This is the continuation of Jill’s dilemma regarding the care of her aging Mother, Dorothy. Dorothy’s memory was declining, and recently Dorothy’s doctor suggested she move somewhere with supervision such as an assisted living community. The family was suddenly faced with difficult decisions. This is the conclusion to Jill’s story.
It was several months after our initial meeting that Jill and I met face to face again. During that time, we had numerous phone conversations regarding her mother. Jill told me that her brother refused to let Dorothy move into a community. He was adamant that his mother was not going to be “put” somewhere. He insisted that if she needed assistance that she move back to New York to live with him and his family. They would care for her.
At the time, Jill was beside herself. Her mother, who favored her only son, was thrilled to be going home to Syracuse to live with her “baby.” Jill, on the other hand, was confident that the situation would be intolerable. Her brother had three children, two of them in their teens, and he and his wife both worked. Dorothy would be alone during the day. Their kids attend gymnastics, soccer, or cheerleading practice most evenings, so again, her mom would be alone. And on the infrequent days when everyone was home, Jill doubted that her mom would tolerate the incessant noise and activity. Besides, they had no inkling how difficult her care would be.
Four months had passed after Dorothy’s move to her son’s house in Syracuse, when Jill called me. She was frantic. She told me that three weeks ago, her mom had slipped on an icy patch while climbing the front porch steps to her brother’s house. Dorothy fell and broke her right arm. After three days in the hospital, her mom was admitted to a rehabilitation facility to undergo physical therapy to recover her strength. Although her injury was not life threatening, Dorothy’s confusion had increased. Her lack of concentration made it difficult for her to remember her body strengthening exercises, so her HMO insurance denied the facilities request to extend her time for more therapy. Dorothy was being discharged in ten days, and Jill’s brother felt she needed too much supervision to return to his home.
“Can you still take her? I could tell she’d been crying. “ I will have to go get her in Syracuse, but I want to bring her back to you.”
We had little time, and lots to do before Dorothy could move into the community. Jill had to complete the state paperwork with Dorothy’s doctor in New York, and I had to confirm with the social worker at the rehab facility that she was still appropriate for assisted living. Dorothy’s social security was not enough to cover the community expenses, so Jill applied for Medicaid Diversion. The Medicaid would pay for the extra care that Dorothy needed. Medicaid, combined with Dorothy’s Social Security is enough to pay for a companion room. It would take several months for the money to come from Medicaid, but Jill’s brother offered to supplement her payment until then.
I urged Jill to hire one of the local movers that specializes in moving seniors. I assured her that they would not only pack for her, but would dispose of the items that Dorothy no longer needed. While Jill was in New York getting her mom, they would move the necessary items from Dorothy’s home in Florida into the apartment that I had chosen for her. They would unpack, organize her clothes in the closet, replace the items that go into drawers, put her few kitchen items in the cupboard, and hang her favorite pictures on the walls. They would put each item in place
so that when Dorothy walked through the door, she would have a beautiful new place to live. “Trust me.” I encouraged. “It’ll be money well-spent.”
When Dorothy finally arrived I was shocked by her appearance. She had aged considerably in the last few months, and with her arm in a cast, she could barely manipulate her newly acquired walker. She looked weak, and she seemed sad. I sensed her age had caught up with her, and that she was having a hard time accepting her recent injury and new infirmities. I hugged her, but she didn’t return my affection. “My daughter made me come here,” she barked. “I want to go home to my house.”
“Yes Dorothy,” I understand. “When you get stronger, that may be a possibility. In the meantime, we hope you will try to call this home. We want you to feel comfortable. Come. Let me introduce you to your new roommate.”
“I don’t want to live with anyone, “ she scoffed. “ I won’t be here long, you’ll see.”
I walked with her as we slowly reached her apartment. As I began to knock, the person on the other side opened the door. “Madeline, you remember Dorothy. She is going to share your apartment.”
Jill was waiting in my office; tears were running down her face. “She is so angry with me. We hardly spoke on the plane. I can’t seem to do anything right anymore.”
“Don’t be so hard on yourself, and don’t feel guilty. Go home now. Give her some time to adjust. If you remember, I warned you this would be one of the hardest decisions you would ever make. I had a male client who compared caring for his mom with a divorce followed by a bankruptcy; he felt dealing with his Mom was far more threatening. I could only assume the poor man had already experienced all three.” Jill smiled at last, grabbed a Kleenex and headed for home.
Three days later, Dorothy appeared at my office door. “Everyone here has been very nice to me.” she said leaning on her walker. “Far nicer than I imagined, but living here isn’t my cup of tea. I have packed my things, and I am going home. Please call my daughter to come and get me.”
“I’m so sorry,” I said calmly. “Jill works during the day, so I won’t be able to contact her until after dinner. Go have lunch, play bingo, and enjoy your afternoon. I’ll call her later this evening.”
I never called Jill, and as the days passed, Dorothy forgot our conversation about moving out. A care aid had discreetly returned her clothes to her closet, and her toiletries to the bathroom. Dorothy never mentioned leaving again. She and Madeline became inseparable. They joined the book club, they played dominoes; they participated in the word game trivia, and together they took the trips to Wal-Mart. Dorothy was often still confused, but Madeline was always on hand to assist her. The ladies continued to sit with Charles during their meals, and it was not long before they gladly welcomed another new resident to the table who was also from New York.
Jill’s relationship with her mom remained delicate. During Jill’s visits, Dorothy made her daughter feel guilty for bringing her to our Community, and she continued to speak harshly to her. When Jill was not visiting, she was sweet and amiable. Jill tried everything, but there was no compassion to Dorothy’s treatment of her only daughter. Eventually they reached a compromise, but their relationship was never the same.
Jill and I knew she had done the best she knew to do. There is no moral to this story because when it comes to finding solutions for parents, there is no right or wrong. “Doing the best you can,” means just that. There is no magic wand to make everything all right, and there are no absolute solutions.
If a genie appears one day to grant me one wish, it will be that adult children will begin to recognize that their parents will eventually age. Preparing for the future, rather than reacting to a crisis, will make their lives and their parents lives easier. It will be a win-win for all of us.
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