A fall in February meant an ambulance ride to the hospital for my Mom with fear of a fractured hip. Thankfully, x-rays showed there was no fracture, but extreme pain warranted a hospital stay. After many tests, pokes and prods, a pacemaker was recommended. Low pulse rates often cause dizziness and even passing out. Was this the cause of my Mom’s fall? After discussion with my two brothers and Mom, we agreed to the pacemaker. Rehab at a local Nursing Home was recommended after surgery to manage pain and gain strength. Made sense. The day after being admitted into rehab, I was notified that Mom was in A-fib, which means her heart rates were irregular and fast. The next day, my brother Dean and I took Mom back to the hospital for a procedure call a TEE Cardioversion. Basically, the procedure shocks her heart back into rhythm. The next day, March 6th was Mom’s 95th birthday.
My two brothers from out of state came for Mom’s big birthday. This was a special day she looked forward to and wanted family with her to celebrate, along with a couple glasses of wine. After all, how often do you make it to 95, she would tell all who listened. The plan was to take Mom to the restaurant on the campus, with birthday cake, presents and yes – a glass of wine or two. When I arrived at the Rebab unit, Mom was in a wheelchair with her back to me. I moved in front of her and said, “Happy birthday Mom!” She looked up at me and mumbled “Huh?” I repeated myself and could tell something was not right. The Doctor on site evaluated Mom. It appeared that right before I arrived, Mom had a stroke. The Doctor suggested we continue as planned; go to lunch and see how Mom did. She started out OK and then I had to feed her. We thought we were witnessing another stroke. My brothers took Mom back to her room and talked to the Doctor. We had limited time to get Mom to the hospital for help if we so choose.
The back room at the restaurant where we were celebrating Mom’s birthday, afforded the family time to talk privately. What should we do? After conversation, I found myself asking my family, “what are our goals”? “What would Mom want?” I teach about this all the time, but never thought I’d be leading my family in this very important discussion. Mom’s voice was the loudest voice in the room, even though she was not physically with us. We decided – no more hospitals, no more procedures, no more pokes, no more prods. We only wanted Mom comfortable. She’s had a good life, she knows where she’s headed and wouldn’t want extraordinary measures to keep her alive just to add days. She’d want to allow for a natural death.
Then COVID-19 hit. Until a week ago, I hadn’t seen my Mom in person since her birthday due to COVID restrictions. Mom was moved to a Nursing Home because her home at the Assisted Living facility could no longer meet her needs. The contents of her 1-bedroom apartment is still fully furnished because we, as a family, can not go in her apartment to move her belongings out. Mom does not understand why we can’t visit, why she only sees family on an iPad via Zoom, why we had to meet for the first time outside the Nursing Home facility with face masks and 6 feet apart. She wanted to hold my hand. She wanted a hug from my husband and me.
Nothing about getting older, having a stroke, memory loss, and this COVID-19 thing is easy. Having tough conversations with family is hard; but once again, I am reminded why I do the work I do, because IT MATTERS. Advance Care Planning should happen during all continuums of life. Our lives are on a trajectory that starts with a beginning and stops with an ending.
July 16 marks our “new” National Health Care Decisions day due to COVID-19. I encourage all of you to plan. My Mom has both a Health Care Directive and a POLST (Providers Orders for Life Sustaining Treatment). She has a plan. As a family, we know what that plan is – we have a roadmap. We also know what “living well” looks like to Mom. It’s still hard. It’s still tough. But what would it have looked like without Mom planning in advance, having that important conversation and the family not being in support of one another? Thankfully, we’ll never know that option. What a blessing we can give Mom in supporting her and honoring her health care wishes. What a gift of love she has given our family by planning and having the conversation before she no longer could.
I beg of you – treasure your loved ones today – none of us know what tomorrow will bring.