My mom, who is 91 years old, fell a couple weeks ago. She was in the bathroom, heading for the toilet in the middle of the night when her feet flew out from under her. She normally takes her time and is careful, but that wasn’t the case this time. She landed hard on her rear and hit her head on the door. She was able to get back up, but had quite a bit of pain. Her doctor arranged for an in-home X-ray, which didn’t show any fractures.
I was out of town at the time she fell but came back five days later. She still was having considerable difficulty getting around. I tried to get her physician to order more tests, but only succeeded in leaving lots of messages and getting annoyed. When, a few days later, she had a great deal of difficulty taking care of herself in the morning, I decided it was time for her to go to the emergency room. A CT scan showed a compression fracture in her lower back, and she was admitted to the hospital. After three and a half days, she was transferred to a rehabilitation facility to regain some of what she had lost in strength, balance, and functionality. I visited her a number of times in the hospital and transported her to rehab. Here are a few observations, some about treatment but mostly about going through this sort of challenge at age 91:
- Emergency rooms are just as difficult to negotiate as ever. Mom was there about eight hours before being admitted. She hadn’t had her medications or anything to eat that day, but the ER staff didn’t address that issue at all.
- Despite not eating all day, mom had no appetite even when the pain was manageable. I wonder if that is because as we get older we can’t focus well on more than one thing at a time.
- It takes approximately forever for doctors called in for consultation (in her case, neurology and orthopedics) to render their opinions. ER staff seem content to wait however long that takes.
- Though mom is still sharp for her age, she had considerable difficulty telling everyone concerned a complete story of what happened. When I was there, I often had to add or explain details.
- Mom knew where she was most of the time, but she was prone to become disoriented. One morning she woke up knowing she was in the hospital but thinking she could get up and walk out of the room to find the closet containing the robe she wanted to put on. When I came to visit a few hours later, she told me she knew at the time that the closet was at home. Somehow, hospital and home were conjoined in whatever mental map she was consulting.
- Mom had a number of visitors in the hospital, and appreciated all of them. What impressed her the most, though, was that the head pastor of her church came to visit. She belongs to a large church and visitation is usually handled by one of the assistant pastors. When she saw me, she exclaimed, “You’ll never guess who came to see me!” She described Pastor Jonker’s visit with as much enthusiasm as might have been expected for a visit by royalty.
- She has had longstanding difficulties swallowing as a result of bulbar polio when she was young and a stroke nine years ago. All her food needs to be pureed, and even then she has trouble getting anything down. I didn’t think she would be able to eat hardly anything while hospitalized. She did much better than I expected. I underestimated her ability to adapt.
- She was given a swallowing test in the hospital and did rather poorly. The staff looked at her results from a couple years earlier, saw they were the same, and decided that, since she had been managing on her own just fine, she could be relied on to decide what she could and couldn’t eat while she was there. I was surprised by the common sense displayed in this matter.
- I had expected it would take a while for her to be in good enough shape to sit, stand, and walk without excessive discomfort, but she reached that point in just a few days.
- The nursing staff did a good job helping her. They were respectful, caring, and encouraging. They treated her the way any of us would hope our elderly mother (or grandmother) would be treated.
- When she was discharged from the hospital her nurse told me that, if he lives to 91, he hopes he is in as good a shape as she is. Nice to hear.
- The move from the hospital to rehab was harder for her than I expected. When brought to her room she had trouble settling in. The rehab room seemed similar to the hospital room, just with less medical equipment, but she found the two settings different enough that she had trouble coping.
- Part of her trouble coping was probably because she wasn’t sleeping well at night. Besides discomfort and the unfamiliar environment, some of her difficulty sleeping was that both at the hospital and in rehab she had a roommate who was making noise when she was trying to sleep. She complained to me about her hospital roommate, who was chatting on the phone with her sister until after midnight. She hadn’t said anything to the roommate about this, though.
- Mom’s coping seems more like an on-off switch than a rheostat. She deals with things up to a point, then is overwhelmed and doesn’t cope at all. That happened the morning we went to the ER and again her second day in rehab.
I had to leave town again her third day in rehab so I wasn’t able to visit her all week. Talking on the phone, it seems as if her adjustment has been up and down. I’m back in town and briefly stopped by this evening to say hello. It’s been interesting to watch her go through the initial stages of this journey, wondering how well I would do if I was 91 and faced the same challenges.