Thursday, June 6, 2013

The Nanny State

G'ma doesn't remember that she broke her leg last week.  She has no cast, so there's not a visual cue to start her memory churning.  She is not in pain when she's not moving, which is most of the time, so there's not a physical cue to remind her.  She doesn't notice that anything is different at all.

The problem is, she is not allowed to bear weight on that limb for five more weeks.  She can touch her toe to the ground for symmetry and balance, but 99% of her body weight must be borne by her left leg.  Should she put too much pressure on the damage leg, the plate and screws securing it to her soft bones will not hold.

She has to grow more bone over the hardware. That thought has not made it into the permanent memory bank. The orange discoloration from the betadine washes has faded.  The bandage covering the incision on her thigh is comfortable.  There's no reason to fill her with sorrow as she contemplates the failure of yet another body part.  For the most part, it's a good thing that she doesn't remember the pain and the fear and the trauma.

On the other hand, she's not safe.  Should she stand up, she'll fall down.  On so many levels, that would not be a good thing.

I tried to conjoin the broken leg story with the Christina-and-I-were-shot story.  That one is embedded, deeply and sadly, and can be called up without too much trouble.  I thought that if I got her attention by reminding her that bullets ended our little friend's life and put the hitch in my gitty-up that I could then attach the broken leg saga to the attention she was paying to the gunshot story.

It was a good idea, at first.  She was focused, her eyes were riveted on mine, her face was screwed up in sadness.  It lasted for a minute or two, and then she wondered why I was hollering at her.

I sighed.

She is sitting on a chair alarm.  As long as the staff remembers to leave the main control panel untouched, bells will chime and an alert will sound if she moves her body weight off the plastic pad.  It works. We tested it.  It doesn't take much to set off the noise, and that's a good thing.  The staff love her, and they come quickly to her aid.

The pad moves with her to the wheelchair when she goes for meals and activities. There is always someone around her at those times; I'm not concerned about her safety.  She can watch movies in the rec room, do crafts projects at the big table, join Glenna and Rita and Fran for meals in the dining room, and there's always a watchful eye nearby.

On the recliner, the notes I taped to each arm seem to be an effective reminder.  DO NOT STAND UP! PUSH THE NECKLACE BUTTON FOR HELP! ... in black marker, in capital letters, angled to catch her attention... it's not much of a style statement, but it's doing the job.

My worries are about the bed.  We rented a low-rise-hospital-bed.  The mattress, yucky plastic now covered with a comfy egg crate topper, isn't too uncomfortable.  The twin sheets are smooth percale, remnants of the Cuters' childhoods.  Her pillows and blankets are her own, recognizable, familiar, comforting.  There's a crash pad on the floor beside the bed frame.  The frame itself can be lowered to two inches above the ground.  There's not much danger if she rolls off the bed.

But she's not likely to roll off the bed.  Instead, she is likely to want to get up for a bathroom break at 4am.  She is going to try to extricate herself from the sheets, turning her legs toward the floor, which will be there much sooner than she expects.  The bed alarm will ring.  The aide will come running.  It might not be quick enough to stop her. She could twist or turn or otherwise injure her already compromised self.  It's not a pretty picture; it's all that was in my head.

The obvious solution is to put a side rail on the bed.  One edge is against the wall, under the window with the sunset view.  If there were a rail along the other side of the bed, she'd be unable to get into trouble. I would be able to sleep at night.

The problem is, such a rail is not permitted.  The State of Arizona has rules and regulations governing the care of people in institutions like the pod castle, and those rules and regulations specifically prohibit side rails longer than 18".  That's the length of your forearm from elbow to fingertips.  It's the distance from the head of the bed, past the pillow, to just below G'ma's chin.  It will make her feel like she's in jail when she opens her eyes and it won't keep her in bed.  It's not even long enough to be useful as a handrail to sit up.

The rental company won't leave one longer than 18".  The pod castle administrator won't let me install one longer than 18".  The visiting nurse tells me the same thing. G'ma is as safe as the law allows.

That's not very comforting.  I contemplated sleeping on the floor next to her, until I admitted that at 61, with my own, very valid, aches and pains, I could believe TBG's reassurances that the trained professionals will be there to assist her.

At a certain point, I have to let go.  I have to trust the caregivers to be just that. This is exactly the situation for which she is paying her rent.  She needs assistance now, more assistance and safe-guarding than she has ever needed before.  That is why she is living there and I have to take two deep breaths.  I did.  I swam, I ate, and then I realized that my anger was misplaced.

I can call the doctor and ask him to prescribe a longer rail for G'ma until she is able to safely put weight on her leg.  Even if he won't, I'm a little less anxious now that the first few nights have gone so smoothly.  I laugh at myself, remembering that every snort and sniffle coming from Big Cuter's tiny little self in the cradle at the foot of our bed sent me shooting upright, bolting from the covers, for the first few nights he was home.  I thought then, and I am thinking now, that there is a way to keep them free from harm. Silly me.

She's happier and more alert with every passing hour.  She's as connected to the world as she was before the surgery, and she's as snarky as ever.  I need to relax and let life go on.

Oh, remember that misplaced anger?  Here's where it is, right now:
Okay, Arizona. Explain this to me:   
I can bring a loaded, concealed, Glock 9mm, with an extended magazine, into a church, or a bar, or a concert hall.....
but I can't put a side rail on the side of my demented mother's bed to keep her safe. 

I'm just sayin'....


  1. My blood just boils when I consider the insanity of Arizona's gun laws. So many examples like the bed rail.

    1. Furious doesn't begin to cover my reaction, Carole. Arizona is wonderful in so many ways... if only the politicians would get out of town :)

  2. Hang in are saying what you need to here...feeling what you need to feel. I am not in your position, but have worked with assisted living and nursing facility folks...and also mistrust most of them that they could possibly do what I would want done for my loved ones. Might I suggest using whatever spiritual meaning you have to get support for yourself? I just send you my own small support via this message, and wish all the best for you and yours.

    1. And the support was felt, consumed, and appreciated, B <3 I take deep breaths and ask for help... and hope someone/soemthing is out there listening.

  3. Wow, the last part got me and it's a great example of how screwed up some laws are. The rail length is utterly ridiculous. Can you put the rail in the part of the bed she is most likely to try and get out? That might help some. I chuckled at the big notes on the chair.

    Hope you are starting to relax. You trust where she's at. She is in good hands.

    Megan xxx

    1. She is in the best hands for the situation, given my lack of willingness to take her into my own home... which she doesn't want anyway... and which would send TBG running for the hills. No one can be around her 24/7.... she likes her privacy, too.

      It's been 2 weeks and she's still alive... that has to count for something!


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