Turning Points

I'm still running on adrenalin. After all, it's just after 5 p.m. and I've had less than 2 hours sleep in 36 hours. Why, you ask? Fall victims, especially those not seriously hurt, even those with dementia, do not have a high priority in emergency rooms.

My dad fell again last night. It must have been about 7:30 p.m.; I remember looking at the clock at 8:00, and the fire department first responders had already arrived. This time he hit the back of his head on the edge of a bookcase, and scraped the skin off two spots on either side of his elbow. It took three brawny fire fighters to get him from his bedroom to the car -- probably 40' total distance. Another team of helpful young men at the ER/Ambulance loading dock got him out of the car and into a wheelchair. I don't know who got him from the wheelchair into the ER gurney. Took Mother home just after 10 (it was going to be 2 hours before the CT scans would be read), and was back in the ER by 11:30. The ER doc (who looked like a teen-ager) called his own doctor at midnight, who asked that a Hospitaler (a doctor who treats primarily inpatients) admit him. It was 4 a.m. before we climbed to the top of the Hospitaler's priority list. He saw no clearly defined problems, although there was enough of a suggestion of pending pneumonia to justify admitting him. That and the fact that it was all two strong nurses could do to keep him standing upright long enough to take a blood pressure read. No way was I going to get him back home by myself. There was no evidence of major stroke, no concussion, no skull fracture. Just the goose-egg where his head hit the edge of the bookcase.

The admitting doctor ordered another chest x-ray later in the day, a physical therapist to work on mobility and check his ability to swallow, and evaluation by a geriatrician. We'd been unable to get an appointment with a geriatrician before April 2009, so this order was an welcome relief. We agreed that he should be kept comfortalble, but that no heroic measures should be taken to prolong his life. I left at 4:30; Daddy did not get to his room until about 6 a.m.

I learned about something called 'sundowning'. After dark, especially in unfamiliar settings, dementia patients tend to get more agitated than usual. The IV lines and monitors, all with associated cords and cables, often trigger agitation and aggressive behavior. So I became the bad guy, because I was the one who agreed to his admission as an in-patient.

Ian did the hospital visit thing today, arriving on the heels of the geriatrician. Did Daddy remember what happened? Of course. He was thrown out of his airplane seat. Did he remember being in the ER? ER, he wasn't in the ER. He was on an airplane, and didn't get home until 6 a.m. Who was that man standing over there (pointing to my brother)? I don't know, but he's been around for awhile. What year is it? 1986. Do you know where you are? Blank stare.

Our father is in an alarmed bed to warn the nurses when he tries to get up. When seated in a chair, he is connected to the chair with a mesh vest-like device to "remind" him that he cannot leave the chair. Today he had to be spoon fed before he would/could eat. When alone in the room he wears large mittens that look like boxing gloves to keep him from pulling out lines and monitors. He got pretty good at that trick in the ER.

The expectation is that he will remain at Queens until at least Monday. I think Mother is relieved. We meet with the social worker on Friday morning to discuss options.

Give thanks for the geriatrician. Look for those silver linings. Keep praying. ...