Tomorrow is the expected discharge day for my mom's most recent hospitalization. This is the same team that worked with her in November and I felt so good about her being treated there. This time the future looks grim.
We've had to decide which delusions we laugh off and which ones we race her to the ER for. There isn't talk anymore of "controlling the delusions." That battle is already lost. Schizoaffective Disorder simply refuses to play by the rules.
My mother has been in Gero Psyche for a week now. I saw her on Monday where she appeared groggy and admitted to hearing voices. On Tuesday I visited her and she seemed a bit more animated, but still wouldn't get out of bed. On Wednesday was her TDO hearing that was rescheduled twice. I didn't attend. This is the first hearing she's had where there wasn't at least one of her children at the hearing. I've heard it didn't go well and what was expected to be a voluntary commitment ended up with a scene, and involuntary commitment and an immediate med change. I've yet to find out what happened and part of me really doesn't want to know.
Back in November I allowed myself to hope that she could be normal again. When she left the hospital back then part of me was angry for starting to clear out her house. I had hope she would one day be able to live on her own again. I guess maybe that's what's been keeping me going through all this. That one day I'd be able to "fix" her if I just tried a little harder. If I prayed harder, if I worked a little more, if I found the right doctor, if I just made the right choice I could change things. Obviously this is a very foolish notion that I need to let go of. She is never going to be "fixed." I'll never have my mom. I've always felt she has been lurking under there my whole life, screaming to be let out. Now I have to wonder if she ever existed.
The discussion this week has been about whether we as a family should sign a "do not resuscitate (DNR)" or a "do not intubate (DNI)" order for her. I didn't think that's a decision I would be thinking of so soon. I had to call all my siblings and ask their opinions, taking a few moments to grieve in between calls and begging in my head for someone else to make this decision. The results were two for, two against and one on the fence for the DNR. Unanimous for a DNI. One of my siblings, in objecting to the DNR, felt that I might feel guilty if I sign the DNR and she has a heart attack. As if the guilt of ending life support would somehow be easier than getting a call that her heart stopped. I'll have crushing guilt either way. This isn't a choice. It's a nightmare.
I remember as a kid I always felt I would never euthanize a pet because it was cruel. Then we did everything we could do to save our beloved cat Piglet. In the end I could see the pain in his eyes and I saw that I didn't help him by having the vet take heroic measures. I made him miserable. We had several more cats who died after long and painful illnesses. And I figured out that euthanasia is not cruel. The heroic measures were what was cruel. Not that I would euthanize my mom - even if I could. It's just that she's suffering so much. I can't imagine wanting to prolong that by artificial means, even if those artificial means are relatively minor and basic in most cases.
Today I spoke with my mom's mom. There was one thing that echoed long after we ended the call. She said she felt she should have done more for my mother when my mom was younger. Maybe she could have said something or gotten help for her or convinced my dad she needed help. This is something I've been wrestling with over the years. I have been angry that no one did anything to help her. I felt this horror show we are living in could have been avoided if someone had just done "something" decades ago. But I've learned a few things. Sometimes we do more harm when we act than when we don't.
All this was set in motion a long time ago and no matter how many people push against it, it can't be slowed or stopped. It's in a constant, steady motion forward. It's only a matter of time.
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