"No dinner tonight. I feel down the stairs into the driveway"
Umm... what?
Knowing mom, I assumed she was minimizing her accident on purpose. Which to me means she's right on the border for needing medical attention but hasn't gone out to get any. She sent that message long after my brother got out of work, so I know he's at least seen her. So I don't focus on the message and head home.
Not surprisingly she is hurt. Bruises on both legs, both hips, both arms, both shoulders, and on her head, just above her eyebrow. She has bandages on two different areas of her right lower leg, and she just looks tuckered out.
After quizing her for a bit, here's what I understand to have happened; The fed-ex guy left a package on our front door. Our front door is rarely used for an actual entrance or exit as it has a pre-formed set of concrete steps that don't quite rise up enough. With the door sill, there's quite a first drop down to the steps. Mom didn't want to walk to the back of the house, outside to the front door and get the package that way. Instead she opens the front door, takes the bit step down while holding the door jam for stability and reaches down to the next step for the package. From her angle, she can reach the package but it's too heavy for her to lift with one hand. So instead of walking fully outside and down the steps to get the package, she lets go of the door jam, grabs the package with both of her hands and tosses it behind her and into the house.
And then she fell. She sent down head first into the steps, rolled down the two or three remaining steps banging her body on the door and the hand railing and ended up sprawled out in the driveway. She says she didn't lose consciousness, but she says it in a way that leaves room for doubt. Not "No, I didn't black out", but "I don't think I blacked out". She was hurting pretty bad and couldn't get up. She tried shouting for help but our neighbor doesn't live close enough to hear, and no one was nearby. She says she was out there for about 45 minutes. In the state she was in (scared, hurt, embarrassed...) I'd probably put that closer to 20 minutes. She ended up being able to get up enough to crawl back up the stairs and into the house.
Now, as I've said, this was about two weeks ago. I still feel a pang of regret and pain when I think of my Mother not only falling, but being unable to get help and having to crawl back into her house.
She called my brother at work and he came home immediately. He said she was doing fine (considering what happened), helped bandage up her leg, and got her comfortable. He couldn't take the rest of the day off and mom refused to go to the hospital or even the doctor's office to get checked out. So he called up my sister in-law and got her to come over and be with Mom until he got off later that afternoon.
She stayed in her recliner and rested until I got home. Knowing how stubborn she could be, I didn't let her know what I was doing but I did every bit of a neuro exam that I could. Asked all the questions, performed all the tests. I even shined a light into her eyes to check pupil reflexes by using my phones flashlight and the excuse of checking out her shin. Thankfully there were no questionable responses. Being that it was going on 9 hours since the accident, I was satisfied that she didn't have some major bleed or concussion. With that part satisfied, I then took a serious look at her shin. Yeah.. she had a 5 to 6 cm area where she pulled all the skin off. It had drained quite a bit of blood, but it looked clean and didn't have any signs of infection. I knew it would have to be monitored and protected while it healed up.
If Mom were my patient, I would get her into to see the doctor. I'd fear for a hairline fracture of her tibia. I'd fear a sprained ankle and/or wrist. I'd fear for the possibility of infection from her shin and assume the doctor would want her to have some oral antibiotics to protect her from said infection.
But Mom isn't my patient. I may be a nurse, but I'm her son first. I gave her my opinion, and she decided to re-evaluate in the morning. While I wasn't excited by that answer, I did accept it and told her that I would take the next day off of work and be ready to take her in to the doctor's office.
The next morning came around and she was improved. Not 'good' by any stretch... but her leg still looked healthy, no signs of infection or breaks, She was able to move around and that's no minor feat. With all the bruises and swelling I was honestly afraid she'd need help. I even woke up early just to be available if she needed assistance.
She had a good nights rest, showed no signs of neurological defect, nor any signs of serious injury... just plenty of minor injuries. I know she didn't want to go to the doctor so I told her that as long as she took it easy... no stairs, no lifting, no chores... that I would go to work and we'd evaluate again the next day. I showed her how to change the dressing on her leg. Not that I needed to.. she dressed it originally.. I just confirmed that she was doing it right.
She agreed, so I emailed my boss and told them that I would in fact be in that day. Once I had that settled... Mom started doing chores. Yeah, stubborn runs in the family!
I ended up taking her to the doctor the next day (my day off). Mom's doctor is away for a few weeks so we saw a PA at the doctor's office. The PA was great. She confirmed everything I was thinking... nothing major, X-Ray's to make sure the leg wasn't broken, oral antibiotics just to protect from injection while the leg abrasion healed. The Xray confirmed that the leg wasn't broken and the PA said that the dressings were fine but changed out the tape to an ace wrap.
Now this type of wound should heal up on a healthy person in a few days. Not fully healed.. that will take weeks maybe months regardless of health. But it should heal over and not require any more dressings. Well, Mom's has just now gotten to that point. Between her heart, her diabetes, and her age, eveything is moving slower. The pain is manageable, but her neuropathy makes it worse.
