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CARING FOR MY MOM:
WHEN THE CARE MANAGER BECOMES A CAREGIVER
For the past year, I have watched my 83 year-old mother suffer the devastating results of a brain tumor and subsequent chemotherapy and radiation. A retired department store executive, Mom had been living independently, driving herself to visit friends at the beach, and using the computer to order groceries and pay her bills.
Within six months of her diagnosis, she became unable to complete the simplest activities of daily living without assistance. Although her comprehension is fairly good, her speech has been greatly impaired, making conversation very limited.
How I miss the long talks my mother and I have shared almost every day of my life! On the other hand, she greets me with a huge smile whenever I come to visit, and I have peace knowing that she is comfortable and well-cared for.
After years of providing services to seniors, I am now on the receiving end. Mom requires 24-hour caregivers, and various other professionals visit her at home. She uses a hospital bed, a lifting recliner, a wheelchair and other assorted healthcare products. Mom is on many medications that must be administered, monitored, and adjusted according to her condition. She requires breathing treatments and pureed food. This is familiar terrain for me as a care manager, and yet very difficult to handle as a daughter.
When my husband and I were planning a trip out of the country, I asked an RN Care Manager to help oversee Mom's care. Now that I am back, we have continued the visits from the RN care manager. She manages medications, M.D. appointments, equipment, supplies, caregiver training, and a thousand other details, so that I am (mostly) free to just be a daughter. It is hard to describe the peace of mind and relief that this brings me, as well as the benefits that an objective, skilled professional brings to my mother's care.
As I review my experience of professional care manager as caregiver, several points come to mind:
- We have to accept that things will not be perfect.
This is a tough one for me. When someone has multiple medical issues and needs almost total care, there will always be problems. I had to let go of the idea that I should be able to fix everything and nothing will ever go wrong.
2. Dedicated hands-on caregivers make
all the difference.
My mother's regular aides are a godsend. They are compassionate, hard-working and resourceful. Nevertheless, things will not always go perfectly. See #1.
3. Care Management eased my burden
and improved Mom's care.
Since I am a Care Manager, I didn't see why we needed anyone else. One of the first things our Care Manager suggested was that I stop rushing to get Mom out of the rehabilitation center before all homecare arrangements were in place, and she was right. Later she let me know when Mom could no longer safely be helped into a car, and needed to use a wheelchair van (right again). As an RN, our Care Manager was well qualified to navigate Mom's complicated web of medications, appointments, and treatments. And without all those responsibilities, I have time to visit with her as a daughter, something only I can do.
- Problems are most likely to occur around transitions, either from home to hospital or on discharge from hospital or nursing home.
Sadly, one can't assume that medication and treatment orders have been accurately communicated or followed. Do your best to follow up and check the details...then see #1.
5. I don't have to do this alone.
Family members and friends have helped in numerous ways. When my Mom was in the hospital and a rehab facility, staff were extraordinary in their dedication to their job. Last but not least, I can depend on the caregivers and the Care Manager to do their best to keep Mom safe, comfortable, and feeling loved.
This is not my first experience with caregiving in my family. I helped care for my father, stepfather, mother-in-law and father-in-law before their deaths. Nevertheless, the pain of seeing my beloved mother so diminished is particularly difficult for me. As I walk in the steps of so many of our client families, I am grateful for all the experiences we shared which have, no doubt, prepared me for this one.
Debra Levy
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Debbie Gann is known to many of us as a provider of special services to seniors. Through her company, 
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