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Once More Into the Fray

This afternoon I am going to attend my mother’s “Care Conference” at the sub-acute rehabilitation facility where she has lived since her release from the hospital. She called me last night and asked if I would be there; she believes that I am the only member of the immediate family who understands how desperately she needs to go home. Despite glowing reviews by both her GP and her nephrologist two days ago, and hearing that both treating physicians believe she is ready to go home, she has been informed that the decision is to be made not by one of her “real” doctors, but by the house doctor at the rehab facility. Yesterday she told him that she needed to go home, and that she was perfectly capable of leaving against medical advice if that was what she had to do. He countered with the fact that a history of leaving prescribed inpatient treatment AMA might make it very difficult for her to obtain insurance coverage in the future. They compromised on today’s conference, with her future to be determined based on the collective judgment of the facility’s nurses, physical therapists and other professionals.

It is an old habit of mine to prepare exhaustively for any encounter in which there might, possibly, be an argument. I think it explains my success as an attorney, a job I really, really hated, but in which I was very successful. I hate arguing, conflict, or any sign of dissent to a pathological degree, and I am an extraordinarily anxious type. The only way I have ever been able to take the crippling edge off the panic associated with “fighting” is to envision the impending theater of battle, write out every point that advances my cause, and then go back through, imagining all possible responses and drafting responses to those responses. It’s a lot of responses, but in the end I am confident that, if not bullet proof, I am at least wearing a layer of Kevlar beneath my fetching outfit. I have also been known to watch the video of Kenneth Branagh giving the “St. Crispin’s Day” speech from “Henry V.”

Despite being the Buddhist Pollyanna of the Midwest, I have a dark feeling about the reasons for wanting to keep my mother as an inpatient. I happen to know that the facility has been struggling financially, it has new competition in town, and it probably needs all the bodies it can get. This is not, however, my best argument. They are unlikely to agree with me that they are greedy bastards, and that their main interest is not the health and safety of the patient.

So I will say the other things that I think, if given an opportunity. I will say that there is more to getting well than daily PT and OT; it is a holistic thing that involves peace, comfort, and proximity to one’s own Corgi, garden and husband. I cannot imagine healing in any meaningful way while crammed into a small room with a roommate who listens to Fox News at ear-splitting volumes from morning to night, or while having absolutely no privacy, eating appallingly bad food, and being addressed by 20-year-old aides as if I had recently lost my frontal lobe in a tragic accident.  I will explain that her doctor will immediately order outpatient PT at a local health club, that my father is in the process of having a stair-lift installed, and that there will be walkers on both floors of the house.

The only real benefit I see from her current life at “The Home” is daily physical therapy, and we are clearly able to continue that on the outside. Aides give her medication, but they are forgetful and scattered; she often has to remind them that she needs her pills. My father, who has been sorting and administering her meds for years is as reliable as the sun. She receives occupational therapy, which seems mainly to involve hunting for imbedded objects in balls of Play dough, leaving scrims of the stuff beneath her fingernails. There is nothing wrong with her fine motor skills, and the insistence that she demonstrate her ability to make a grilled cheese sandwich in the OT kitchen without setting herself on fire is demeaning. She hasn’t cooked for years, she does not live alone, and it seems equally reasonable for them to insist that she be made to reassemble rocket engines, or complete circuits on a board. In short, there is nothing going on in rehab that is necessary and available only within their dank, urine and canned corn flavored halls.

Finally, and I hope I do not have to get to this argument, the place is badly run. It isn’t the best facility in this town; the best facility had no available beds. She has been in that better place in the past, though, and the differences are startling. The other night when I took her an edible meal, there was a woman lying in her bed for more than thirty minutes calling for a nurse. Another woman asked her aide if she could “get into bed, please.” The girl replied in a heavily sarcastic tone that the patient had “just gotten out of bed, please.”They are short-staffed. The dining room is run by a kindly, harried woman who does her best, but admits that she has a nearly impossible job trying to sort out and provide meals to each patient that fit their dietary orders – low sodium, low carb, pureed, liquid, low potassium, or reduced calorie. The food is unappetizing, worse, in my opinion, than standard hospital food. If it was not the case that the facility is literally 2 minutes from my parents’ house, and 5 minutes from my house or my brother’s, or if my mother was not fully in possession of her mental faculties and a telephone, I would worry constantly.

I am ready for this. I am moved by the fact that my assertive, self-possessed mother has selected me to be her champion. She knows me better than anyone, and she knows that I would be largely incapable of fighting this battle if I were the patient. I would be submissive, assume that “they” knew best, and not want to create a stir. She also knows that I become an impressive instrument of passionate fire wrapped in cool steel when I advocate for someone else, particularly if I believe that an injustice is being done based on some imbalance of power. She also knows that I understand her frustration, her righteous anger, and her sense that everything in her life is upside down and she lacks the strength to right it. I have that strength, I have my handwritten list of points and counterpoints, and I’m ready.

 

 

 

 

 

 

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About imagineannie

I feel like I'm fifteen - does that count? I'm lots of things, I get paid to be the Managing Editor for a local news publication, and I love my job. I am also inordinately fond of reading, animals (I have four), elephants, owls, hedgehogs writing, tramping in the woods, cooking India, Ireland, England, avocado toast, Sherlock Holmes, Harry Potter, Little Women, Fun Home, Lumber Janes, Fangirl, magic, Neil Gaiman, Jane Austen, YA books, not YA books, classical music, Salinger (OMG SALINGER), Brahms, key lime pie, indie music, podcasts, sleeping in, road trips, marmalade, museums, bookstores, the Oxford comma, BBC, The Miss Fisher Mysteries, birdwatching, seashells, kombucha, and stickers. Not a huge fan of chewing gum, jazz, trucker hats or dystopian and/or post-apolcalyptic fiction (but I'll try anything).

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