On April 29, 2006 at about 5:30 a.m., May C. fell in her kitchen in a rural area 10 miles west of Yakima, Washington. As she fell her right leg was thrust back while the rest of her body fell forward, resulting in a compound fracture of her right femur. May called her LifeLine service for help and was transported to Providence Yakima Medical Center. Surgical repair of her leg was delayed for 3 ½ days due to a doctor shortage in the Yakima area. She is currently placed in Parkside Nursing Home in Union Gap, Washington and is not expected to be able to return to her home. Six years ago she broke her left femur and hip under similar circumstances and returned home after a very poorly tolerated three-month nursing home placement. First names are used in this article after identifying significant characters to avoid confusion. This report is based on the personal experience of the author with her grandmother and family members.
[...] Anne does not want or require assistance with more concrete matters, but does appreciate having her feelings validated by someone who knows May and understands how difficult working with her can be. Much appreciated is the Social Worker checking in with Anne to confirm whether her assessment of May's emotional and cognitive status is accurate. In at least one case staff thought one of May's statements indicated a worsening paranoia but after Anne put it into context if was determined that May was grounded in reality in that situation. [...]
[...] The family consensus at present is to allow the nursing home Social Worker to work with May on accepting that she will not be able to return home. If May questions the necessity of continued placement in either the nursing home or an Adult Family Home, Anne, Doris and Lance plan to it on government rules that do not allow neglect of the elderly. They will appeal to May's law-abiding nature in the event she does not understand the necessity for placement, hoping this approach will preserve their relationship with her. [...]
[...] The thought of damaging her relationship with her mother is painful, but at the same time Anne knows she can no longer go on providing all the care May needs. An additional worry is that May's Medicare benefit limit has nearly been reached and she will soon begin receiving large monthly bills for her care. May, having been a young adult during the Great Depression, has a great fear of running out of money and it is anticipated that she will try to insist on returning home whether that is safe or not. [...]
[...] The female family members are frustrated with the males, who have avoided helping with May's care. The males wish to avoid unpleasant situations and as a result they avoid May whenever possible, leaving the females with nearly all care duties. May has been emotionally and verbally abusive to Doris for a number of years, believing that Doris was good enough” to marry Lance, yet at the same time is grateful for the care and companionship that Doris provides. This dynamic has contributed to distancing Diane from May and strengthening her relationship with Doris. [...]
[...] Diane's in-person contribution has been limited due to distance, but she visits with May by telephone, provides emotional support and conflict mediation to Anne and Doris by phone and email, and, with education in Social Work, and assists the family in obtaining social service and other benefits. Diane's older daughter Madison has spent a month each of the last two summers providing partial respite for Anne. May does have a few friends who are still alive and distant cousins who write to her, call and occasionally visit. [...]
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