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Dateline: A care home in Ajijic

So what can I say about my mother? It’s a sad situation for all concerned. As many of you know, in mid-January she suffered a fractured vertebra. Fortunately, that’s pretty much healed now and not giving her any pain. Thank God! You’ll also recall that she was simultaneously diagnosed with stomach ulcers and an inoperable stomach hernia. That was doubly concerning as she was eating very little due to stomach pain. For the first time in my life, I began to worry that she might get too thin. The doctors put her on an industrial-grade antacid, some other stomach medicines, and an appetite stimulant. Fortunately, that all seems to be working, and she’s now eating normally, more or less. Yeah, they have to feed her. She’s no longer able to get food into her own mouth at anything faster than a snail’s pace. Left to her own devices, lunch would take several, very frustrating hours. So someone spoon-feeds her. Still, it’s progress over where she was earlier in the year. At least she’s getting nutrition again. So there are some positives.
The big negative is that she had a minor stroke toward the end of February. This has resulted in weakness in her left side and some mental deterioration. Despite 5 days a week of physical therapy for months now, it’s pretty clear at this point that she’s never going to walk again. The physical therapists haven’t given up trying to get her to walk, but I think she has. And it’s pretty obvious to me, a non-professional, that she’ll never walk again. Even leaning forward in her wheelchair so I can take off (or put on) her sweater causes her to shake with weakness. She can barely stand, even after you’ve hoisted her up, and that only for a few seconds. And 40+ years of my wheedling never got her off the couch and walking or doing any other exercise. So she’s pretty much wheelchair-bound for the foreseeable future.
Mentally she also seems to have taken a step down. She still recognizes me. Even when I just showed up out of the blue on Friday, she knew who I was. But it took a moment. She’ll answer questions, but is completely incapable of carrying on any kind of conversation. At least the answers make sense. But she seems incapable of initiating any kind of sentence. She tried a couple times, but forgot mid-sentence what she wanted to say, and I couldn’t figure it out.
I worry she’s in physical pain. She often looks distressed, with a furrowed brow. But I’ve now spent a week asking her how she feels, and she always says “fine” or “OK.” Even when I get specific, she claims to be fine. “How does your back feel?”
“Fine.”
“It doesn’t hurt?”
“No.”
“How does the rest of you feel?”
“I feel fine.”
“Your joints feel OK? Stomach? Head?”
“Yeah, they’re fine.”
And I go on, asking about various body parts. She says it’s all fine or OK. Though the answer is somewhat hard to believe, at this point I’ve asked her every day for a week and the answers are the same.
Still, it’s hard to believe. Apart from her furrowed brow, when she was in extreme pain from the vertebral fracture, she developed the habit of moaning on every exhalation. And she still does it. It’s become habitual and she doesn’t even realize it. It’s unnerving, and it’s why I kept asking and asking and asking if she’s in pain. Because if you just met her, you’d think she was very uncomfortable. And when I wheel her across the patio of the facility where she lives, she groans a little louder when we hit bumps or go downhill. “Did that hurt?” I always ask.
“No,” she always replies.
“You’re sure?” I ask. But the answer is always in the negative. She says she’s fine.
But she’s also unquiet. She fidgets, pulls up her blouse to look at it. Frets over the buttons. Adjusts the brake on her wheelchair: on and off and on and off. She hands me the sleeve of the sweater she is still sitting on with an expectant look like she wants me to take it away. I take it and then put it back on the arm of the wheelchair. She constantly wipes her lips. She dabs her forehead with the sweater sleeve, and I ask if she’s hot. “No,” she replies with an expression somewhat puzzled. “Why would I ask that?” her expression seems to say.
Two days ago I bought her a sort of stretchy, rubbery doll filled with sand. The doll, some kind of alien warrior queen, is pale blue and has an interesting texture. It felt weird buying my 92 year old mother a toy, but it seems like something perfect to fidget with. It’s stretchy and can be molded into different shapes. I also bought a jar of Play-Doh, figuring that it might be entertaining to squeeze it into shapes, or simply to knead it. My mother looked at these things with some very mild curiosity, but then put them back on the table with no further interest. While we hung out yesterday, I played with the Play-Doh myself, but she wasn’t interested. Instead she kept doing her regular fidgeting. I tried to redirect her fidgeting back to the doll or the Play-Doh, but she wasn’t interested.
So today I saw her for the last time on this trip. The fidget toys were no place to be seen, and presumably long forgotten. We sat on the patio with her two friends. These three women, all in their late 80s or older, just sit together on the patio, seldom saying anything. They are all “out of it,” to one degree or other. One can’t remember where she’s from or how many kids she has. The other one, who’s 89, tried to persuade me that her mother was still alive and still working as a nurse in Georgia.
