobody has come to visit or call! This does not bode well for when I'm old & really NEED to be here... :-(
People have asked what they can do. Is it possible for someone to stop by Rambling Oaks Friday night and Sunday night?
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