caring from a distance

"Grandma is in the hospital"

it is one of the worst texts you can receive first thing on a Sunday morning. Your thoughts race as you contemplate about what happened; is she okay; and what does she need to get back to where she was? While all these thoughts race through your head, something that you might not consider is--is this the moment where her level of care takes a turn?

"The turn," is a figure of speech used to describe a change in direction, here it is something I refer to when someone's physical or mental ability status changes.

This can be from a traumatic accident or a simple fall in the night. This "turn" changes the person's level of care, meaning their physical and mental (even emotional) needs are different now. Therefore, care takers of this individual must now adjust to maintain this person's level of autonomy.

When I received the text notifying me of my grandma's hospital stint, I was filled with a sense of dread. I also realized fairly quickly, this visit was "the turn," as she went from being independent and walking in her own apartment to not being able to sit up in her hospital bed, all seemingly in an overnight span. Due to her socio-economic status, she was quickly discharged to a medicare skilled nursing facility. When she was discharged, she was in a state where she couldn't sit up nor walk on her own--a dramatic shift from living independently days before.

My family realized straight away that my grandma's care level had shifted. She could no longer live in her own independent living retirement community as she could not perform ADLs (activities of daily living). Moving to a new facility was deeply concerning to my family. We knew the move would be confusing but also physically stressful for her. Currently my grandma lives multiple states away from close family and myself. Although she has access to family nearby, my immediate family who isn't close by wanted to ensure she was adjusting well to the new facility and her new way of life.

During this time, I asked myself--how do you provide care to someone who lives multiple states away?

While we were concerned about my grandma's transition, something more pressing happened--her health went into steady decline as she rapidly began losing weight. Over the span of three weeks she lost nearly 20 lbs which is deeply concerning for someone in their 80s. When family members inquired about this to healthcare professionals, our concerns were brushed off and were told how her vital signs were all normal (implying it was fine).

My family and I sprang into action and flew to visit her immediately. During my visit to see my grandma, we made many inquiries at her new facility. First on the list was her dietary restrictions, prior to living in the facility she was on a heart healthy diet which limited what she could and could not eat. This was immediately scrapped. She could now eat anything and everything she wanted in order to address her rapid weight loss. Next, we noticed she had not received grooming care since her visit to the hospital, therefore we made her an appointment to the facility's beauty salon. There she got a hair cut, style, and manicure.

During this time, we saw her show many changes and overall improvements. She began sitting up in bed on her own, and working toward larger physical therapy milestones including walking once again with the assistance of the rehab team.

This showed us the impact of how different care givers affect one individual. Her care team of family, facility nursing staff, rehab personnel, and her physician were able to intervene and change her downward path to create upward change.

These small actions of care changed my grandma's daily outlook and she began conversing more by the final day of our visit. We knew that we couldn't stay with her forever, but we felt comforted knowing she was better adjusted to her new facility. Although she is still adjusting to this new way of living, "the overnight turn" is something a lot of families encounter in their loved one's care journey. It is how families are able to adjust and help their loved one's cope with their new lifestyle that shows the importance of care in aging populations.