Monday, October 7, 2013

Family Makes the Difference

Mom and Dad are late in their years. Mom is 89 and has moderate dementia. Dad just turned 91 and was in excellent physical health despite a history of heart disease and bypass surgeries.

"Was" is the critical verb in the prior sentence.

Dad is the decision maker, always has been. A retired dentist who had a successful practice, he is a leader and is used to being in charge.

Also a faithful husband and family man, Dad made a personal commitment to himself years ago to take care of his wife to the end.

He will also admit that he is the world's worst planner ... except for when it came to vacations.

He didn't count on disability.

Having elderly parents, seeing their travails on a weekly basis (my commitment to them was to visit at least once a week), and watching them sunset physically and mentally, provides some awareness of the disabled state.

Dementia is a terrible disease. It progresses gradually, taking elements of memory away from daily functioning in a cruel manner. At Mom's stage, she forgets sometimes just how to walk, so she falls and then can't get back up.

Dad thought he could deal with this. He thought wrong.

Dad has sciatica and pain radiates down his leg. This started a few months ago.

A shot of cortisone every once in a while alleviates the symptoms and he goes about his days with good energy and strength. But when he has to wait because of dosing issues, or just access issues, he can't move much without a walker.

This past week was a seminal week in my father's understanding of the fragile state of his physical being when Mom's temperature sky rocketed due to infection, she fell and couldn't get up, and he couldn't get her up because of his back issues.

Finally Dad understood what I, and my siblings, had been trying to get through to him for the past 2 years - there is a time when a single person's support isn't sufficient, and in fact may further jeopardize the well being of another.

Last week I wrote about support - that an injured worker needs support from professionals, from the employer, and likely most importantly, from family, in order to truly be successful in elevating above the misfortune that was handed to him or her from an employment injury.

In my own family situation I see the same elements, though obviously without "compensation" in the way.

Dad's frustration with his physical limitations, and the vapor from pain that clouds rational thinking, were leading to bad decisions on his part. It's obvious that his thought processes were not all there - Dad's a really intelligent man, but between the trauma of seeing Mom degrade, and the depressing emotions of pain and incapacity, his logic and capacity for good judgment are compromised.

They live in a retirement community and have made many friends since they moved there nearly 2 years ago - which is not surprising. Both of my parents are gregarious and make friends easily. Even at her stage of dementia, Mom is always smiling and saying hello to the other residents. Dad is a leader and is always taking charge of something there - whether an event, getting favors for fresh spinach in the dining room, or getting folks rounded up for a trip to a local attraction.

Their friends are going through similar stages of life so the compassion and understanding of the trials and tribulations of aging are shared.

Mom & Dad also have doctors that they have great faith in. So much faith that when I suggested to Dad that he see a chiropractor a few days before his scheduled appointment in the event that a simple adjustment might ease some of the pain, his response in typically cryptic fashion was, "I have an appointment on Monday for a shot."

Fortunately my brother, a retired Navy Master Chief and currently a defense contractor at Marine Corp Air Station Miramar, lives close enough to my folks so that he can respond and help out more quickly than I can.

And also fortunately aviation allows me to traverse the 150 miles to their home in the relative blink of an eye so the demands on my most precious resource, time, is minimized and I can provide some personal support and assistance every week, and on call as necessary.

I've witnessed the frustration of Dad trying to sort through his emotions and make appropriate decisions for the care of Mom. I've also witnessed the difficulty Mom has just getting through life trying to uphold her dignity when her control over bodily functions fail.

Dad made some very difficult life decisions this past weekend - decisions he didn't want to make because there weren't any good compromises. These were black and white sort of decisions, but ones that were critical to providing the highest quality of life possible under the circumstances.

He would not have been able to make these decisions without the support of family - there is no question in my mind that while his friends and the professionals assisting them would provide some support, they don't have the influence and the weight of family.

In workers' compensation terms we call this the biopsychosocial element - where biology intersects psychology and socialization. As professionals we do the best we can with the resources we have to make things better, but the family ...

I know intuitively, and though experience, that family is a huge component to the wellness and recovery of an injured worker. Professionals and the employer play big parts too, but family support is the cornerstone.

I am not aware of any formal studies on the impact of family support to work comp outcomes and I'm not even sure how to incorporate this knowledge into the work injury recovery process.

I just know it's a big part, and injured workers with big family support systems are very fortunate.


  1. Damn, Dude - you are so Dead On. Bless you for the courage to make this post!