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Between the Lines: When You Need the System...

...you’d better keep your fingers crossed.

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Tuesday, October 15, 2013

It was the call you never want to get, the call that comes at night, wakes you up, forces you abruptly out of your fog.

I heard my sister’s voice and I knew something was wrong right away. She started out strong, but three words in, she lost her breath. She was choking back tears.

It was my mom, a woman in the mid-to-late stages of Alzheimer’s disease. During an episode of intense confusion followed by agitation and eventual aggression, she pushed her way past my sister (whom Mom suddenly no longer recognized), ran out the front door, wobbled across her lawn and into a car parked in front of her neighbor’s house. She fell to the ground and instantly began crying in agony. My sister called an ambulance while neighbors began gathering at the curb, trying to comfort my mother. Only as the EMTs loaded my mom into the ambulance did she finally recognize my sister, warning her not to go back in the house.

“That woman is still in there,” Mom said. “She tricked me and she’ll trick you, too.”

After my sister’s call, I was on the phone for several hours, talking with various doctors and nurses and social workers. In the emergency room, Mom was diagnosed with a badly fractured hip. She would need an operation, would have to have a metal rod and screws inserted from her hip to her knee. The operation had risks, I was told. Assuming a good outcome in surgery, the doctors said, it was after that that the hard part would begin.

To heal properly, Mom will need to be back on her feet almost immediately after the operation; her physical therapy will begin right away and likely continue for months. To make a full recovery would be hard work for any woman in her late 70s, the doctors warned me; it could be especially difficult for my mom, whose cognitive issues would almost certainly complicate her physical therapy.

The process that began when my sister called continues. Mom isn’t even out of surgery yet, and the hospital is asking where we’d like her sent for rehab. Meanwhile, her primary care doctor, who is also an Alzheimer’s specialist, is telling us not to worry, not because Mom’s going to be OK, but because there’s nothing much we can do.

“The best thing you can do,” she said, fully aware of how it sounded, “is let the system do its thing.”

Facing many tough questions about my mother’s short-term recovery and long-term prognosis, about what care she’ll need and who’ll pay for it, the best thing we can do is “let the system do its thing.” That would be hard enough advice to take in the best of times, but when you know the larger “system” is being held hostage by political hooligans willing to shut it all down to make a point, it’s nothing but a slap in the face.•

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