Trigger Events that Generate Awkward Transitions When Dad’s stroke left Mom on her own and vulnerable
Families in distress were commonplace for those of us at the agency, and yet I for one could never avoid feeling shaken. With the passage of time and a succession of crises I got more adroit at resolving some of the typical issues, and yet every heart-wrenching experience still left me deeply affected.
Dad’s stroke –someone’s Dad- left his wife on her own and vulnerable –someone’s loved Mom. He had been looking after her, and suddenly there was no one with her. She had early sundowner’s syndrome and could not be left unattended. Come the early evening hours, she would get agitated and would start pacing. She had also started wandering out on the street in the middle of the night and had occasionally vivid hallucinations.
Trigger events give no notice
Those are referred to as trigger events: strokes, broken hips, traumas that bring about the overnight onset of vascular dementia –all things sudden that leave someone else stranded and in need of immediate attention. It goes without saying that trigger events have the most devastating impact when families have no contingency plans in place.
When the old normal is torn to pieces
The daughter, Jennifer, a school teacher with two kids in college, had called and had started crying as soon as I took the call. I tried to calm her down on the phone but promptly saw that I would have to send a caregiver there right away and go talk to Jennifer in person.
I knew that above all, by the end of my visit I would have to persuade Jennifer to let go of the old normal –that she had to start accepting new circumstances as being her new normal. I had to gently support her in discovering some of the critical considerations of her new normal, particularly as it related to her mother –where she would live, who would look after her, and how they would pay for it.
Turning into a family of one
A typical crisis brought about by a sudden trigger event never stands still long enough for one to adapt. It unravels, displaying new, multi-layered additional givens. No sooner does Jennifer began to regain some of her bruised wits than she realized that:
- her mom needed immediate attention
- caring for Mom was going to require some help
- her dad needed attention, although for now he was safe in hospital
- her husband stood to lose his job if he started taking time off
- her parents were insolvent –nearly broke
- she would have to get a lawyer to draw up living wills and such
- she would need to get new signature cards to her parents’ banks
- her three brothers could not be counted upon for much
- she would have to take a break from work
- she might have to leave work altogether
- who was going to pay for her parents?
- the kids may have to forgo college
- the family savings would probably be spent in a year
Of course, most of that could have been foreseen, for after all, her parents were both in their late seventies. There could have been a comprehensive contingency plan in place, with legal documents already drawn, signatures in bank accounts shared, and long term care insurance for both parents secured.
Seek help from discharge planners at hospitals
Armed with a whole load of well vetted resources, discharge planners (usually social workers or RN case managers) know “everything”: they can:
- Keep you informed of your loved one’s condition and discharge status
- set up an ambulance in a jiffy
- get you the medical equipment you need at home (such as wheelchairs and Oxygen)
- get you Medicare-paid skilled nursing for at-home post-surgery rehabilitation
- get you a caregiver from a long term, “non-medical” home care agency
- set you up for a tour of several assisted living facilities
- and much more
They are trained to help solving the problems of others, particularly older or disabled persons. One may call the “social services department” (in some hospitals referred to as the “human resources department”) at a hospital where a parent is –or even where the parent was in the past- and get this kind of invaluable assistance.
Ushering in the new normal: early path to recovery
A logical sequence to getting Jennifer on a comeback path would have her:
- first doing whatever it takes to calm down
- then getting organized (with a pad, taking notes and telephone numbers)
- then viewing the issues in the singular, not the plural
- then taking all matters one day at a time
- and maintaining a vigil over her own health and wellbeing needs (it is only too easy for the feeling of being torn apart to get the better of one physically and mentally)
Regrettably, Jennifer’s predicament is lived by others thousands of times every day across the United States. Here is what Laura Castensen, Director of the Stanford Center on Longevity had to say:
“The norms that told us when to get an education, when to marry, when to retire evolved when we lived half as long as now; In those norms, we’re raising kids, reaching the peak of our careers, and taking care of aging parents, all at the same time.”