I tried very hard to make conversation with my mother. I asked about pain. Still none, she replied. I asked what she was thinking, whether she remembered living in California, many other questions. I told her about my remodeling process in Mexico City. She answered very little. As we talked, she edged her wheelchair away from me. I couldn’t tell if it was anything more than leg fidgeting or if she just wanted me to stop. So I asked her if she’d mind if I listened to a radio program. She said no. So I listened to a podcast for a while. The other two women were silent, and my mother moaned softly in the background.
I had planned to spend the afternoon. But after 40 minutes, I just couldn’t do any more. There was nothing to talk about. There was nothing I could do to make her situation any better. I’ve literally done every single thing I can think of to make the last years of her life less tedious. But despite it all, she’s now just sitting in a wheelchair, staring off into space and moaning. She’s literally beyond help and yet still very much alive.
I just kind of reached my limit. So I told her I was going back to Mexico City early tomorrow, gave her a hug and said good bye. Somehow it feels close to the last time. A big part of who my mother was is already gone.
It’s harder on you than it is on her. It sounds like she’s in Transition Land, with one foot here and the other reaching out to the beyond. She’s had a good life, and she raised a good son.
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Hola Jenn,
Yes, she’s in Transition Land. Whether it’s harder for me or her, I don’t know. She has to live with it all the time, while I don’t (except for gnawing concern). But she also didn’t take particularly great care of her own health, despite continued urging from me. Especially since I was in Redding when I really pushed her to get out and walk. So she’s reaping her own consequences, which means I shouldn’t wreck myself over this. I’ve literally done what I could. Cheers and thanks for your comment.
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From your comments, it sounds like she is being well cared for. The facilities NOB leave much to be desired. When I flew in for the final weeks, I was appalled at the living conditions. The room was dirty, her sheets covered in blood from her leg ulcers. No one fed, bathed, gave her any attention at all. The “staff” were poorly trained and most looked like meth addicts as evidenced by the condition of their skin and teeth. Paid minimum wage to clean excrement, etc all day and night, I guess thats the best you can get. All for the princely sum of $6000 per month! The behemoth healthcare corporations suck you in with fancy decor and glistening brochures. Its a giant largely unregulated racket whose residents no longer vote so they get away with it. Yeah, its been 11 years and I’m still mad. Sorry for the rant.
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Hola Sr. Gomez,
My mother is getting good care, but there are things I could complain about. I won’t here, but let me know if you want me to email you. Cheers!
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Thanks for enlightening information about elder care in Mexico. What kind of visa issues are involved U.S. residents staying full time at these facilities.
Rick
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Hi Rick,
The visa requirements are the same as for any non-paid activity. You need to either demonstrate some kind of monthly income, or liquid investments of a certain level. It’s easier to get a visa temporal than a visa permanente. When my mother was interviewed for her visa at the Mexican consulate, I went with her and did most of the talking. She was already having some age-related memory problems. This didn’t seem to be much of an issue. I said I had planned to get a visa myself and wanted to be near her. But I would have to apply in Boston whereas my mother applied in California. Hope this is helpful. Cheers!
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My dad’s decline was very similar. When he died at 80, he had intermediate stage Alzheimer’s and the onset of Parkinson’s. (we know with certainty because we had a brain biopsy done). With the Parkinson’s, he couldn’t balance well and needed a walker, but he couldn’t remember how to use the walker, so he fell and ultimately broke his hip. He never recovered the ability to walk and spent close to the last year of his life in a nursing home.
Ultimately, he died of an infected gallbladder. After consulting with my brother and my dad’s physicians, we decided to keep him as comfortable as possible and just let him go, as the future was nothing but bleak. Regarding the pain management: he would always say that he felt fine, that he didn’t have any pain. I think because he didn’t want to be seen as a bother. So we simply made sure that he was on a regular steady dose of pain relief, no one had to ask him how he felt, they just kept him drugged. You may want to consider something similar for your mom.
What you and your mom are experience experiencing is never easy, and you are doing the best you can in what is an unhappy situation with no good alternatives. All the best to you.
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Hola Deborah,
Thank you for commenting. I’m really heartened by the number of stories that parallel my experience with my mother pretty closely. I’m sorry for the loss of your father, but I think you made the right decision to let him die. At this point, were something similar to happen to my mother, I think I’d decide the same. Thank you.
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What a change in just a few years, it hasn’t been that long since we had that nice lunch with her at Tabarka in Ajijic. I am so sorry to hear she’s had such a rapid decline. xoxo
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Hola Nancy,
Indeed the decline has been even more rapid than that. She was pretty OK at Christmas, and now this. Thanks for the kind reply. Cheers!
