Tuesday, August 30, 2016

What happens when it’s you?

by Michael Fratkin

Nobody was prepared when Barbara’s husband died quickly last month. It turns out, he was both covering for her difficulties and caring for her 24 hours a day. Barbara was accompanied throughout life by a profound depression and, for 40 years by a man who was many things. Strong with integrity and a dedication to Barbara, he had a 24/7 obsession with Fox News. No one, especially his family, described him as nice. He pretended she was functioning reasonably well, even after an anoxic brain injury took its toll three years ago. Since his death, Barbara’s two daughters suspended their own lives and traveled to her side. What they discovered was profound confusion, emotional lability, incontinence, and essentially no ability to function independently. In addition, though the husband gave the impression that all the business and affairs would be tied up with a neat ribbon, everything was a mess. With two children of his own and three of hers, the stated plan was simple equity of all material possessions, but the will and structures didn’t reflect that. His children felt screwed, and rightly so. A house full of stuff thousands of miles from the children, an eight year old yappy and tragically non-housebroken “Teacup Matlese” named Itsy, a rat’s nest of bank accounts and bills, and a woman. Barbara has meltdowns with sobbing and immobility on most afternoons, has little insight into her substantial limitations and is now preparing to relocate to an assisted living facility in the town where her only son lives in Northern California.

Of course, Barbara is my mom and I love her. On Saturday, I am flying to Texas to accompany her back to Northern California. We are hoping that grandchildren and people simply treating her nicely will offer a measure of joy and peace. We are prepared for the worst.

Many of us are now facing the tragedy of our aging parents as Palliative Care professionals. Do we really need any further experience with the failings of our healthcare system and the failings of our social structures to provide even the most basic needs for our elders? My mother has Long Term Care insurance that will allow for the “best possible care” whereas statistically, very few in our society do. Many families are spread out all over the map and complicated by the fragmentation resulting from a culture and society that has been changing at lightning speed for decades.

Let’s take a moment together today to look at what it feels like and how we cope when it becomes clear that there isn’t any “us and them.”

T1: Do you have experience with a parent/grandparent/close family member who was no longer able to care for themselves?
T2: What impact do you think the geographic mobility has on the care of our elders?
T3: What type of reform is needed to ensure our elders do not “fall through the cracks” as they lose independence?
T4: What successful solutions or pilots have you seen that can help elders age in place?

What: #hpm (hospice and palliative med/care) chat on Twitter
When: Wed 8/31/2015 - 9p ET/ 6p PT
Host: Dr. Michael Fratkin (@MichaelDFratkin) and Torrie Fields (@TorrieKFields)

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Photo Credit: Michael Fratkin used with permission.

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