Amazing woman. She was picked, as part of the initial five member volunteers to do a case study on because she was believed to be an outlier in the positive direction. An 88 year old, to set the high end example of what is possible! She was the previous senior’s Minister, and one of the first geriatric case managers in the city. Fighting to stay self-reliant and engaged. Her scores showed her to be struggling and at high risk for failure. She definitely fits the category of some older adults who have gained great pleasure from caring for others during their lives, but are not comfortable receiving help themselves and resist asking for it. For these people, accepting assistance, particularly from someone outside their family, is difficult.
She is not safe for driving and still is. She has problems doing things around the house and has not modified how she is getting them done enough to match her declining physical skills. She is not taking her medications. She is increasingly confused. She has multiple medical issues going on and is not managing them. She fell and broke her hip a year and a half ago. She is unable to understand the bills that are still coming in. The skilled nursing facility switched her to co-pay for several weeks prior to discharging her and didn’t explain it well enough for her to understand her costs. She despised how she was treated by the healthcare system, who by the way, sent her home with all of the problems she had before plus the new ones and did nothing to address them. She has talked for years about selling her house and moving to an independent living apartment but has not been able to organize herself to do it. Her metrics say she will continue to have multiple bad things happen, each time reducing the chance of living where or how she wants to (she was admitted to the hospital three days after the visit by the church). She gave an insightful quote when asked if this was a perfect world and perfect church, what would we do different with our seniors.
She thought about it for a moment, then replied, “reaching out to the youth is very important and we should stay focused on that. But let’s not forget the seniors who were the backbone of the church. They feel abandoned… I feel abandoned.”
For people like her, it is especially important to have an understanding of being patient with seniors who are trying to come to grips with their declines. To help them to recognize their feelings and that it’s ok to feel sad and frustrated at times for not being able to do what they used to do, which I see written behind her comments and views about her driving and other things. But she is completely unable to recognize ore deal with the loss of these things at all. Why? I think, multiple reasons. The first being cognitive impairment. The second because no one has given her any other options. No help, no alternative solutions. How long has she had to carry her family (two of her children still live at her house)? She presents so well, do the children even understand how frail and failing she is? What is the church’s roll in all of this?
After seven months of known data, two hospitalization, numerous reports from friends/members of the church about increasing confusion and anxiety, the church decided to intervene. A meeting was held at the church with the seniors minister, the head of Ministries, and two of the adult children. Conversation was engaged in about their mother’s needs. It seemed initially the children (who live with her) were unaware of how much she was struggling. The scoring metrics helped to draw attention to specific areas and data that moved beyond opinion. This involvement has shown a significant step forward and commitment to helping in this very trying situation on behalf of the leadership of the church.
(1 months later)
Follow up. The children fell off of the things they were realizing during the meeting and have done nothing with the problems their mother is having to deal with. The follow up meeting with D and the pastor has not happened yet. She continues to drive, not take her medications, and is fighting to maintain her status quo despite her challenges.…She fell yesterday, split her head open and is in the hospital. Came home. Very sore. Nothing from the church for follow up.
(3 week later)
Three weeks from the last entry, D is in the hospital again. I just left the hospital, she fell again, this time trying to use her three in one (bedside commode) in the bathroom. It tipped over. She now has a fractured orbital, fractured shoulder (rotator cuff destroyed as well, severe pain) and fractured R hip. Can’t do surgery due to her low weight, low blood pressure, and enlarged heart. NOT a good situation for her. Still in Trauma ICU (6 days so far). Hospital undecided of how to proceed forward at this time. She has been visited by clergy and members daily in the hospital.
