Aging in the Coronavirus Plague Year – Part 2

. . . The woman who could make Greek taxi drivers cry.

 

 

And now we begin the next case study:  my  mother-in-law - Eirini Ianas.

My mother-in-law and I didn't get along.  I wasn't Greek, I wasn't Greek Orthodox, I didn't speak Greek, and I didn't have a dowry.  The last was the clincher.  On my part, I refused to fight with my mother-in-law and I refused to be a doormat.  So, for the most part, I stayed as far away from my mother-in-law as possible.

I knew my mother-in-law as The Woman who could make Greek Taxi Drivers Cry,  The title was earned.  Once when my husband and children were in Greece for a visit, they were going somewhere in a cab.  My mother-in-law got into an argument with the driver because she didn't like the route he was taking. He rejoined that it was his cab, he was the driver, and he was going the right way.  The cab stopped for a red light at a 5-way intersection.  My mother-in-law got out of the cab and started walking down a side street.  The light turned green and the cabbie didn't know what to do. Finally, with horns blaring behind him, he turned off his motor and got out of the car and ran after my mil. They argued up and down the side street, with my  mil crossing the street to get away from him. The horns were still blaring as cars were trying to cut into the traffic.  The police sirens could be heard.  And the taxi driver started crying.  "Please, Kyria, please come back to the car."  They argued all the way back to the car.  When they got back she saw the police waiting for the driver, she harumphed with satisfaction and got back into the taxi.  I don't know whether the driver got a fine or just the disdain of the police detail.

Some years later, we had my mil over from Greece for the summer.  She was her usual self.  I, myself, was somewhat older and a little weary of our standoff, so the summer didn't go badly.

Then in April of the following year, my husband got a call from one of her friends.  She wasn't eating. She wasn't taking her medications.  And she wasn't leaving the house.  My husband put in a call to her and found her incoherent on the phone.  He couldn't get her to make any sense.  He hung up in frustration.  Then began the worrying - what was he going to do?  Although I didn't really want to bring my mil permanently into our daily life, I knew that I had had the luxury of having my mother close by until she died, so how could I deny him the same comfort.  I said - you're going to go to Greece and bring her back.

When she arrived here from the airport, I  had a hard time grasping the change in her.  She laughed hysterically at nothing.  Couldn't sit straight in a chair.  It took months for her to become reasonably herself again.  Almost.  She was not all the way back and would never be again.  My husband had a hard time accepting this.  This incomprehensible woman was not his mother.  Since I don't  speak greek fluently, we spent a lot of time playing Greek rummy.  In this way I was able to let my husband know about the advancing  cognitive decline.  She can't tell the difference between spades ad clubs, between diamonds and hearts.  She can't tell the difference between the face cards.  She can't add up her score.  My mil had been a master card player so when I began winning, it was a notable change

Ever stubborn, my mil needed to walk with a cane and refused. Over the years that she was with us she fell again and again.  Fortunately, most of the times she fell on carpet.  We had gotten her an older dog, a Golden Retriever named Casey.  Whenever she fell, Casey would sit by her and bark until someone came to get her off the floor.  Casey unfortunately died, a story I'll tell another place.  Along with Casey dying, she heard from Greece that her last friend in the world died. Agitated, she walked back and forth, the length of the house with no cane. I had to stop my husband from yelling at her about the cane, because she only became more agitated while still being stubborn as ever.   She finally fell - not on the carpet this time, but on the hard tile floor of our front hall.  She broke her hip, and it was a bad break.  She had been with us four years and wouldn't be eligible for Medicaid for another year.  Charity care paid for her hip surgery and hospital stay, but we would have to pay for her rehabilitation stay at a nursing home.

When we arrived at the recommended nursing home after my mil had  been admitted, there was a man in the lobby waiting to speak to us.  As the man waved us down, my husband indicated that my daughter and I should go on to see his mother.  A while later, he entered the room and greeted his mother.  I asked what the man wanted.  My husband made a face  - "Oh, something about home-nursing, probably a scam."

The next weeks were fraught with emotion.  My mil knew about as much English as I knew Greek, none of it helpful in communicating with physical therapists.  My husband insisted on being present during the physical therapy sessions and that did not go well.  My mil was scared to death.  My husband was yelling, mostly at his mother, but occasionally at the therapists which he defined as emphatically explaining things to stupid people.

The physical therapists pulled me aside and asked if I couldn't keep him out of the therapy sessions.  They knew his mother was scared and felt that with  a calm atmosphere they might be able to reach her despite the language difference.  I said I would try but, in truth, I knew that asking him to let the physical therapists handle things would only insure that he would be there - he was, after all, The Son of the Woman who could make Greek Taxi Drivers Cry.

It ended as badly as you might think:  the physical therapists gave up hope.  My mil was in no shape to come home, so it seemed she was going to be in the nursing home  a long while.  To give you an idea of how much nursing home care costs out of pocket.  The weekly rate we paid would add up to $65,000 a year.  We would be going into debt.

