The Gray Line

Recovering from sepsis, Mom toes the gray line.

Recovering from sepsis, Mom toes the gray line.

Mom seemed to be settling nicely into her new home. I was glad she found a boyfriend (and as per her recent pattern, soon dumped him for another). Then her falls started.

The first one yielded a bruised hip. X-rays at the local hospital revealed no fracture. A week later, Mom had scuffle with a caregiver and fell. She complained of soreness, so she was sent to the hospital again. This time, her blood work showed a very high white count. She had moved from the familiar realm of urinary tract infections to a new, far more dangerous one: sepsis.

Mom had an infection in her blood stream. This apparently evolved from an unchecked UTI. She needed IV antibiotics. Unfortunately, in her condition, she tends to pull out her IVs, leaving nasty tears in her skin. She had to be restrained.

The infection was identified and could be treated with oral antibiotics, so she could be freed from IVs and restraints.

During this hospitalization, I thought Mom was going to die. She looked terrible. She was mostly unconscious. Her first day, she ate with assistance, with her eyes closed the whole time.

The next day, after a course of IV antibiotics, I found her sitting up in a recliner, alert and watching TV. She chatted with me a bit. She was off her psych meds and was a little clearer than usual. Next visit, she was passed out again.

After about a week, the infection was under control, and Mom’s doctor felt she could be transferred to a rehabilitation facility for reconditioning. I worked with the social workers at the hospital to find a suitable facility.

Mom was transferred, but she needed clothes. All she had was the clothes on her back from when she had been admitted to the hospital, where supplied gowns were all she needed. In rehab, she would need clothing.

The facility called my brother first (I suspect his mother in law had been in the same facility at some point and had his number on file) and told him about Mom’s need. He told them to reach out to me for decisions, but he texted me to ask if I wanted him to handle the clothing request. I gratefully accepted the offer. He bought her new blouses, sweatpants, socks and a bra and sent them by UPS overnight. She would have them Thursday morning.

Meanwhile, that Wednesday, the facility called me about paperwork, and I went down, bringing sneakers for Mom. I filled out the paperwork and went upstairs to see her.

She was sitting in a wheelchair in the day room. She was on oxygen. She didn’t seem to know me. She was pretty out of it. I didn’t stay long.

I returned that Saturday with my husband. Once again, she was in the day room wearing the same clothes. She was still pretty out of it, but she did interact with us. I asked about the clothing my brother had sent. No one knew anything.

I spent a good deal of time trying to track down my mother’s lost items, but on a weekend, it’s an uphill battle. I went to Mom’s home and picked up some things from her room and ran them back to the rehab place. I inventoried the items with the staff and went back to check on Mom, who was still in the day room. Did she remember that we had just been there? Do you remember seeing Bobby?

“Yeah, he was sitting right next to me.”

Okay, she registered something.

On Monday, I worked the phones until I got a hold of someone who could help and I got confirmation that her clothes were found and she would be wearing them.

Tuesday, I returned to find Mom slumped in her wheelchair, completely unresponsive. She would not open her eyes. She wouldn’t react. I went to the nurses.

Mom’s blood work was bad. They gave me all the specifics and told me what they intended to do. I called Mom’s doctor. I was alarmed. Had she been released from the hospital too soon?

They told me it was my decision. Mom is DNR: Do Not Resuscitate. Do Not Intubate. Do Not Hospitalize. I could change my mind any time, but sending her to the hospital would mean aggressive, life-extending treatment.

Wow. This was a first. This was not black or white. I hit the gray line. I was prepared to let Mom die if it was clearly her time. But here I was, unsure. Was she getting appropriate treatment? Or was she being mistreated in some significant way that was accelerating her decline? I was working with a new team and I sincerely didn’t know what to do.

I called her doctor’s office again. I was told he would call me back. But he didn’t. So I called his office in the morning and got his recorded message, which gave his cell number. I sent him a text asking him to please call me. And he did.

The doctor told me Mom had been put back on her psych meds and they were probably the cause of her extreme fatigue. He would take her off them.

When I visited later that day, a physical therapist was adjusting Mom’s chair and chatting with her. Mom was alert. She didn’t know me until I told her who I was and she smiled broadly and kissed me.

The therapist told me she was able to stand up and they had played balloon volley ball. They demonstrated. She remarked that Mom’s range of motion in her arms was good. She also remarked that Mom had a good sense of humor.

Clearly, Mom was a whole lot better.

Today, I met with Mom’s team to discuss her plan of care and to review what the goals were. We’re trying to get her mobile enough to go back to the home, where she can walk with a walker, get around and be a little more steady on her feet. I wasn’t expecting miracles, just a little better quality of life.

Mom’s speech therapist told me she enjoyed Mom’s sense of humor. Showing Mom a pen, she had asked if Mom knew what the object was.

“A fountain pen.”

Did she know what it was used for?

Mom made a remark that the therapist did not wish to repeat, but she blushingly indicated that Mom knew exactly what she was saying and let the therapist know that if she didn’t know what to do with the pen, Mom was willing to show her where to put it.

So the line becomes a lighter gray for now, as we work to restore Mom to some kind of condition that allows her to resume the life she had before sepsis, with a little of the old, funny Mom thrown in for good measure.

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About traceysl

Digital Artist, creative technologist, problem-solving lover of life. Having cared for my mother, who died on April 14, 2015 after a long fight with dementia, I have refocused professionally to helping others through my experience. I have started a company called Grand Family Planning to provide unique Family Support Services. In this way, I share my knowledge and give meaning to the tragic turn of my parents' journey through the misery of dementia.
This entry was posted in aging, assisted living, caregiving, delusions, dementia, Family, life changes, long term care, physical therapy, rehabilitation services. Bookmark the permalink.

5 Responses to The Gray Line

  1. A sense of humor is good for the patient and good for the caregivers. I think my dad’s good sense of humor is one reason the caregivers really like him. It helps them to remember that this elderly sometimes really needy resident is a real person too!

  2. dementedgirl says:

    Oh gosh, that sounds very, very frightening. We had a similar scare when MIL’s duodenal ulcer (that we didn’t know about) burst, spilling pints of stomach acid into her abdomen.

    Glad to hear she is slowly on the mend, though of course it’s often the aftermath of these things and just trying to restore what previously went for “normality” that are just as challenging from a caregiver perspective…

    DG x

  3. There is something about that picture that brought tears to my eyes. Maybe it’s because she looks a lot like my grandma…

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