FALL REFLECTIONS

My 86 year old mother is at home now recovering from a fall she took on September 12th. It was a lulu...and it's left her brain injured. I just returned home after spending 10 days with her because the doctors have decided she needs supervision 24/7. I think they would have preferred that we put her into some kind of long term care but she has always maintained that she wants to die at home. In fact she would never even consider the possibility that she might not be able to live at home until her death. It was surprising how easy it was to hang out with her for 10 days. I have grown countrified inside and out. I am not always able to call up my old Massachusetts driver. My skills for city living have atrophied and though I miss several people that live down in the Salem/ Marblehead area, there is very little that excites me about urban life. Given my penchant for the open spaces, I thought I'd hate being in Salem for so long. I actually enjoyed myself. Mom is like a 4 year old...she's highly distractable and easily becomes confused as she sets out to go to the bathroom and notices something out the window and before you know it she has forgotten what she got up for. But she is actually quite pleasant to spend time with. She can mask her confusion with stories from long ago and as long as she can keep her focus, she can be entertaining and appear pretty sharp. She can use the toilet and she is not taking medications except for vitamins. Consequently, she doesn't seem like a nursing home candidate and the assisted living model doesn't quite provide her with enough attention. Everyone at the rehab stressed her need to be safe. I think about Priscilla who was in a nursing home...she couldn't talk or toilet or even walk around. Her care was so far beyond our abilities to provide but she still took daily falls at the nursing home. Mom may fall even with someone supervising her whether she is at home or at a home. What was amazing was how strong she became when she came home. Sleeping in her own bed and eating home cooked food, being surrounded by the things of her life...she became more of herself when she got home. When I look back at her cognitive changes, I can see that she had started to fail over a year ago. When I encountered neighbors of hers in salem, they commented on how unsteady on her feet she had become. I didn't really notice that. As far as I could tell, she was walking to work and all her appointments as usual. Had I known would I have done anything? What could I do? If I had told her she couldn't go out walking she would have anyway. I couldn't stop her then and I doubt if I can stop her now when I am on duty. I can't live in constant fear and hovering over every move she makes. She needs to do things by herself so she maintains functioning. When I leave her alone, she endangers herself because she becomes disoriented. Twice, in the middle of the night I was woken up by her flushing the toilet. She had wandered into the bathroom even though she had a commode beside her bed because she went to the bathroom from her bed every night for 50 years. I lost a lot of sleep wondering if I'd hear her up and around...hypervigilance exhausted me. Whether she is in a home or at home with a sitter...the truth is she will fall again. There isn't a situation that can keep her from endangering herself. All we can do is do our best to give her support and love the time we have left. The laughter and the stories and the warm feeling of "I'm here for you" can give the heart wings but only if I can keep my balance by being there for me too. Because when I come home...I too am strengthened.