Should Have Seen It Coming

When Mom called to tell me Dad had fallen out of bed and couldn’t get up, I rushed to their home thinking how unprepared I was for the ensuing trauma. My father was in poor health. A smoker since age 9, he had chronic obstructive pulmonary disease (COPD). Dad’s left eye and face had been severely damaged in a hunting accident, and he had a heart attack at 64, followed by a stroke. Most of all, my father loved to drink and talk. He’s loveable but stubborn and determined to live life his way. That night, he had too much alcohol and fell out of bed.

Little did I know that Dad and my mother, who was suffering from mild Parkinson’s disease, were about to spiral downward into medical nightmares.

The Crisis

At the hospital, the doctor informed me that Dad had crushed his hip. He was immediately transferred to a shock trauma unit, where a world-renowned orthopedic trauma surgeon told me he could not operate because Dad wouldn’t survive surgery.

Medicare and insurance carriers decide patients’ medical institution level and assigned my father to a sub-acute unit. He was nowhere near ready for the rigorous physical therapy of a sub-acute unit, because he wasn’t yet medically stabilized. Dad almost died, but instead, he succumbed to vascular dementia and was transferred to a nursing home.

Transfers happen quickly, and quality facilities are scarce. Dad was sent to a low-rated facility in 2009. The equipment was broken, the therapy was sparse, and my father laid in a bed across from a dead man for almost a day. Every morning at 4 a.m., I had to calm my father, who was screaming and kicking the door to get out. I eventually took him home and hired a nurse to come in a couple of times a day.

It was short-lived, as he kept trying to leave to break into a neighbor’s home, thinking it was his.

He had another brief stay at a hospital and then another nursing home with a slightly better rating. This three-star facility was prettier, and the staff members were caring, but the programming was slim. Patients wandered the halls or lay in bed, as if they were waiting to die. I took Dad home again and tried adult day care.

Day care for early-stage dementia is cruel, as patients don’t have symptoms until sundown, so they look on at advanced-staged patients, which reminds them of where they will be at the end of the day.

The Department of Aging and the Veterans Administration saved the day. They sent Dad to a magnificent facility with an amazing dementia unit.

I was so focused on Dad, I didn’t see Mom’s Parkinson’s escalating. During one episode, she fell and broke her shoulder. Coupled with a debilitating bone disease, she soon couldn’t walk. During one of many hospital stays, a doctor gave her Haldol, which causes Parkinson’s patients to have paranoid delusions.

This medical mistake turned into a blessing. Mom was transferred to the psycho-geriatric unit at a geriatric center, where she was treated by renowned Parkinson’s specialists. She recovered mentally and was transferred to the affiliated nursing home. It looks like a grand hotel and provides similar services.

My parents were finally at peace, and so was I.

Five Tips in Seeking Nursing Homes

First, plan ahead. Buy long-term care insurance if you can afford it — and do it early. Current medical care normally involves nursing homes for most seniors.

Second, at the first sign of a disease, search for skilled nursing facilities that specialize in the disease(s) that will need to be treated. Most states’ Departments of Aging have free counseling and planning programs. Volunteer at, donate to, or somehow keep in touch with the facility of choice, so that it will be able to expeditiously find a bed when needed.

Third, consult expert doctors for the specific disease to make sure they will provide medical care during nursing home stays. Most expert doctors don’t attend at nursing homes but oversee doctors who do. Most patients don’t realize they have a choice to go to outside doctors’ offices after being admitted to a facility.

Fourth, be active with your loved ones. Remember how scared parents may become as their illnesses progress. It can be difficult to visit. Participate at the facility. I arranged with the nursing home to volunteer for holiday programs. It was ideal for my parents, other patients and me. Be creative with your talents.

Fifth, be good to the staff. Working in a nursing home is challenging even for those who love their jobs. They are not always at their best, but it is important to let them know how much you appreciate their work.