I haven’t written for a while. I’ve been thinking about things and involving myself (rather thanklessly) in the care of my elderly Mother-in-Law. She’s now in respite, less than a ten-minute walk from the front door of our house. It’s very convenient for her oldest son, my husband, and for me because now he isn’t half living at her house any longer. Nor is her younger son, who lived there more like three-quarters of the time. It was a situation that couldn’t be maintained especially after she developed cellulitis in her legs.
You’ve heard the story about the frog in the frying pan? It gets hotter and hotter and he just sits there thinking ‘It’s a bit warm, isn’t it? But, I’m alright, don’t bother about me!’
But you are watching that pan begin to sizzle his behind. You are screaming for him to jump out because you can see he’s getting burned but before you know it, and certainly long before he knows it, he’s Frog Friccasee, stewing in his own juices. That describes, in a frying pan, how it’s felt for the past few months with my dear MIL.
We would never have known about her legs if she hadn’t mentioned that she was ‘just a bit concerned’ to my husband’s cousin who’d dropped in to say hello. Mary, I’ll call her, who has some medical training was about to go out the door. ‘Can I look at them, please?’ she asked.
My MIL agreed and Mary alarmed that the swelling and redness had trebled the size of her calves and reached her knees, declared she would not go anywhere until MIL had seen a doctor. The doctor nonchalantly prescribed some antibiotics and sent her home.
She’s 92 and suddenly she became far less mobile than she had been. When we talked to her that night I told my husband he had to go the 150 miles to see her and send me pictures. I’d have gone too but I had reason to stay home. The pictures he sent me and the following ones sent by his brother sent my alarm bells clanging.
In my career, I’ve seen many elderly people with wounds that won’t heal, unexplained rashes, and infections of all sorts and kinds. I had never seen a more severe case of cellulitis than was evident in the photos of my MIL’s legs. Cellulitis is an infection, generally staphylococcus, in the deeper layers of the skin. It shows up as a red, raised rash, it is often accompanied by fever and can cause substantial swelling especially if it is in the extremities. Don’t look at the following picture if you are squeamish:
Complications of cellulitis can be very serious. These can include extensive tissue damage and tissue death (gangrene). The infection can also spread to the blood, bones, lymph system, heart, or nervous system. These infections can lead to amputation, shock, or even death. John Hopkins, Medical Center information.
Sepsis and all the worst scenarios flooded my brain. On my husband’s phone, I figuratively screamed on several separate occasions, seemingly into the void, ‘She needs to go to hospital and be on a drip of antibiotics!’
The brothers were both there, they were, therefore, the protectors against the invisible, and nothing bad was going to happen to their Mum. Since I wasn’t there, I didn’t have any authority. There is nothing worse than seeing the pattern, knowing the likely outcome, and being unable to find anyone who will listen and has the power to change it.
This first event, and thank the stars for Mary, started weeks of back and forth with the various doctors who saw her, round after round of antibiotics at home, and finally, after nothing changed and things got worse and she began to really slip downhill, a ten-day stay in hospital.
When the swelling finally went down and the redness began to diminish it was agreed she’d need a period of respite (mostly for my husband and brother-in-law) and rehabilitation after discharge from hospital and before going home. That’s when suddenly I became ‘the one with the expertise’ but also the one that the most ire could land upon. I found the care home months earlier because I do that sort of thing; think of possibilities and prepare contingencies. It isn’t difficult to consider future needs when your MIL is 92.
She did not want to go. Period. ‘I’m fine now! I can take care of myself!’
But she couldn’t (she hadn’t) and even she saw it before hospital discharge. But that realization did not change her resentment at having to accept the help she thought she ought not to have. She made that resentment known very clearly by refusing to participate in any rehabilitative activities at the home.
My husband went to see her every day. I often accompanied him or went on my own. She’s one of my favorite people and I didn’t want her to feel neglected or forgotten. But we were frustrated with her. She dug her heels in and kept saying ‘It will be better when I get home.’
Finally, my husband had a pointed and painfully truthful talk with her. ‘Every day you refuse to help yourself get stronger is a day you will have to continue here in this care home.’
He emphasized that she needed to be able to show us that she could be responsible for her own health and safety, with certain aids and help in place. For instance, we insisted that she have carers in to see her every day. We insisted that she no longer hang out her own laundry. We demanded that she not toddle out to the garage on her own to retrieve food from the freezer. We asked that she accept help in and out of the shower. ALL of these ‘danger points’ we’d found out after the fact, had caused a fall. She just didn’t want to ‘worry us’. My nightmare was that she’d fall and break a hip and not have anyone there to call for emergency help and that she wouldn’t be wearing her necklace that alerted services and she’d die before anyone found her. It was certainly possible. I couldn’t stand it and I think my brother-in-law would collapse and my husband wouldn’t ever get over it if something like that ever happened.
She is still in the care home as I write this but the plan is she will go home in a bit more than a week. I’ve written a care plan that details what will support her at her home with some of her input. If she doesn’t feel buy-in, she will not adhere to the plan. Hopefully, this care plan and the people we’ve already hired to implement it once she is back will keep her healthy and well for a long time yet. It’s still too much to ask that she is happy to have the ‘invaders following her around’, as she puts it.
My MIL can no longer stand long enough to cook herself a meal so she’ll have yogurt and fruit for breakfast and perhaps a muffin half or a piece of toast. She’ll have a ‘ready-meal’ thawed and cooked in the microwave for a mid-day meal and perhaps a sandwich for dinner, all this prepared ahead of time by her carers. She’ll be able to make herself a cup of tea and slide it to the table but she is not able to carry it to the sofa safely. She is English so tea will be the majority of the liquid she drinks. Dehydration is a worry for people her age and so the carers are instructed to ensure she has a full bottle of water to hand and a glass for drinking. Walking to and fro in her living area will be the majority of her exercise. She has a stair-lift to go upstairs to the toilet and bed. She has a Rollator to walk with outside, a Zimmer Frame, or holding on to furniture serves inside. She will no longer do her own laundry or hang clothes on the line outside. She is able to take a taxi to WI (Women’s Institute, once-a-month meeting and/or lunch out) or one of the other ladies will transport her. We don’t want her to go to the grocery store on her own anymore but if we aren’t there, there is nothing to stop her calling a taxi and going anyway. Being 150+ miles away is decidedly a problem but visits back and forth will continue at least once a month for each brother. It’s a good thing they can work remotely.
I have to admit that I’m terrified but this is life isn’t it? We have to let people do what they think they can do until it becomes clear to them that they cannot do what they did before anymore. I’m looking at my own future when I look at my dear, little MIL. I wouldn’t like the ‘invaders’ either. But I hope I am a bit more cooperative. When she is discharged we’ll transport her and either my husband or my brother-in-law will stay with her for a least a few days until everything gets to be routine. I’d be hard-pressed to prevent either of them from doing this loving duty. They want to be satisfied it is the right thing to leave her ‘on her own’.
At 92, the truth is none of this will last all that much longer. No matter what we do, we cannot prevent the inevitable. We are lucky our feisty Mum, though thoroughly deaf and losing a bit of short-term memory, is still as cognitively intact as she is. Though, now that I think of it, if she weren’t, well there would be no arguments or foot-stamping about respecting independence and we could wrap her in cotton wool and keep her safe. But what kind of existence is that? No, I’d rather the worry and the arguments and the effort to do the best we can to keep her safe and healthy for as long as we can. There will be another chapter to this story but I hope not for a long time yet.