Caring for an elder in the time of coronavirus

One night after a fall, my 94-year-old mother-in-law was catapulted into dementia at a speed that was unfathomable. Four falls in six days, three ambulance transports to the hospital ER and an eventual admittance after sustaining a fracture were just the beginning.

Each step became more unbelievable and our family was thrust into an unbalanced world that left us all feeling helpless and overwhelmed. This sudden onset of debilitating dementia changed our family plan, our commitment to care for our elderly family member within the walls of our own house, and daily life as we knew it.

When our loved ones cannot stay home safely and continue to be in danger of hurting themselves, the decisions to be made are painful and difficult. For my mother-in-law, what started with a hospital stay became something completely life-changing. From the hospital she was transferred to a rehabilitation center and then to a short chapter in assisted living; these steps all seemed to be leading to the realization that care at a deeper level was absolutely necessary.

After several more falls at the assisted living facility, another hospital stay for a second fracture, and quickly deteriorating cognitive and emotional capacity, the hospital doctor and social worker guided us to the understanding that memory care was truly needed.

During both of her hospital stays we watched as nurses became the example of patience, even doing their charting in her room just to keep her calm. Everyone was so kind and compassionate, even when her mental state and words were not the best.

When someone has advancing dementia, any type of changes can have an impact. One of the hardest things to witness is when an elderly and confused family member becomes frightened by all of the changes they can’t understand. Words comfort only for moments, and the reality of living in different places being cared for by strangers, can be terrifying. As a family member, the feeling of helplessness and heartbreak is real and only continues to grow as the condition deteriorates.

We have witnessed some exceptional people in the facilities my mother-in-law has resided in, but the reality of that world is that often the setting is not pleasant and the caregivers are worn thin. Understaffing leads to limited one-on-one care and a sometimes stressed atmosphere.

Nothing is like being home with your loved ones, and for my mother-in-law, she had never known a different reality. Throughout her life she was protected in a safe cocoon by her mother, her husband, by friends when her husband passed away and then by her family when she relocated here to be with us. Nothing about this new reality felt fair or just.

In December, desperate for a better facility with improved care and food choices, our prayers were answered. We were able to move my mother-in-law into a memory care facility that she had been on a waiting list for and there were immediate improvements on every level. The transition was still hard on her, and it has taken over two months and fluctuating medication adjustments to help her feel more at peace, but we know she is now being cared for possibly even better than we could do ourselves.

The one thing that brings stability and peace into my mother-in-law’s life are the multiple visits per week from her family. Seeing her son is first and foremost; he gives her a real sense of security. My presence is always received with a joyful greeting and grandchildren and great-grandchildren somehow help her feel a sense of what was and still is — the multigenerational love of a close-knit family.

I think it has been the awareness that we are coming that gives her something positive to focus on and with her mind now unable to focus on television, books, magazines or conversations, those visits truly became another lifeline. And yet now we have one more challenge in this tragic journey: the coronavirus.

Again we could never have foreseen something quite like these current times. We had just gained a sense that my mother-in-law was becoming somewhat stable, bonding with her caregivers and settling into her new home. Prior to tightened restrictions on gatherings, we celebrated her 95th birthday, thanks to the staff facilitating a nice private area to have our family dinner party in. Surrounded by her family, it was a really good evening.

Things felt like they were headed in a better direction, but that feeling was short-lived after a national order closed these types of facilities to all non-medical staff.

The serious threat of COVID-19 is higher with the elderly and we are grateful that our government took the necessary measures to protect those living in care facilities. However, when dealing with dementia, there is no way to explain why you aren’t coming to visit those within the walls you can no longer enter. Staff can explain and explain and explain again, but those minds cannot remember five minutes later what was said.

In this time of rampant and sometimes excessive fear reactions, the fear within those walls is completely real and their world is now more isolated than ever.

Where have their families gone? Has something happened to them? Don’t they love me anymore? Am I really all alone now? These are the questions that were already being asked by those whose minds couldn’t stay anchored in reality. Already being asked before a virus closed them off from any sense of their place within a family and the outer world.

For those who have progressed into a deeper level of dementia, the forgetfulness may just be a blessing at this point. But for those who do still remember, the coronavirus just became the most cruel hand dealt.

Now more than ever we are completely dependent on those tasked with caring for our vulnerable family member and so grateful for their dedication. We can hear in our recent phone conversations that this newest challenge is affecting my mother-in-law’s dementia and breathing (due to anxiety). We can only hope and pray that we are allowed back in before too much more deterioration occurs.

Once again we are even more helpless and heartbroken; we don’t know what each new day will hold. We can only pray that there are positive advancements in a timely manner so that nothing worse happens while we can stand outside looking in.