Saturday, May 8, 2010

A different kind of Mother's Day -- but happy nonetheless

Nothing much to say today ... Just want to extend a Happy Mother's Day to all you mothers out there (and you know who you are!).

On a more serious note, tomorrow will be a different kind of Mother's Day for us. For the first time in my almost-57 years, we won't be celebrating it at the family manse on Bonavesta Street in Lynn.

Instead, we'll be going to a nursing home, where my mother is now a permanent resident. And while everything that's intelligent in me knows it's better this way ... that mom had just too many physical issues to allow her to stay in her home, this is still a tough pill for any of us to swallow.

My sister and I -- and our respective families -- did everything we could to keep her in that house, especially after my father died. We hired home health aides, visiting nurses, physical therapists ... and, between the two of us, made twice-daily visits to prepare meals and just look after her welfare.

For a little over two years, that worked. We had a system, and, with rare exceptions, the system sufficed. I came in the mornings, got her breakfast (bought it at Dunkin's usually) and stayed for a visit. Jayne came in the evenings, got her dinner, and stuck around for another visit.

In between, we had Tutu, the home health aide who gave her her shower and got her dressed; Linda, the housekeeper; and Lisa, the visiting nurse. We all combined to make my mother's life as comfortable as we could, considering she could no longer walk, and do much for herself.

That ended the Saturday before Thanksgiving. Mom was getting more and more unsteady on her feet, even in transferring herself from her easy chair to her motorized wheelchair. She began falling more often -- and stumbling even more often than that. Finally, my sister, the nurse, decided it was time to admit her to the hospital.

From there, two days before Thanksgiving, she went to the Life Care Center of the North Shore for rehab. And shortly after Christmas, the nursing home recommended that she become a permanent resident.

I don't want to get into the myriad of paperwork that's involved when you apply for Medicaid (which is the only way you can pay for chronic care in a nursing facility unless you're obscenely rich). I don't want to get into the spend-down of assets you need to do to qualify for such insurance. It is heartbreaking to see everything you've worked for (or in my mother's case, everything my father worked for to make sure she'd have if she needed it) be treated as if it's something evil.

My parents, like probably most Americans, were what I call 'tweeners ... not rich enough to be able to afford the best our health care system has to offer on their own; not poor enough to qualify for help. To do that, we had to spend down their assets, put their house in a trust (which, thankfully, we did in plenty of time to qualify for the exemption) and hire a lawyer (a very good one, by the way) to shepherd us through the process.

And even that was difficult. There's an awful lot of misinformation on this subject, spread around by people who should know better, and one of the most important lessons I learned was to keep my eye on the ball and not lose focus. Thankfully, our lawyer came through for us and got us approved for Medicaid with minimal fuss.

There's still the issue of a lien being put on the house, but that's a formality. All that means is that should we sell the house while my mother is alive, Medicaid would be entitled to a portion of the proceeds. The lien is lifted after she dies.

And I hope that's not anytime soon!

Legal issues aside, though (and make no mistake, it was a tremendous relief to know my mother has been approved), the emotional part of this has been a huge drain -- especially for one who, as power of attorney. Doing all the paper work, and obtaining all the necessary documents to complete the application, is time-consuming. There were days (at a time) when I couldn't make it to Life Care to visit my mother because, between work and running around, I just didn't have time.

There were frustrations, such as dealing with banks and insurance companies who don't understand what "power of attorney" means, and require additional proof that I'ml the designated handler of my parents' affairs. There were lots of days, even when visiting my mother, when I'd spend the entire time I was there on my cell phone, wading through layers and layers of automated greetings for the privilege of speaking to a real, live person -- and all for the purposes of having my mother tell someone that, yes, I am designated to handle her affairs.

And that, of course, came after I'd already sent the bank, or insurance company, a notarized document stating that I had durable power of attorney over her affairs.

But we did it. And now, on the eve of Mother's Day, the emotional aspect of spending it in a nursing home, and not at their house, in a nice, relaxed environment, is hitting me.

I complain about how hard this has been for me ... to anyone who will listen. Now that it's over, I can start thinking about how hard this has been on my mother.

This has been a huge adjustment for all of us ... but none more than her. For 55 years, all she knew was that house, life with my father, raising my sister and me, and a very long and fruitful number of golden years together. Over 20, to be exact. My dad retired in 1984 and died in 2007.

That ended abruptly the Saturday before Thanksgiving when an ambulance took her to Union Hospital. I think both Jayne and I had an inkling, that night, that she'd never come home. But I don't think she did. I think my mother thought that this would end up like all the other hospitalizations ended up: with her in a short rehab at the nursing home, and then being sent home when she was strong enough.

But this time, that didn't happen. This time, the issues that have plagued her for most of her golden years were just too insurmountable. The situation was untenable. And the only thing I can say is that I'm glad, now that it's close to being resolved, that we went through a process where someone else made the recommendation. Because, honestly, I'm not sure it was something that either my sister or I were in any way, shape, or form, eager to make on our own.

Mom has adjusted about as well as anyone in that situation could (better than I ever thought she would). She's sad ... and I know she misses her life. But except for brief bouts on the pity pot (which all of us have now and then) she's held up remarkably well. And for that, I'm grateful.

I think it's inevitable that when children make these decisions about their parents, there's a little guilt involved. It goes with the terrain. You always think that you can do it all ... that you can handle the tremendous responsibility of being a caregiver for an elderly parent ... and that, dammit all, it's your obligation to do this, regardless of where it leads you.

But sometimes, that just isn't to be. Sometimes the obstacles are just too steep to overcome.

So, yes, I go into tomorrow with a heavy, heavy heart. But at the same times -- and I hope Jayne feels this way too -- I can also look at myself in the mirror in the morning (to the extent that I even want to, that is) and know that we both did all we could, for as long as we could, to keep my mother in that house.

Happy Mother's Day, Evelyn.

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