I interrupt Shelly, the evening shift's head nurse who is coaxing Milly to open her mouth to receive her pureed carrots. Milly is angry with my intrusion. "Go away!" she yells in her raspy, exorcist-like shout. "Get the hell away from me!"
"I am sorry to bother you," I whisper to Shelly as I bend closer to her ear feigning some semblance of privacy in a space shared with thirty other dementia unit residents. "I'm worried about Mom. Her hands are shaking and she seems very uncomfortable."
"That's her baseline," Shelly responds nonchalantly.
(A trigger -- this nonchalance. My mother's dying and in pain and you are casual about it? Like this is nature's way?)
"Baseline?" I stammer, mustering straggly strength to protest her definitive dismissal.
"Baseline? I don't think so!" I blurt in angry frustration. Mom's hands are shaking like my friend Ernie's who has late stages Parkinson's. Her eyes strain as they always have when she is in pain. A martyr to the end, Mom never speaks of pain. Only her eyes betray her as they narrow and fix at some point beyond me refusing contact. I pull my chair closer to her, a plastic-coated rocking chair that is sticky from lunch's spills.
"Momma, it's Emmy. I love you."
"No you don't!" Her eyes flash!
Baseline? This is not baseline. Mom's baseline is a tough surrender. When I say, "I love you," her baseline is a weak, forced smile. With lips pulled against unbrushed teeth she replies, "I know you do. I love you, too!" Now that, is her baseline!
"I love you."
"No you don' t!"
(Another trigger -- guilt; guilt for having her here instead of home; guilt for not visiting more often even though I have the time; guilt for paying an aide extra to do her laundry; guilt for farming her out to strangers for this last lap of her life.)
"Momma, it's Emmy. Are you in pain?"
Blank, distant stare.
"Momma, are you uncomfortable? Is there something I can get you, something I can do for you?"
Eyes close and her head tips back; hands continue to shake.
I fight the tears. "Never cry in public!" I fight the tears, give her one last "hug for the road" and leave, visibly upset.
During dinner I tell my husband that I feel badly because I was rude to Shelly. I begin to cry and again, fight the tears. I put my fork down, pick up the phone, and dial the home.
"Shelly in Haverhill unit, please?"
"Hello, Shelly. Look, I am very sorry about the way I snapped at you. I know you do your best to care for so many. It's just that I'm terribly worried about my mother. She seems in pain. You know, if this is her next natural stage in her passing, I can accept it, but if she has an infection and we are letting it go and she is unnecessarily suffering, I cannot accept it. Do you understand what I mean? This is very important not only for now and for mother, but for later, after she's gone. I need to know that I am doing everything I can for her now to make this late stage as comfortable as possible. Do you understand?"
Silence.
"I understand, I do. You don't need to apologize."
"Yes, yes, I do. So, I am sorry for how I spoke to you but I really need us to test for an infection. I think she has another UTI. Mom has something. Please, can we test her?"
"I will write a note to Carol, the day shift nurse."
"Oh, thanks, Shelly. Thank you so much!"
I hang up somewhat more hopeful but still frustrated. It took two weeks of asking three times to get a urine catch. I have been told different things. One is startling. "We have a change in policy and no longer test routinely, only if someone is symptomatic." Yes, but if symptoms are being read as "baseline" who do we call? Or, this one startled me even more, "It's difficult to get a urine sample now that she wears depends all the time." Wow! I am worried! In the morning I call and speak with Carol who is very responsive. She runs the test and voila, we find Mom has another UTI. I receive a call later in the week saying Mom has been put on an antibiotic, Macrobid. Again, I slip into frustrated venting. I tell the nurse, "Great! Thank you so very much. Just one thing, I asked for this two weeks ago and was told that it was difficult to do due to her wearing Depends. That doesn't make sense to me. Does it to you?"
Silence.
"Well, thank you so much. Mom should be feeling better soon. I appreciate all you do. Thank you."
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by eskearns
2:20:00 PM
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