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A very good friend of mine, Carol, is in the beginning stages of taking care of her mother with dementia.  It began suddenly Christmas Eve when her mother took a fall.  The result was an ambulance ride to the ER and then her mother spending over a week in the hospital.

Like me, like all of us, Carol had been noticing odd behavioral changes and forgetfulness in her mother for a few years.  She’d talk to me about them, and all I could offer was my concurrence that my mother had exhibited the same, or similar, behavioral patterns.  Carol had not taken her mother for any type of cognitive exam.  She just watched her mother more closely.  Her mother’s fall Christmas Eve also exposed an addiction to alcohol that was more severe than Carol realized, and why her mother had to spend more days in the hospital than expected.

Together, Carol and her brother, William, tag-teamed their time at the hospital being with their mother, talking with nurses and doctors, making phone calls to insurance companies, physical therapists, and the like.  Because William is listed as the executor to their mother’s estate, he has taken the lead, and Carol is perfectly fine with that.

William determined that when their mother was discharged from the hospital, she would live in an assisted living residence for at least one month.  When Carol called to talk to me about it, I could hear the sadness in her voice, not only because of the turn of events, but the disappointment in, and the possibility of, her mother never being able to go home again.

I gently told her I felt the one-month stay was a good idea given the challenging symptoms and behavioral issues her mother was exhibiting.  It sounded to me like her mother needed more attention than what both she and William could provide physically and emotionally.  They did discuss moving in with their mother and splitting the stay during the week between them.  However, I knew what the reality of trying to do that would be, and how difficult that kind of stress, along with 24/7 care, would do to their lives and psyche.

What I heard Carol battling with most was her difficulty in accepting how bad things really were for her mother.  While her mother was in the hospital, Carol was busy making provisions at her mother’s home, i.e., setting up an area for her to live that didn’t include stairs or a stove.  Her mother could be self-contained on one level of her home while she and her brother would split their time there and would stay in the rest of the house.

Both Carol and William work, so I gently offered probable complications that directly affected their mother’s safety.  For one, she still had driving privileges even though they both felt she shouldn’t be on the roads.  Secondly, she could easily hit the store for alcohol, or summon someone else to buy it for her.  There was no locked door to keep her contained in her part of the house. She could easily walk freely through the house, stairs included.  Bottom line, their mother was not in her right mind any longer and too many factors threatened her safety.  I expressed how worried they both would be while they were at work and not with her.

Hearing the level of sadness and grief in Carol’s voice was significant.  Carol wasn’t necessarily in denial. I could hear her trying like hell to accept the reality of what was happening with her mother and their family dynamic – it was changing fast and changing forever.  Carol’s shaky voice catapulted me back to the days I had lived having to hire outside caregivers for my Mom.  At first it was just for a few hours a day.  It then became necessary to increase the hours, over a year’s time, to eventually arrive at two choices: either she had to have 24-hour in-home care, or she would have to move to an assisted living facility.  I was reminded how long I had been making “parental” decisions, but more importantly, how Life didn’t give a shit how I felt about it, or how sad I was, or how sad this was making Mom.  It was what it was, and the acceptance of it was almost unbearable.

What Is True For Me:  There’s no magic wand I could wave to suddenly accept what was happening to Mom’s life or mine. It’s a process just like anything else — and it takes as long as it takes. 

One of the things that kept me on track to make the right decision was asking myself, “Is what I have to decide best for Mom’s safety?”  My mantra has always been to keep mom safe, calm and happy, and in that order.  Sometimes all three are not present at the same time.

I allowed myself to cry and grieve, lose my composure and temper, process this fully so I could get to a place of acceptance.

The level of grief varied daily even after I felt I had accepted the reality of my caregiving role and Mom’s disease.  The decisions that have to be made do get easier and more acceptable as time goes on.  Always keep “safety” in the forefront of your mind. It will make decisions easier, and it will usually always be the right choice for the one you are giving care to.