Within 5 days of delivering the report, Mrs. B asked me to come to her home. She was shadowed by another woman who she sponsored at AA and who was there at our first meeting. We will call this woman, her shadow. At first I was suspicious. It is not just that I have an inherently distrustful nature, it is that I have seen these types linger around frail older adults with assets many times and THEY HAVE DONE BAD THINGS TO MY CLIENTS. In time, I came to not only trust the shadow, but because Mrs. B’s daughters were out of the country, I came to rely on her for doing the things that a daughter would do.
When I arrived, Mrs. B was sitting up in her bed upstairs eating a peanut butter and lettuce sandwich. Because she had to sleep in an upright position, she developed stenosis. She complained of pain. Overall she seemed determined and strong. Mrs. B again reiterated her desire to move her husband elsewhere and the conflict she felt about “institutionalizing” him. The consensus was that she would tour a facility by her home that I recommended. I asked her to articulate her wish list, and certainly regaining her strength was primary. However, it was clear that her mental attitude was an impediment, so we discussed anti-depressants. Being the stoic person that she was, she had stopped taking them.
I spoke with Mr. B, he was bored. Every day that I spoke with him he said he was bored. He had very bad hygiene, could not make his own meals, pick his clothes out or do his own laundry. I came to feel that placing him was the right and kind thing to do. He sat and sat and sat all day without any social interaction.
We had a plan. Mrs. B. would tour the assisted living facility the following Monday. By the time I left, she was up and about and demonstrating her new lift. She looked happy and hopeful. The next Monday when I met her at the facility, she looked like she was knocking on death’s door.
What happened? I kept asking myself this question. Just two days before it seemed like you could swim in her eyes. When I saw her that Monday, she did not look spry and her lids were heavy over her big blues. She could barely get out of the car and I needed to get wheelchair assistance. She had fallen the night before. There was no one there to help her.
The next morning I got phone call after phone call from one of her many friends “Mrs. B… keeps saying she is dying and she won’t let us take her to the hospital or the doctor.” I rushed back from my appointments and cancelled my day. Both she and her husband had fallen the night before and this time she was in terrible pain and scared. He was oblivious. She could barely breath. She was gagging on her coughs.
I gave her two choices I would either bring her to the hospital or I bring a doctor to her. She told this doctor, (a geriatric concierge medical doctor who did her residency in geriatrics) was accused of being a quack while conducting a bedside examination and dismissed her. Now what?
