“It’s about time I go to a doctor for a physical,” my healthy, elderly mother said to me. Aside from childbirth, my mother rarely sought medical help, and she rarely took medication. My mother thought it was important that she get established with a local doctor in the event she had an emergency. My mother was very active and mowed her lawn, raked leaves, and even shoveled her driveway. These tasks brought my mother great joy.
My mother left her doctor appointment with a prescription for high blood pressure pills. She hesitantly took the pills, but they made her dizzy. This resulted in a fall in which her sacrum and pelvis were fractured. My mother was sent to a rehabilitation facility for several weeks to heal. A month after coming home from the health center, the biggest snowstorm of the year walloped the town where my mother resided. The day after the storm, my mother informed me that the person I hired to plow her driveway had not shown up. A few days later, my mother gave up hope that hired help would arrive. So, little by little, my mother shoveled her entire driveway over a period of several days. I was not able to assist because of my own health problems. Wouldn’t you know, the fellow I hired arrived the exact moment my mother was tossing the last bit of snow.
Months later, my mother was put on a different type of blood pressure medicine since the first one made her dizzy. Once on the new medication, my mother experienced positional blood pressure changes and heard imaginary voices. Apparently, an invisible man greeted her each day at noon with a “hello.” The routine nature of this greeting left me wondering if it was related to the medicine. My mother stated many times that she did not feel right on the medicine.
Weeks later, I received a call from my mother who, in the midst of doing taxes, suddenly found herself on the floor. She didn’t know how she ended up on the floor. I suspected a mini-stroke. My mother would not go to the hospital; instead, she got up from the floor and continued with her paperwork. At this point, I knew my once healthy mother was much worse since she went to a doctor.
A few days later, while visiting my mother, she asked me, “Patty, do you know where my basement is?” She also told me that the car in her garage did not look like her car. Clearly, my mother was mentally confused. I snuck her iron, car keys, and other items that could pose a danger out of her house. Soon, it became apparent that my mother needed twenty-four hour care, and my mother was placed in a nursing home. Unfortunately, my own physical problems prevented me from caring for my mother at her home.
My mother was still quite “with it” at this point; in fact, so much that it seemed she should be back in her home. Some of her doctors were puzzled, as well. For a while, I wondered if I made a mistake placing my mother in a nursing facility. My mother was the intellectual at the nursing home. She read the newspapers and even kept track of her certificates of deposits. Other residents were not so fortunate. There was the roadrunner who ran aimlessly around the nursing home, the screamer who periodically cried out across the hall, and the thief who unknowingly stole clothes from other residents during the night. Eventually, my mother succumbed to some of these labels herself.
My mother and I convinced the doctor to keep her blood pressure medicine at a low dose. Many years ago, my mother warned me to not allow doctors to give her too many medications if she became unfit to care for herself. Later, another doctor, who was affiliated with the nursing home, insisted that my mother take an additional medication. Neither my mother nor I thought it was in her best interest. So, my mother and I paraded down the hall to the social worker and I said, “Mom, tell the social worker how you feel about this drug.” My mother boldly exclaimed, “I don’t want the medicine,” and then we proudly walked back to her room. ‘Good for you, Mom,” I said. It was clear the risks of the medicine were not worth it.
After several months, my mother’s blood pressure slightly rose. This resulted in a doctor doubling the dose of her blood pressure medication. My mother suggested stringing along a few more months at the lower dose. She was put on the medicine, however, and lost her zest for life. My mother was rapidly deteriorating. We both knew the medications ironically had the potential to increase the risk of a stroke or heart attack, and we were very concerned. After requesting and looking over her medical chart, I noticed my mother’s blood pressure, overall, was no worse on the lower dose of high-blood pressure medicine. We finally convinced the doctor to lower the dose; my mother improved. She continued to do well for quite some time, until another doctor decided she should be put on yet another medication for precautionary measures. I feel this medicine only hastened her demise.
The next year was a roller coaster in terms of doctors, medicines, and other care. Periodically, my mother fell and was sent to the emergency room. The hospital called me to question why the nursing home sent her there since the hospital staff could not do anything for her.