Now... this isn't the first time Mom has fallen. She's fallen down the steps into the basement. She's fallen down the steps leading to the second floor. She's fallen when using a step ladder, and even just fallen walking. Neuropathy is a cruel disease and can make it feel like you've lost your balance. But this is the first time her falling has really really scared me. She was outside in the driveway. She fell onto concrete steps and ended up on blacktop pavement. The handrail is wrought iron. She was damned lucky that she just ended up with a goose egg on her head. She could have easily cracked it wide open. Honestly... where and how she fell, this was the best outcome. And it's taken her a couple weeks to heal enough to only barely limp.
So that's where the title of this post comes in. When is it time to stop helping Mom make decisions and start making them for her? I mean this in two specific ways.
Before I get to far into this thought exercise, understand that legally I can't make any decisions for her... but I can stop asking and move to actively pushing her into smarter decisions.
OK... with the problem of Mom falling my fear is that she falls again (I honestly believe that's inevitable), and she does real harm. A broken bone. Loss of consciousness. Internal injury. If those types of injuries occur while she's alone, then they could lead to permanent disability or even death. It's not as much of a concern except when she's alone. Between my brother and I, we're around her a lot for this very reason. R goes to work at 7 AM. I go to work just after Noon. R gets back at 4 PM, and I get back around 11 PM. So she's only alone for about 4 hours. BUT I just transferred to the new job. I'll now be leaving a couple hours earlier, leaving Mom alone for 2 additional hours.
The first solution is Life Alert or some other medical monitoring service. Mom absolutely hates the idea. It would mean wearing some of their equipment all the time. I would mean having to answer the phone when they call (if the equipment shows she's possibly injured). It would mean paying a bill (which I would and could easily cover, but she'd still think about it). And to be honest, I'm not really excited about that as an option either as it's not a solution... it's a way to get her help if (when) it happens again. It does nothing to prevent the fall in the first place.
The other option is moving. Getting a new home and selling this one. My aunt was at one time married to a paraplegic who was in a wheelchair, so her house is completely wheelchair accessible. From the garage to all room sin the house, there are no door sills or stairs. All the doors are wide. That main bathroom has plenty of space and hand holds built into the wall.
Now Mom isn't in a wheelchair, but that setup would be nearly ideal for her. No stairs to climb would mean far less chances for her to fall. It would also be easier for her to get in and out of the house. Most often when Mom comes home she has shopping to bring in. By the time she parks in the garage, she's already tired. Now she has to lug those bags from her hatch, into the breezeway, into the entryway through an old narrow door, up some narrow steps and into the kitchen. It's hard on her. It doesn't matter if she's trying to lug in a 10 lb bag of potatoes, or a small bag from the pharmacy... it's hard.
I broached the subject of a new house to her last night. I got about what I expected... no. Her first argument was easily tossed out; Moving would be an absolute bitch. And that's true. We have af ull basement full of shit, we have too much furniture for the size of the house, every counter space and table top is full of other stuff, and we have an attic with all manner of shit. Not to mention the garage full of shit.
Mom and Dad bought this house 3 years ago, and have spent every year since trying to fill every single nook and cranny. I use the term shit, but it's just 4 decades of accumulated stuff. But hey.. that's why they invented two men and a truck!
The other problem was the more obvious one, and the one I'm far more sympathetic too. Memories. Both my brothers and I were brought here after being born. We grew up here. Mom and Dad have done major renevations to the house. We put on the third roof this year. They put the second floor onto the house (it's more of a dormer, but it's BIG and added a lot of square feet to the house). They knocked down walls and made entirely new rooms. They moved the front door from one side of the house to the other. They expanded the driveway and added parking for the various cars we've had. They fenced in the back yard and planted trees that now stand over 200 ft tall.
Dad died here.
To me, this is the house I grew up in and that I currently reside in. It's home, but it's not MY home. It's Mom's home. In the last 20 years I've moved (not including the times I moved back here) four times. My memories of this place are either purely childhood ones or mixed in with the other four places I've lived. Mom's been here for FOUR DECADES!
I certainly didn't expect her to simply think about it for a moment and start looking for a new home. But I do hope she considers it. Staying here means a fall is just far more likely. After the fall down the stairs from upstairs, Mom has more or less banned herself from going up there. Now she's more or less banned herself from using the front door. But we can't eliminate the stairs in and out of the house. And we can't eliminate the stairs down to the basement. Well... we could probably ban her from the basement, but that's where the laundry area is as well as our chest freezer and second refrigerator. She goes down there daily and those things don't have room to be moved upstairs.
My fear is that eventually we'll have to move her out of this home. It will be because of some major accident that disables her or she'll have to have continual care with no room for a caregiver. A new handicap accessible home will not only hopefully keep that accident from every happening but could also provide access when she's disabled.
I just don't know. I don't think anybody is ever ready to start making these kind of decisions or even leading their parents to these kind of decisions. But it's even harder when she was just so damned vibrant a few years ago. It's harder when you step back and realize she's only 67. I'm not talking about an 80 or 90 year old.
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