I was up at the crack of dawn this morning (what else is new?) but this time to take my dad to a specialist appointment. We are the first ones here, even before the receptionist!
Since I have taken over this role of being present at most of my parents’ various specialist appointments, I have come to enjoy watching another physician do a physical examination. It’s a great refresher for me, especially the neurological exam. This was my nemesis in medical school. It is probably the most complex sequence of tests and observations I have ever had to learn and I still feel like I never mastered it.
Today I witnessed a skilled clinical fellow perform a thorough neurological examination on my dad.
I knew everything she was doing and why. There were tests I had forgotten about, ones that are very specific and others more general. At the end of the 3 hour appointment, we had some answers and now a few hours later, I have nothing but questions.
I need time to process. I know the road ahead of us. I’ve seen patients and their families go through it. It’s not what I wanted for my parents, least of all my father.
But this is life. It is hard. It is ugly. It is rewarding. It is love.
Last night I took my elderly father to his MRI appointment at a downtown hospital. As the machines in my city run 24 hours a day, 7 days a week it wasn’t surprising to me that his appointment was for 10pm. Both my parents can drive but neither my brother, nor myself or my husband wanted them driving that late at night, so I decided to take him myself.
Walking through the hospital hallways at night reminded me what I loved most about my medical school and residency training. The quiet and tranquil feeling of walking down a hospital corridor at night. No matter what kind of day I had, or night for that matter, being allowed to roam the quiet hallways at night was always comforting for me. It didn’t matter if I had just lost a patient or was heading to the ER for yet another consult, walking those quiet hallways was like therapy. I honestly felt right at home. The lights are dimmed. Patient care areas are quiet except for the occasional sounds of IV machines beeping. Cleaners are buffing the floors. I might see another resident walking in the opposite direction, sometimes a family member from the ER who had gotten lost and asked for directions back to the unit. It was a privilege to be one of the club.
For a few minutes last night, I yearned to be back in that club again.
My brother and I had a long talk the other day about our parents. He has positioned himself to be their power of attorney for finances and I am their power of attorney for personal care. In the past year, it has become evident that we may need to start exercising our roles. I can’t tell you how sad that makes me.
Growing up, my father was larger than life. He was a tall, formidable man with a deep voice but he was for all intents and purposes, a gentle giant.
Over the past year or so he’s become impatient, occasionally verbally aggressive toward my mom and is forgetting things. He was diagnosed with mild cognitive impairment last fall but his condition seems to have deteriorated in the last 3 months. He has a much shorter fuse now and asks my mom to repeat things several times a day. He denies feeling depressed but we all think he is. Thankfully his family doctor suggested a trial of a low dose antidepressant and he actually agreed.
He will be having an brain scan soon. I fear it will be normal. Why? Because the thought of watching him continue down the road of dementia is heartbreaking. It would frankly be much easier if he was diagnosed with a brain tumor. I don’t think I could bear the day he forgets his grandchildren and then me. I don’t think I can watch him become aggressive and angry and frightened at his memory loss. I see it already happening with my maternal grandmother.
And there’s the kicker: dementia on both sides of my family? What does that mean for my brother and me? Are we destined for the same end?
We talked about all of it. Dad won’t want to go into a nursing home when the time comes. Will I have to have him declared incompetent and take over as POA? If dad moves into a nursing home, mom won’t be able to stay in the condo; will she live with me or my brother or alone in an apartment? How long are we going to have to watch him deteriorate? He would never want to live like that. I certainly wouldn’t.