Following that night I spent with Dad after my first unsuccessful shower weekend another week went by. That Friday I came to dad's house and he, again, was very weak...too weak to shower. Again, I spent the night. Mike stayed with me. Early that morning Mike went home to feed our dogs. I stayed and made breakfast for myself, Allison and Dad. I made eggs, cinnamon toast and sliced strawberries. Dad enjoyed the homemade breakfast while I observed. He was having trouble locating his mouth with his fork. It crossed my mind that he was still just tired but I messaged Paula letting her know what I was seeing. We agreed to keep a close eye on him for the next couple days. After breakfast, Allison and I hugged Dad and promised to come back that night.
We returned, as usual, at six o'clock, Saturday. Dad was standing when Mike and I entered and it was apparent that he had lost control of his bladder. We would have to insist on a shower no matter how difficult it would be. Dad fought us as best he could, arguing, promising to shower later, getting angry and demanding that we leave. We finally caught him off guard and got him to sit down in the rolling walker. Tipping it backward we rolled him into the bedroom. He continued to protest, even going so far as grabbing the door frame. It was at that point I decided, "This is getting unsafe. After tonight I will need to say something to Paula. We have to get help with hygiene." Dad finally gave in and showered. It took a while but he definitely felt better when he was clean. We followed up with dinner and a movie as usual. It would be the last "normal" evening for a while...possibly ever. I had a gut feeling that we were about to be hit with another big wave of change. The next day would prove me right.
Our family always celebrates birthdays on Sunday. Since my niece, Tom's daughter, turned sixteen in October, it was time for a party. Text messages flew back and forth through out the day. "What does Casey need/want?" "Is Ann making the cake?" "I can't make it to the store, can you pick up _____?"
I had made it home at three o'clock after choosing gifts to bring and getting fruit to make a fruit salad. We began putting together our packages when I noticed I had missed a series of texts from Paula and responses from Bradley.
Paula: Dad fell in the bathroom. I have been trying to help him and am drenched with sweat. Need help.
Bradley: I am an hour away. I'm sorry. Wish I could help. Call Dad?
Paula: He's at work. I guess I will call 911.
Bradley: On my way back. Did you call?
Paula: Called. On way to emergency room.
We knew which hospital so I responded: Just saw this. Meet you there.
I quickly told Mike what was happening and we jumped in my car and raced to the ER.
As we walked through the sliding doors, Paula exited the automatic doors of the patient rooms. She walked straight to us.
"Dad isn't able to talk other then the occasional whisper and he isn't making much sense. I haven't been able to reach Hillary yet", she informed us.
"Okay, should I come back with you?" I asked. Bradley entered the ER just as I said this.
"You can. They will only let two of us in at a time."
I gave Mike a quick hug and kiss and followed Paula, glad that Mike had Bradley to wait with him.
Dad was in the room immediately after the automatic doors. They had really just arrived. We helped keep him calm as his IV was administered. He was also given an automatic blood pressure cuff. During that first hour he said a total of three words. When Dad's blood pressure cuff squeezed his arm uncomfortably he belted out a breathy "JESUS CHRIST!" A little while later when a tech came to take him for a CT scan I told him I would go with him and he managed an "Okay". That was pretty much all I heard from him that first night.
I stood in the doorway as he was positioned for his CT scan by two talkative techs. He was very agitated and kept moving and making noises trying to voice his confusion. I continuously called out, "It's okay, Dad. Stay still. They aren't going to hurt you." Then they closed the doors and I listened. I could hear the techs chatting and laughing as they did their job. Could they not see how confused and frightened Dad must be? I sat in the hallway, helpless as I waited for them to finish their scan. A woman in a wheelchair was in the hall with me. She was next for a scan. The waiting was awkward. Should I talk to her? Ask her how she was? Mind my own damn business? She broke the silence.
"Your Dad doesn't like hospitals much, does he?" she asked with a knowing smile.
"No, ma'am...no he doesn't. Ironically, he's a doctor", I replied.
"They're the worse patients", she smiled.
"They certainly are", I nodded, smiling back.
The doors opened and the techs wheeled Dad out and back to his room. He held my hand tightly as we made our way back. He was frightened and disoriented.That first night was a series of tests, scans, blood draws, poking, prodding and, above all, no clear answers.