One doctor suggested my mother see a cardiologist. My mother and I suspected the visit would be non-productive, but we went anyway to satisfy the nursing home. Before going into the appointment, my mother reminded me she did not want to take diuretics. Sure enough, the doctor was adamant about her taking water pills. When my mother said she didn’t want them, the doctor rudely responded, “Honey, you need them!” So, when my mother gave me a covert clue, I cut into the conversation in support of my mother. Still, the doctor would not budge, so we left with a prescription we didn’t want. My mother’s reasoning, despite her dementia, made more sense to me than the doctor. It seemed the doctors had been passing meds out like candy. The nursing home, of course, agreed with the doctor, so my mother was put on diuretics despite our resistance. After a very short time, the nurses saw how badly my mother was doing and quickly withdrew the medication. How absolutely unnecessary this further suffering was for my mother.
The nursing home grew weary of my mother and I resisting medicine. At times, the pressure from the nursing staff and doctors was overwhelming. At some point, another doctor added yet another high blood pressure medicine. One day, a nurse backed me in a corner and shouted, “If your mother’s pressure is over 120, she’s going to the hospital.” The staff wanted her on this additional medicine, and they meant it. They seemed oblivious to the side effects. Can’t my mother and I have a choice? My mother and I had discussed such factors long before her mind was failing.
I eventually arranged for a psychologist to visit my mother so she’d have someone to share her concerns with. The visit did not go well. Neither my mother nor I felt she was properly assessed, and this doctor only suggested she consult another doctor for more medication! During this time, a good friend of my mother’s was temporarily placed in the same facility. My mother and her friend played cards together and laughed about old times. My mother’s spirits quickly brightened. Soon after, when my mother and I were sitting outside the nursing home, the psychologist happened to walk by, and he welcomed her to come in for another visit anytime. My mother, being the hoot she was, said, “Oh, I don’t need you. I have my friend!”
Suddenly, my mother was put on high doses of anti-seizure medications. The seizures were an unfortunate side effect of the blood pressure medication. At this point, my mother rapidly deteriorated. She sat slumped in a wheelchair outside her room with all the other hallway people. It happened overnight from just one dose of the medicine. The medicine was slowly killing her. She began to lose her appetite. If I withdrew the medication, the staff would consider me unfit to care for my mother, or they would place her in a hospital. Keeping my mother on the medicine was risky, though. I was in a catch 22.
The next day, my mother had a very bad seizure while she was still on the medicine. She was immediately hooked up to oxygen. The nurse asked me if I wanted my mother placed under hospice care. I said yes, but asked where the hospice facility was. “Right there,” the nurse said, pointing to my mother’s room. They didn’t have to physically move my mother, but the facility could treat her differently. The advantage of this was I could stop or reduce medications as I desired. As soon as I reduced the dose of medicine, my mother mentally improved. Yet it was too late for her physical body to respond because she had become so weak.
The day before my mother died, I walked into her room and was horrified. She was scrunched up in a ball on the bed, with a dried out mouth. An oxygen tube that had fallen from her nose lay aimlessly across the bed. This was the most helpless I have ever seen my mother. I have not been able to shake this image from my mind. I ran down the hallway and got the nurse who was already overloaded with patients. The nurse kindly came in and made my mother comfortable. Most of the nurses meant well, but they were caught in a system that clearly was not working. As I stood by my mother’s bed, I couldn’t help but wonder, “Mom, I bet you’d be mowing your lawn right now if you never visited the doctor.”
I’m not a doctor, but I know the treatments for high blood pressure are controversial. Fortunately, the future holds promise for personalized doses of medicine. Isn’t it possible that my mother would have been better off mowing her lawn and exercising instead of taking medicine that only led to her demise?
Kudos, however, to the doctors and staff who honestly thought they were acting in my mother’s best interest. I am thankful for the nurses that were supportive.
Can I prove that my mother did not have an underlying condition before she was placed on medicine? No, yet there is no question that once my mother was under medical care, she quickly spiraled downhill.
“I did the best I could,” I said to my mother as I sat near her bedside. “I’m proud,” I thought, “that as you lay here dying, you are finally free of medications.” “Perhaps they’ll get the message now,” I whispered to myself, as tears dropped from my face.