There were some bright spots.  We all missed Casey and so we adopted a puppy.  It was a Golden Retriever/Rhodesian Ridgeback mix and so we thought he would be a big dog and we called him Alexander the Great - Alex for short.  We were allowed to bring him to the nursing home and he was a cheerful uplift for the lines of residents in their wheelchairs (This was when I first noticed  this docking of wheel chairs along the corridor.)  Eirini was cheered up by Alex as well.  One day, he got scared by something and he dived under my daughter's sweater to pop out of her neckline, making Eirini laugh out loud for several minutes.  But when our visits were up, things were bad for my mil.  She had no one to talk to.  The "entertainments" they had on offer were irrelevant for her who had lived her entire life in Greece.

Then, one day, when we came, we saw tremors along her jaw and her mouth working involuntarily.  My husband went to the nurse on duty to find out what was wrong.  "Oh, well, she's depressed so we've been giving her an anti-depressant."  When would the tremors stop?  "Oh, when she gets used to the dosage."  And when will that be.  "Oh, in  about two weeks."  More than they're not bothering to inform us, they didn't consult us or ask our permission.

Two weeks later, the tremors were still there.  My husband said he wanted her off the medication. They agreed reluctantly.  Asked how long it would take the tremors to stop, the nurse said, "Oh, about two weeks."

Another two weeks and the tremors were still there.  My husband went again to ask about the tremors.  "Oh, they may never go away, " the nurse said.

That was the last straw.  Up until the time of her accident, my mil had been treated by an old, common-sense general practioner.  When she had her accident, he told my husband, "You are going to have a lot of expenses now.  There will be a doctor at the nursing home, so I will bow out now to help you keep your costs down.  But if you ever need me, I'll be there."

My husband called the doctor who recommended he ask for a review of her case.  "I'll be there with you, if you want me to."

The case review was an eye-opener.  They were doing everything they were allowed to do  by Medicaid, but at full price.  The doctor challenged every drug they gave her.  For example, they were giving her a $200/day blood thinner.  He asked why are you giving her that - all she needs is half an aspirin.

When they left the meeting, my husband and the doctor headed for the lobby.  Waiting in the lobby was the man who had been there the first time we came, and had been there other times and tried to talk to him.  Their eyes met, and my husband thought for the first time, I have nothing to lose.  He and the doctor sat down with the man, the owner of an in-home care company.  For half the cost of nursing home care, he could provide a live in home aid who, with the exception of one day off, would care for his mother round the clock.  The doctor asked several questions about the service and practice and nodded briefly.  My husband said he'd think about it and took his card.

After talking briefly with the doctor he came home.  After we talked, we decided to try it.  Although the home aid generally sleeps in the same room as the patient, I felt that we could offer more.  My son had married and his room was empty.  The least we could do was to offer her own quarters.    Eirini was older and fragile, to be sure, but she really didn't seem to be hanging on to life  by a thread.  Let each woman have the dignity of their own space.

Our aide's name was Olivia.  She was from Ghana.  Now, I have the robust skeleton of a  Polish peasant.  Olivia was a full head taller than me and half a body wider.  She was majestic.  She and my mil got along very well.  My mil was amused by Olivia's taste in TV programs (as was I).  We were all introduced to Joel Osteen and his cheery, "dress for success" brand of church - interesting theology.  The pair were really on the same wave length with Soap Operas.  Without a broad knowledge of english Eirini had to make up her own plots to fit what she saw on TV.  When my husband translated Eirini's concept of the story, Olivia would laugh and say, "Might as well be."

I cannot tell you whether we were lucky - i.e., hit the jackpot - with this particular home care agency, but clearly Eirini benefited from being at home, and we benefited from having a skilled care aid to take charge in an area where we had no experience.  Eirini didn't talk very much, but it was clear that she was more alert than she had been for a while.  So much so that my husband thought she might be better in a nursing home in  Greece.  He thought that his mother would "snap out of it" if she were around people speaking her own language.

Now, I will agree that nursing home practice in Greece is different than in the US and in many ways better.  However, my mil did not "snap out of it".  At the suggestion from his lawyer, my husband negotiated the terms of her care in considerable detail.  In addition, at the lawyer's suggestion, he hired a woman from my mil's apartment building to visit once a week.  The lawyer cautioned that she should vary the times that she went so as not to establish an expected pattern.  Sure enough, when Eirini had been there close to a year, we got a call from our paid visitor.  The home had violated the terms of the agreement and moved Eirini to a high floor where she could no longer see the street and its traffic and had been saddled with a disturbed woman who screamed and made odd noises.  The visitor reported that Eirini was visibly upset.  The home's owner was very surprised indeed to get a call from my husband who recited chapter and verse about where their agreement had been breached.  Then he called the lawyer who would call the home then next day.  The situation was corrected promptly and we never had another problem with the home.

About four years after, Eirini died.  It was a week before Thanksgiving here.  We were expecting a house full of people on Thanksgiving.  We decided that he would go to Greece to  see to her funeral and that the whole family would go next spring so that we could all pay our respects.

Olivia had gone on to  her next care patient.  She caught a live wire!  My daughter saw Olivia and her charge in Garden State Plaza enjoying a day of shopping.  The thought of Olivia makes me smile.  The thought of the nursing home doesn't.

 

 

 

 

 

 

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Tags: aging, nursing home problems, in-home nursing care, difficult people

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