Over the next several days it appeared Dad had a break with reality. The few intelligible words that he spoke indicated that he thought he lived with his parents in Ohio. Other interesting things he said were that he had three sons, five daughters, five cats and five dogs. Dad usually knew Paula and Hillary and for some reason also knew Mike by name. He was still comfortable with me but not sure who I was. After an ultrasound it was determined that he had had a TIA (Transient Ischemic Attack) or mini-stroke. Whatever had brought it on, it appeared to have accelerated his dementia. The second night he was there he ripped out his IV three times and continuously pulled off his leads. Because of the swelling in his legs, relocating the IV to a nonstandard entry was not an option. Hillary texted me and Paula, so frustrated and out of ideas to control him. We had no helpful suggestions.
From time to time Dad would become aggressive with the staff, demanding to leave, lashing out verbally and physically at the nurses trying to help him with toileting, changing, sitting or standing. We did our best to calm him but even we, his family, were not entirely safe. Each of us had to deal with his combative temperament. Once he managed to hit Paula in the face. He wrestled with me and Hillary. I remember after three days marveling as two tiny nurses came in to help with toileting and thinking, "Really? You couldn't find ANYONE bigger than me?" (Recall, I'm 4'11". Yes, they were that small!) The few times that he would remain calm we would try to explain to him that he had had a stroke. This explanation never stuck for more than a few minutes and eventually he would demand to know what was going on and try to get up to leave. Ultimately, we had no choice but to allow the nurses to sedate him for the safety of everyone including Dad.
Hillary covered many of the day shifts while Paula and I covered afternoons and evenings. The stroke ward was understaffed and it was important that we tag team it until either Dad remained cooperative or the staff was able to cope with his bouts of frustration. Doctors took me and my sisters aside individually and counseled each of us that it was no longer safe for Dad to live alone. Clearly arrangements would have to be made. By day five, the neurologist decided Dad should be released to a rehab facility for seven to ten days. I took the afternoon off to relieve Hillary and she went home, half delirious with exhaustion, to sleep it off. I stayed and awaited transfer orders. Around three o'clock we were told a transport to the rehab facility had been arranged and Dad could get dressed. Bradley stopped by with shoes for Dad and helped me dress him for transport. Still unable to stand for more than a few seconds Dad wanted to leave immediately once he was dressed. Bradley and I helped him to sit in a recliner in his room for the remainder of the time as we awaited his ride. It was clear he still was not in reality. He was sure that on the other side of the bathroom was a living room and wanted to go lay down on the couch. Dad also was convinced his house was only two blocks away rather than across town, and that he could easily walk there on his own.
Finally the nurse came in to tell us the transport was there and asked if he was ready. We would have preferred she had worded that differently. Of course he was ready.
"Okay, let's go!" Dad said, trying to stand.
"No, Dad, they're going to come up and get you", I said trying to keep him in his chair.
"Why? I'm just going home", he said.
"No, Grampa", Bradley explained, "They are taking you to get physical therapy."
"But I can walk just fine", Dad insisted angrily.
"Dad, you can barely stand", I said firmly, still trying to restrain him as he attempted to push us out of the way.
"Grampa, everyone leaves on wheels", Bradley said, "Even you."
Dad calmed down.
I knew the transport people were a few minutes late so I went out into the hall to see if they were on their way, There they were. Instead of a couple orderlies with a wheel chair, two huge guys were rolling an ambulance gurney down the hall. I went back into the room and quickly whispered to Bradley what was coming.
"This is going to be bad", he said with a look of fear.
"I think we should get out in the hall and let the transport team do their job", I suggested. Bradley agreed and we cleared out, waited and listened.
From inside the room we heard a few profanities from Dad followed by a loud, "Why do I have to go on there?"
"Sorry, sir. That's just what the orders say", one of the orderlies replied. A few seconds later they wheeled him out. Dad didn't see us in the hall. I grabbed his things and Bradley helped me to my car.
"Wow", he said in the elevator, "I'm surprised that went so calmly and quickly!"
"Really?" I smiled, "I'm more surprised the nurses weren't cheering and calling out 'Bon Voyage'!"
We both giggled. A rare moment of humor before the next storm.
To be continued....
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