A Writer's Notebook, Day Nine-Hundred-And-Seventy-One

Melissa and I had a call with the hospice staff that is caring for her mother in Ohio and had to discuss end of life care, including making decisions about her code status and whether to issue a DNR.  Unfortunately, Ann, Melissa's mother, has become bed ridden and needs full time care, but she is not happy in the nursing home.  She has dementia and does not really understand that she needs care.  At this point, she has not been able to get into a wheelchair in some time, and even when they attempt to adjust her position in bed, it leads to intense pain.  At the same time, Ann is convinced she can get up and in her wheelchair on her own, and that they are keeping her from going outside for no reason.  The thing she most wants is to go outside.  We had discussed getting her some sort of mobile device other than a wheelchair which might accommodate her in a prone position, but it is not really feasible at present because of the pain that transferring her out of bed would produce.  The truth is, there is not a good solution, and we are doing our best, but it often does not feel that way.  Other members of Melissa's family have been very opinionated, and often in unkind ways, and I know Melissa is carrying a lot emotionally as a result.  In the end, we have little control over such things, especially with the current eldercare system in this country.  I do not know what could be done to improve things for Ann right now, but it would be good to feel there were some options and possibilities that might be realistic to consider other than institutionalizing her when she clearly wants to be in her own home.

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