Remote Caregiving Challenge

This past weekend, I drove my Spouse to his Mom’s house. She lives about 250 miles away, all by herself in the only house she has known for some 68 years. Via frequent phone calls, she had been signaling to us that she was not well, but what we found was…

…strikingly frightening.

M-I-L was acting rather strange (even for her.) When we arrived, for a moment, she did not know who her son was, and thought I was her doctor. I guess she confused me with her doctor because I was assessing her condition, taking her blood pressure and pulse, examining her eyes, nose, and throat, and asking a lot of questions.

She figured out in her own way that her son’s presence was unusual, and she feared that because my focus was on her health condition, we were going to make her go to a hospital. She began to fight, call out in anger, and otherwise resist with a verbal tirade that there was no way in hell that she would go anywhere.

Actually, her passion and fury convinced me that she was better than she seemed to be, because she had the energy to fight us so forcefully (mostly verbal, and man, she can be verbally abusive!)

When my assessment was complete, I regained control and some peace by calmly asking when she last ate or drank anything. She couldn’t remember.

She let her son guide her to the dining room while I prepared her a light meal. She ate it while watching me closely, wondering if somehow I was going to make her go to the hospital.

While she was eating, I went to another room out of earshot and called her doctor’s office. I left word with the answering service, and was pleasantly surprised that the doctor called me back in just a few minutes.

I explained what was going on and that I thought M-I-L was dehydrated and malnourished. She had not been eating or drinking much, yet she claims that she has had diarrhea.

With dementia, it is easy to confuse a loose stool with diarrhea, and all she knows in her own mind how to control it is not to eat or drink. So she starves and dehydrates herself to fend off what she thinks are the causes of her loose stool.

She has had this problem before, so on further questioning, we found out that the caregiver who we hired through an agency has been giving M-I-L a lot of grief for using up so many adult diapers, requiring frequent disposal and replacement. So M-I-L also took those complaints as another reason not to eat or drink anything.

Additionally, the caregiver left notes saying that M-I-L “refuses to eat. I give her a sandwich or a drink, and she tells me to throw it out. I find food in the garbage when I arrive for my shift.”

My Spouse’s concern and my own is that if the caregiver noticed this change of behavior, why in the hell didn’t she alert her agency who then, by law, would have to alert us?

While mulling these facts, the doorbell rang. It was her doctor and a nurse! Yay! Housecalls are unheard of, but we are grateful.

The doctor assessed her condition and concurred with what I found. With some coaxing as well as a threat of hospitalization “unless…”, we got M-I-L into her bed and the nurse inserted an I.V. designed to add nutrition and hydration.

The doctor and the nurse gave us instructions, and I assured them that I knew how to manage an I.V. Throughout the night, I got up and checked, and replaced the I.V. fluid bag twice. I assisted M.I.L. to the bathroom and she “did her business.”

By morning, her color had changed from ashen gray to her usual pale, and she was stronger and more mobile. She ate breakfast, mid-morning snack, late morning snack, lunch, and early afternoon snack. She had returned to be more of herself. Not great, but not dying of malnutrition or dehydration, either.

The nurse returned in the early afternoon and upon approval from the doctor by phone, removed the I.V., then left.

That morning, I had gone grocery shopping and prepared lots of light meals for both M.I.L. and The Spouse to leave in the fridge. Spouse had made a bunch of phone calls and has arranged for a new caregiving company to visit on Monday. He will make arrangements for caregivers to be with M-I-L now seven days a week.

While difficult, the Spouse had to remain to get the new caregivers on board and to deal with follow-up issues that I can’t describe here. I drove home alone. As my friend “S” would say, “I’m batchin’ it” this week.

No worries, though. Full-time work keeps me more than busy at the office, and I have not one, not two, but three meetings or activities each evening this week. Oh joy — this is indeed my “busy time!”

Life is short: intervene in person and get things back on track!