Post 58: "Why Didn't Mom Tell Me She Fell?" - A Common Caregiver Question
"Why would my mom lie to me about her fall? Why would she hide this?"
I sat next to the 74 year old woman. Rose was a new patient, and she answered questions like "How are you doing?" and "How do you spend your day?" For other questions, she would look towards her daughter Vanessa, sitting next to her with a pen and notebook, to confirm that she was answering correctly. Sometimes Vanessa would jump in and provide an answer when her mom floundered.
"Have you had any recent falls?" I asked.
"No," Rose answered.
"Well," Vanessa interjected, "You did fall last year." Vanessa turned towards me, "She was alone in her room. Sounds like she was returning from the bathroom to her bed and it was dark at night. She says she tripped and fell. She says she was able to get back into bed again. But she didn't tell me about this for days! I call her every day to check on her. She never told me! Until finally, I guess the pain was too much, and she told me she needed to get her hip looked at."
Looking at her mom, Vanessa quietly said to me, "She had a hip fracture for days, and we didn't know about it! She just lied to me about being fine. I don't know why she would lie to me about that." Vanessa paused with a hurt look on her face.
Being a caregiver, especially an adult child caregiver for a parent, can be a daily push and pull, attempting to find that balance between respecting your parent's independence, privacy, and sense of control and putting into place measures meant to keep your parent as safe as possible, which sometimes may feel like restrictions, hovering, or just too much change for your parent.
There are many things a caregiver might do in an attempt to finding this balance, specifically attempting to keep their loved one living in their own home for as long as possible:
· calling daily to check in on a loved one
· setting alarms in a loved one's phone as reminders to take medications at certain times of the day
· visiting the loved one daily
· visiting weekly to set up a loved one's pillbox and/or counting pills to see if medications are being missed
· visiting daily or weekly to do the laundry, mopping, vacuuming, meal prepping, and/or lawn mowing
· setting up automatic bill pay for a loved one or taking over the big finances
· bringing over frozen meals, home cooked or otherwise, or groceries
· counting the full tupperware in the fridge to keep track of how often a loved one is eating and/or looking in the trash to get a sense of if their loved one is eating
· hooking up video monitors throughout the house
· staying overnight at a loved one's house
· supervising or assisting a loved one when they are showering, dressing, or using the bathroom
· paying for a housekeeper
· paying for a companion
· paying for a home aid/caregiver/provider to supervise or assist a loved one with showering, dressing, or using the bathroom
· working from a loved one's home so that their loved one has supervision or assistance during the day
· taking time off work to drive a loved one to their appointments
· bringing a loved one with them for all errands, leaving them in the car if their loved one does not walk well, so that their loved one is at least not home alone
· modifying a loved one's home to add ramps, install grab bars or railings, remove rugs and other tripping hazards, rearrange furniture to create a large clear space for walking, plug in night lights, convert tubs into walk in showers, or widen doorways
When one works so hard to keep their parent safe, it can be frustrating when it feels as if their parent's actions, such as not notifying them when something feels off or after an event such as a fall, seem to be undermining their attempts. Some family caregivers may even feel hurt or betrayed, interpreting these actions as a lack of trust.
Many times parents say they do not want to burden their adult child who is "already busy with work, their family, their children." Or they do not want their adult child to worry, stress, or feel anxious "about this little thing." I suppose when one is a parent attempting to take care of their child for most of their adult life, this protective nature probably does not turn off just because they turn 75 or start requiring a cane to walk.
I give suggestions for the person who worries about "being a burden" in Post 39: Seven Steps to Talking with Your Family if You Feel "Like a Burden" and for the family member caregiver in Post 48: How to Respond When Someone You Love Says, 'I Don't Want to be a Burden' - 5 Thoughts."
Back in the clinic (read Post 1: What Exactly Does a Palliative Care Specialist Do?), I make eye contact with Rose. "Well, I don't know what happened last year. It does sound like Rose has been independent and active all her life. Many independent and active people are used to shaking things off, like banging their knee against the table leg or tripping over the curb on the sidewalk and then shaking it off to move on to the next errand of the day. Many of us don't even think twice about it, assuming that this bump, cut, soreness, or pain will get better on its own. When this happens, I don't think it's intentional lying or hiding information. I think this behavior stems from a lifetime of 'shaking things off.' "
Rose turned towards her daughter and nodded, "Yes," and Vanessa's expression turned from hurt to thoughtful.
I continued, "It sounds like eventually when Rose realized something was not right, she did trust you to ask you for help. It takes time to adjust to big changes in life, one of which is realizing that what may have been 'a little thing' in the past may require more attention in the present."
When family members take on the responsibility to assist in the day to day care of a loved one, they may also start feeling responsibility if "something goes wrong," whether or not this in their control. "The doctors say she needs to drink more water, but I can't get her to drink more!" or "I left the kitchen for two minutes to switch the clothes from the washer to the dryer and she got up to grab a cup. Even though I told her to wait for me! So she fell."
The guilt, frustration, fear, hurt, betrayal, or anger over a situation in which their loved one gets hurt may color how a family member caregiver perceives a situation, and it may affect how they talk to their loved one.
I hope this post serves as a gentle reminder on having compassion both for yourself the caregiver as well as for your loved one who is trying to adjust from living fully independently to now having to compromise on their definition of independence.