Thursday, January 27, 2011

Dutiful Daughter, of Sorts

Friends, the Matron has found herself suddenly thrust into the kind of situation for which she was unprepared. Not that this is necessarily a negative; she now has a greater grasp on not only what's ahead for her aging family members but perhaps for herself and the beloved.

Her dear, dear next door neighbors are in their mid-eighties. They never had children (wanted to but it just didn't work out) but have a lovely, large, and devoted family of nephews, nieces, sisters, cousins, and all that. Now, the sisters and brothers are also in their mid-eighties so the Matron's neighbors really rely on that upcoming generation of nieces and nephews for help.

The trouble? They all live at least an hour away.

A few days ago, it was determined that the husband of this long-time husband/wife team is dying of heart failure. Suddenly, his frail 84 year old wife was thrust into a position of command and decision making for which she was utterly unprepared. She also needs daily help herself for simple things that she's now unable to address, like feeding cats and putting in eye drops.

Please don't commend the Matron for what she's about to say next - really. People should take care of each other, period. That's basic goodness in the world and not laudable. Yours truly is no saint (just ask any of her children or her husband).

But the Matron decided to get involved; she's lived next to this lovely couple for 8 years and considers them family. The reception? Instant relief and welcome.

So she suddenly finds herself with the legal authority to make decisions on behalf of her neighbors --and with the additional freight of the wife asking the Matron to make those decisions on her behalf because she's exhausted and confused. Confused by the insurance, Medicare, VA requirements, nursing home regulations, hospice stipulations, the two social workers, three doctors and even driving on the freeway. The latter frightens the neighbor the most.

The Matron took some official time off from work today to navigate this terrain; she spent more time on the phone with the social worker than she did with her husband. Tonight, she'll go over at 9 pm, administer eye-drops, tend to cats, and have a conversation.

But the sobering thing? The real point of this post? If you're old and ill --or dying -- without someone to navigate the world of medicine, insurance, and government regulation, you're doomed. Make those decisions well ahead of time, friends. Have a team at your ready. And why in the world would a medical institution send home an 84 year old man who can't walk, pee, or breathe to be in the care of his 84 year old wife while he dies -- when they both wish he could be in the hospital or hospice? Every fiber in the Matron's body is now aligned toward preventing this death of two people instead of one. She knew this all in theory but living it is something else.

The other sobering thing? Well, the Matron isn't much one for glorifying eras gone by. Sure, before there was birth control, women had babies well into their forties. Lovely. Takes away the freight of having a 'later in life' baby today because childbirth was from 17 to 45 in years gone by. That's all good but after those women had babies, they died. So there's nothing romantic about the past.

Perhaps with one exception. People helped one another. Think Little House on the Prairie books (God-Buddha-Oprah-Allah-Universe, she hopes those books were accurate about the community spirit, Nellie Olson aside) Every single person on the Matron's block--many of whom have known this couple for 20 years -- should be highly attuned to and involved with helping them right now. This shouldn't be a place to praise someone who is, but a moment to contemplate what each of us can do better, next time.


smalltownme said...

Our family had a very similar situation. Beloved aunt and uncle, childless. Aged siblings. One niece 300 miles away (me). Two nephews who knows where (they didn't care). Kind, wonderful, saintly woman from their attorney's office befriended them and took care of everything.

Lena . . . said...

Bless you, Matron. You're a wonderful, caring person.

michiganme said...

That's a lot of good karma you're creating, bless you. (Perhaps they'll be able to use hospice visiting nurses?)

*m* said...

Another real reason to glorify bygone days: family members used to live nearer and could help each other. (Though I guess Ma and Pa Ingalls did leave their folks behind when they left the little house in the big woods...) My parents are starting to have health issues and they are 700 miles away. I foresee much angst and travel and many issues in the near future.

Your neighbors are lucky to have you.

unmitigated me said...

Yes, hospice nursing. I know in Michigan it's a 24/7 service available to the dying, mostly because actual hospice space is so limited. Theoretically, the social worker(s) should be able to help with that. Even if you don't want me to say it, it's good of you to help. Has the POA decision been revealed to the family, though? Hopefully they won't cause trouble for you, and just be grateful you are there to help!

Karen (formerly kcinnova) said...

You are doing exactly what you were created to do: loving your neighbors.

Navhelowife said...

I am grateful, over and over again, that my mother has been very practical about her ALS and the upcoming decisions that will need to be made. And that my siblings live close enough to help...and that the legal paperwork is already in place to help with all the permissions, etc.
Hospice for my dad was wonderful - but it was a self contained facility, because home hospice could not keep him comfortable.
I will pray for your neighbors - and you- for peace, and comfort, and strength.

carol said...

If they do use the services of in home hospice get ready to meet some angels. The nurses and other personal care people who do hospice work are the kind of people we all aspire to be. Your neighbors are lucky to have you and you are lucky to have them. You are about to learn some valuable things.

Jen on the Edge said...

Such a sad situation. I'm glad they have you for support and assistance.

We went through this two years ago when an elderly neighbor went through his last illness and then died. Virtually every neighbor helped in some way -- making food, running errands, raking leaves, or just sitting at the hospital holding his hand.

My late mother-in-law had all of her affairs in order the last few years of her life. My husband's sister had medical, legal, and financial responsibility, which made things so much easier when the end came and details needed to be handled.

My father is terminally ill and one thing he has done has been to get his affairs in order, including making arrangements for the funeral. It was incredibly difficult for him emotional to plan his own funeral, but we all appreciate that level of consideration.

Anonymous said...

That's so so so tough for older people. Our surrogate grandparents have kids in Chicago area. Too much distance to be truly helpful, yet should A &B move to be more convenient to help? Getting old is full of as many issues as growing up, isn't it?
I feel thankful I live in a small town and in a neighborhood where help is around the corner.

Anonymous said...

Why did the hospital not make a referral to the public health agency? That is the kind of work for which public health nurses exist. If you lived in Mississippi I could understand the oversight, but in MN? Damn. You could try calling the public health department and get to the p.h. nurses' department. (My husband was a public health nurse in Mpls for a number of years.)

Anonymous said...

bless you for stepping up, I am about to step into guardianship for a cousin who has many complicated health issues and requires a legal guardian, her mother is aging and has irritated the courts to the point that they have taken away her rights to decide for adult child. Thanks for saying this just right now as I go review the papers in the morning.

Murr Brewster said...

We had intended to move my ailing sister in with us but her time ran out before she was willing to give up independence. I still feel rotten because I knew I should have made it happen. We were both leery of crowding each other, afraid it would impinge on our love. When people used to live like puppies in a basket, were they comfortable with it, or was it just that there was no choice? I'm nearly old enough now to see my own deficits looming. Thanks for what you're doing. I hope to help someone down the line.