By Kathy Kappler, RN

So often as we meet with our clients, we get to know the other family members. One such family comes to mind. I was referred to the daughter of a gentleman that was in the hospital with a very serious diagnosis. After talking with the daughter, we arranged a time to meet at the hospital so I could meet her father. I arrived at the hospital the next day. I was able to introduce myself and talk with her father for only a few minutes as his strength was greatly compromised. The daughter and I moved to a private area away from her father in order to discuss the situation privately.

It wasn’t long before the tears started flowing. The daughter shared with me that her father was only one of the concerns. She and her sister had been taking turns staying overnight at their parent’s home for the past four months. Both daughters were exhausted and very worried about what the future held. They shared that mom had mental health issues and had been this way her whole life. She was totally paranoid about being alone so any time dad was in the hospital or gone for any reason, the girls had to stay overnight with her. Because he had been in and out of the hospital so much it had truly been four months that they were taking turns staying with mom. Mom was difficult and in total denial about dad’s condition and was adamant that he was coming home and she would be taking care of him. The girls had also realized how poorly mom had been taking care of him, especially when it came to nutrition.

Dad was going to rehab following discharge from the hospital and the strong recommendation was for assisted living after that. The daughter’s wholeheartedly agreed but did not know where to begin with mom. Every time they brought up the subject, mom would get irate and accuse them of all sorts of things. I offered to meet with mom from a nurse perspective but they told me it would just not be well received. So my main goal, besides following dad’s care, was to support these amazing daughter’s. One daughter could not talk about it at all without falling apart and simply said she could not do it any longer. Mom was increasing difficult and accusing the daughters of all sorts of things. I stayed close while they kept working on mom. We did arrange a follow up doctor appointment for mom and I suggested the daughter have a phone conversation with the doctor prior to mom’s appointment. The goal was to ask the doctor to prescribe some sort of calming medication to help mom adjust to what was coming in the next few weeks. The appointment took place and the medication was prescribed but mom refused to take it. Dad went to rehab and he wanted the next step to be assisted living as he could see how much better he did with the help he got at rehab. Mom did visit him there and he tried to have conversations with her about moving together to assisted living but she just kept saying he would be fine at home. Dad finally gave up and said at the time of discharge that he would go home for a short time. He felt that the only way he could eventually go to assisted living was to try home at first for the sake of his wife. He did agree that he would go to assisted living alone if it came to that. Preparing the daughters for the next step I showed them some assisted living options. As we visited one community, I made a point of asking for extra time to discuss the full situation. I chose this particular community because I was familiar with their ability to work with challenging situations. We discussed the option of dad moving in but mom following shorty one way or another. The daughter’s both agreed that they could not continue spending the nights with mom. The home stay was a failure, as we expected, and we set up admission for dad to the assisted living community. Mom was still not taking her medication but visited dad the first few days. I sat with the Executive Director, dad and daughters to figure out the plan to get mom there permanently. The daughter’s brought mom to lunch the next week and then left while she was visiting with dad. The staff was wonderful in dealing with mom, knowing she would be very upset when she realized she was not returning to her home. They also had a plan in place to assist mom with her medications, and with time and patience they succeeded.

My follow up call found dad getting the care he needed and mom actually visiting with other couples….taking her medication and adjusting. They were together as they should be, and the daughter’s had their lives back and could actually visit just as daughter’s and not caregivers.
As an advisor in this complicated and amazing industry, we enter the private lives of our clients . They touch our hearts and bring a sense of accomplishment when we have played small part in helping with a major adjustment in their lives.