A friend of mine has talked to me about the concept of “good enough” parenting, or caregiving as the case may be – about accepting that it’s impossible to be a perfect parent/caregiver and letting it be “good enough” to know that the vulnerable person in your care is safe, well fed, clothed and getting necessary medical attention. Today was not a good enough caregiving day. We came so close to disaster today that I’m still shaken.
Mom was referred to a gynecologist for a pelvic and breast exam due to some symptoms her PCP had noted on her last visit. I made arrangements for her ALF driver to take her to the appointment, where I would meet her. I told her about this last night and again early this afternoon. We’ve done this a couple of times and it worked out fine. But this is a new doctor in an unfamiliar office building, and maybe I should have realized that would be harder.
When I arrived ten minutes before her scheduled appointment (I meant to be earlier but LA traffic didn’t cooperate), I found her sitting on a bench in the building lobby. She had her purse in her lap and was going through her wallet. I walked up behind her and put my arm around her. “Have you been here long?”
“I’ve been here a very long time,” she said. “I don’t even belong here. Someone brought me here, I don’t know who, and they just left me here hours ago. I don’t even think he knew where I was supposed to be. He just thought he could leave me here.” She met my eyes, finally. “I was so confused,” she added. “I didn’t know I could be so confused.”
Do I need to tell you just how hard it was to hear that? It’s hard to even put the words in print, they hurt so much.
I sat next to her, held her hand, and told her that I was sorry they brought her so early and just left her here. I explained that she WAS supposed to be here because I had made a doctor’s appointment for her, and that if I had known they were going to bring her early I would have come early too. “I don’t think they knew about your appointment,” she said. I didn’t try to argue that point. I checked the time on my phone and asked if she wanted to go on up and see the doctor, since we were here. “Might as well,” she said.
I was angry that they had apparently dropped her off in front of the building, instead of taking her up to the actual doctor’s office on the third floor. I was angry that they brought her so early and didn’t let me know that’s what was happening. As we rode the elevator, I took deep breaths and tried to stay calm and smiling, for Mom’s sake.
I found her a seat in the waiting room, signed her in, and picked up the clipboard of paperwork to fill out on her behalf. I had called her ALF a couple hours before the appointment to ask them to send a printout of her medication list with her. I asked her if they gave her that. She said she didn’t think so, checked her purse, checked the basket of her walker. No med list. I called the facility and asked them to fax the med list to the doctor’s office. While I had them on the phone, I asked if they could tell me what time she was dropped off. “Well, they left here at 2:45,” I was told, “so probably around 3:15.” For a 4:00 appointment. She was alone and confused in a strange place for 30-40 minutes, and I totally understand how that could feel like hours.
(Sidebar: When I was eight or nine years old, my mom forgot to pick me up from school one afternoon. We were leaving the next day on a family vacation and I’m sure she was busy packing and lost track of time. I remember sitting outside the school, watching the other kids get into cars and drive away, one by one, until there were only a couple of cars left in the parking lot. I have no idea how long I waited, but it felt like hours. Finally a teacher came out and asked me if I wanted to come in to the office to call my mom. “Yes, please,” I said. “I think she forgot me.” It was the most awful feeling. I thought about that today and I wondered what it must feel like, as an elderly adult, to think that you’ve just been dumped somewhere that you don’t belong and forgotten.)
I went to the desk to tell them that her medication list would be faxed over momentarily. The girl held it up. “We have it,” she said. “She brought it in with her. Here,” she added, handing me another form. “I don’t think she filled this one out before she got up and left.”
So, I guess the driver did bring her to the doctor’s suite. But she must have gotten confused, perhaps when they gave her all that paperwork to fill out, or because I wasn’t there – and so she left. Oh hell. My mom has never “wandered” before, never attempted to leave the place where she’s been asked to wait. It had never occurred to me that she would just walk out of the doctor’s office before I got there. Thank God she stayed in the building lobby! If she had just wandered off, out of the building, I don’t know how – or where, or in what condition – I would have found her. Holy panic attack, Batman.
We got lucky this time. She didn’t leave the building, or have a heart attack or a mini stroke from the stress. She was confused and unhappy while she was waiting, but she calmed down right away once I was with her. She did think it was rather absurd to be seeing an ob/gyn at her age (because of course she doesn’t remember the symptoms that made it necessary) and she did NOT appreciate the pap smear, but the female doctor was as gentle and kind as could be, and it was over quickly.
The silver lining of dementia is that even traumatic stuff is quickly forgotten. By the time we were in the car talking about where to go for dinner, it had all been wiped from her memory. “Good to have that over with, isn’t it?” I said, smiling. “Good to have what over with?” she asked, looking puzzled. “Never mind,” I said. “I’m going to take you out for dinner. What would you like to eat?”
The “good enough” parent or caregiver knows she can’t be perfect. She knows she’s going to make some mistakes, but she learns from them. Lessons learned: No more ALF shuttle for Mom. I will personally pick her up and take her to any appointments, though it will mean an extra 60-90 minutes of lost time from work. And no more leaving her alone and unsupervised in a strange place. Never again.