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Oh my gosh Kim, This post really touched my heart, my husband and I are going through the same situation with his Mom and it is so hard to watch. Don (my Hubby) has a hard time going to visit because he tells me the same thing that you mentioned, she only responds to questions, there is no conversation, just a lot of yes and no. Unfortunately, she has aggressive Dementia so her short term memory is gone. I have known her for 15 years and have come to love her very much, and to watch her body and mind slipping away is so hard. But on the lighter side of her having dementia, she doesn’t realize that she has been in the Care Home for a few months because she thinks that she goes home every day to watch TV and then comes back, so there is that!! Don’t carry any heavy guilt for having to leave Kim, because I have been reading your blog for quite a few years and I know without a doubt that you love your Mom beyond measure. I think you are a wonderful son and she is so lucky to have you in her life. So, even though you aren’t right there with her, she knows your heart is there my friend and that is what true love is all about!! Sincerely, Donna
Sent from Outlookhttp://aka.ms/weboutlook
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Hola Donna,
Thank you so much for your kind comment. It’s really very heartening to know that a lot of other folks are going through the exact same thing. My mother is my first elderly relative that I’ve been involved with so late in her life. I didn’t really know what to expect. I’m sorry you are going through this with your husband’s mother. It’s sad to watch. But I guess in the end, we all are going to age and die. It’s part of life. Thanks again, and thanks for making your first comment.
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I was sorry to hear the news about your mom. You and your mom are in my thoughts
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Hi Marc,
Thanks for the comment. It’s nice to hear from you. I hope you’re well. Thanks
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Very sorry to hear about your mom’s situation. I had to go through that with my own mom, who developed all sorts of physical problems, including incontinence and loss of mobility, though her mind remained surprisingly clear. “Winding down” is an inevitable part of life that catches up with one’s parents and ultimately ourselves. It’s one of those things “that cannot be changed” and that we must learn to accept, as the old adage says. Hugs and hang in there.
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Hola Al,
Yes, the latter bits of life are indeed part of that life. My stepfather went pretty quickly, after about a month of being “off.” But he was lucid to the end. When we lost him, we lost all of him at once. There was no wasting away. Now that I’m writing this, I realize I miss him quite a bit. But as you say, (paraphrasing) death is part of life, and we just can’t change it. Thanks for the kind comment. Cheers.
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Hi Kim. I’m sorry to read about your mom. Just remember, the road of life get’s bumpy near the end, and there’s not much you can do about. It is the price of living a long life. I have one suggestion: as we get older, our memories start to slip, with newer thoughts rather than old. I liken it to the hard disk in my computer. The old data got there first and found an easy route. Newer data has to split up and find different places to be stored. It doesn’t seem so important to remember it. Right now, I can’t remember where I put my next book of blank checks.
Instead of asking your mom about something that happened six months ago, ask her about her favorite restaurant or maybe the name of your music teacher. I can remember the name of my violin teacher from grade school. Or maybe the lady’s she played cards with many years ago. If you took a trip with her 30 years ago, ask her the name of the hotel where you stayed. I think you’ll be surprised with her response.
One other thing, take her for a walk in a park, or maybe by a school ground. She’s probably more interested in seeing children playing than seeing somebody in a wheel chair. Just my 2 cents, as they say. Take care.
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Hi Phil,
Thanks the sympathetic comments. Sadly, last year my mother couldn’t stop talking about her life as a teenager in Copenhagen. There was one dinner in particular where we ate dinner outside with a view of the San Juan Cosalá mountains. Every time my mother glanced at the mountain, she told us about the tallest mountain in Denmark, a country that’s pretty flat. Over the course of dinner, she talked about this mountain a couple of dozen times. Now? I asked her if she could remember Denmark, or Copenhagen, but she can’t really. And she can’t walk either. So here we are. But thanks for you kind thoughts. Cheers.
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I went through the exact same thing with my mom including the fractured back and the hernia. They sell items for the fidgeting but my mom, like yours would only try it for a minute then set it down. The visits become shorter and my mom seemed devoid of any feeling, good or bad. It is like the shell of the person only remains. Even though I was close by I could only go once per week for hour when previously I would go every other day. Years ago she told me when she dies she wants to go to sleep and not wake up. On February 13th she did just that.
I don’t know what I can say to help just that you have done everything you can. I understand how unsettling it is not to be able to help her. Growing up , My mom would always say «try not to worry dear, worrying doesn’t change anything.« Kim, try not to worry. It is heartbreaking to witness and we feel helpless and our mind keeps trying to think of different ways to help them.
