Friday, April 20, 2007

Woman Without a Country

"I'm a woman without a country," Mom said last night at 10:30 pm. She had been in the ER from noon to 5 pm, then arrived in a hospital room, but she wasn't sure where she was.
Someplace unfamiliar. Almost a different country.
"They've closed up my room and locked it," she continued. "They can't sell my room! Don't let them sell my room!"
Her eyes searched her surroundings, full of fear, not seeing anything familiar.
Her assessment was uncanny in its accuracy. In fact, I had given notice in her current residence that she would be leaving after her hospitalization, moving to a skilled nursing facility. I had sold her room.
But we could cancel our plans to move her. We could keep her in assisted living, memory care.
The debate continues, the lists of pros and cons.
Today Emily commented, "The chair is really her home."
Mom lives in her big recliner with the push button that electrically sits her up or reclines her. We can take the recliner, television, desk, and other furniture and framed pictures to her next room.
I visited Country Villa again to gather information that will help in the decision. See pros and cons below.
One issue is whether to continue to subject her to continuous medical procedures. She endured two catheterizations yesterday, 6-7 hours apart, as well as an ultrasound of her kidneys, a blood draw, and the setting up of an IV. There's a lot to be said for just returning her to assisted living and putting her on hospice--no further medical interventions except meds.
The decision is ours, not Mom's. She's can't think clearly enough to really decide though she makes it clear that she wants "her room." We could either leave her in her current residence or recreate her room at Country Villa (a process we have done several times before over the last six years).
Central issue: Do we place her among others at her level, or keep her in a higher end place where she is closer to the bottom of the group?

Here's my list of the pros and cons.

Factors favoring Country Villa

Room 16 is great--roomy and pink decorated, nice window looking out on grass, flowers.
Would hold all her current furniture.

Room is right next to the nurses' station--attention.

Hustle and bustle of the place may interest Mom--59 residents (max = 68).

Nice neighborhood around the place to push her in wheelchair.

All residents on ground floor, access to patio and grass, flowers, sky. Safe in case of fire or earthquake.

Small round dining tables, eating in groups of four with consistent group.

IVs allowed. All catheters, blood draws, chest x-rays on site. One full-time PT on site.

May not need private caregivers after moving to SNF. (But we may cancel them even if she stays in her current residence, to conserve her dwindling financial resources.)

Factors against Country Villa

Her bathroom is too small.

No convenient bar for her to hold onto while her Depends are being removed.
(The bar that is there is going to be hard for her to reach.)

All 60 residents share two shower rooms. Most get 2 showers per week, bed sponge baths on other days. (Flexibility of up to 4 or so showers per week if needed.)

Many residents are in wheelchairs, out-of-it looking. Sitting in the crowded room full of wheelchairs would be depressing for Mom.

More people, density than at Sunrise (28 people on 3rd floor Sunrise in comparable amount of space to main floor of Country Villa).

Dining area not as nice... but looks out on patio and grass.

Much smaller closet--a portable wardrobe, not walk-in.

Food probably not as good.

What would you do? Eventually we will all be making decisions like these, either for others or for ourselves.

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