I know by reading your words you a kind and loving son to your mom and being a mom myself there is nothing more in the world your mom could want.
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Hi Cathie,
Thanks for the kind words. It helps knowing this is not uncommon. I’m sorry for the loss of your mother, but I can also very well understand that you get to a point where it’s time to go. As for me, I just don’t want my mother to suffer. I can’t imagine living in the state she’s in. But here we are. We all just have to make the best of it. Thanks.
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My mother suffered a minor stroke following hip surgery. She had lucid moments when she explained to me that sometimes she could simply not find the word she needed. She might be cold but the word for the feeling of cold no longer existed for her and she could not ask for assistance. It was so frustrating for her and for those trying to help her as they tried to guess what she was trying to say. She knew exactly what she wanted but there were no longer words for it. It is a very helpless situation. All we can do is to make sure they are cared for and to be there for them when we can. You have my sympathy my friend.
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Hola Croft,
Indeed, I think that’s my mother’s problem. She just can’t put her finger on the word she wants. And I can understand the frustration. Jumping back and forth between Spanish and English, I can often only think of a word in one language. A friend of mine asked me the other day if I had a tool to break up tiles. All I could think of was the Spanish word, “rotomartillo,” for hammerdrill. Thanks for your kind words.
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This was difficult and heartbreaking to read about your mother, and yet wonderful to read of your warmth and selfless acts. Hopefully she isn’t in pain and understands the beautiful relationship between the two of you.
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Hola Perry,
Yes, it’s very sad. I have done a lot for her, but I wish it could have had more effect. At least in staving off this last stage. Thanks for your kind comment.
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Kim, I know it is hard to watch your Mother’s decline in her remaining years; so many of us go through it; as with my Dad, at 91, he had started having skin sensitivity; bought him an expensive cashmere sweater (so soft) to stop his irritation and hand washed it with a special medical detergent. As far as conversation, we used a large album of old family photos to determine who he might recognize; he recognized his mother and father a lot, but not many more relatives. In fact, he began to believe his mother was still living; I never corrected him; it seemed to give him some peace to talk about her. Bless you! You will get through this.
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Hi Dee,
Thanks for the kind comment. I’ve tried showing my mother some photos but her macular degeneration is such that I don’t think she can see much of the photos. The last time we did this she didn’t really recognize folks she should have recognized. Sigh… I’ve gotten lots of good ideas from people, but we seem to be beyond them. Thanks.
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My heart sinks as I read one sentence after the other, as if a part of me would rather not read on. The fidgeting, the moaning, the empty gaze are all too familiar and painful. I close my eyes and see myself sitting by a silent old lady, asking myself where my loquacious mother went. It’s just overwhelming. I know exactly what you feel and just don’t know what to say to you, Kim. All I can do is send you a big, big hug in the distance.
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Hola Tino,
Thanks for the kind words. Indeed, it is sad, and at this point, inevitable. I guess I kind of harbored some hope that she’d get better. But my first instinct when she fractured her vertebra was correct: it was the beginning of the end. I cried at the time, and maybe that has somewhat insulated me from what’s going on now. Thanks for the hugs. My fondest hugs back.
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Very sorry to hear this, Kim. I send hugs.
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Hola Michael,
Thank you. That’s very kind.
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I can relate. I experienced the same with my mom and grandmothers. A time comes when interacting as before is no longer possible. What you have done for your mom the past years and now is what all mothers dream of. She is the luckiest mom in the world!
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Hi Fred,
Thank you for your kind words. It’s actually comforting to know that you have gone through something very similar. I guess this is the curse of living a very long life. At the end things get dicey, and God only knows for how long. Hugs!
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I believe like coma patients they know you’re there and it comforts them. You may not get the response you want but console yourself with that knowledge. My mother could only lash out at everybody with anger and paranoia. However, every once in a while, she would laugh at something on TV, or hum along to a tune she heard on the radio. Her favorite lotion, perfume or a sweet snack would sometimes get her attention. Talking about the “good old days” would sometimes jar loose memories of happier times. Don’t give up. I know its hard and exhausting but everything you do helps her cope with the imprisonment of her mind. Best wishes to you both.
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Hola Sr Gomez,
Thank you. I think you’re right. My mother was obviously pleased to see me. Even if it was difficult, I was able to bring some joy into an otherwise pretty bleak life. And indeed, I was in Ajijic for a week, and spent 3-4 hours a day with her. It was only that last day that I just couldn’t take any more. But I’ll be back in a few months again. Whatever her condition, she’s still my mother, after all. Cheers
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