The dilemma of parental decisions

by mymothersbrain

My sister called with an impossible question yesterday. Impossible because I will be second-guessing myself for weeks. Mom is due for a mammogram next month. Should she have one? My gut reaction was “No. What for? She’s about to turn 80. She has Alzheimer’s. What good would it do at this point in the game?” Though her primary care physician once told my sister that women should keep getting mammograms as long as they can, my sister agreed with me.

The thing is, in parenting our mother, we are faced daily with making decisions that will affect her life. And we strive to make the best possible decisions with the information we have at hand, but we lose sleep over these decisions, as I’m sure parents of children do. At what point does a fever warrant a trip to the hospital emergency room? When is diarrhea dangerous? When is your child/mother really sick and when she just out of sorts? And can you be strong when she begs to be allowed to do something you know isn’t in her best interest, or yours?

The past two weeks have been filled with such decisions. Mom started adult day care, and for the most part, seems to have rather enjoyed it. She has sung, danced, done exercises and eaten healthy meals while there. But when my sister was going to drop her off two days ago, Mom didn’t want to go, announcing that instead, she would go in to work with my sister. When she was told she couldn’t do this, Mom insisted that she would rather sit indoors quietly with my sister nearby. Picture the four-year-old in your life saying, “But I’ll be good, I promise.” Picture saying to yourself: “Be strong, you’re the parent.” Mom finally went in to the facility but not without a couple of barbed words at my sister. Needless to say, she’d forgotten about it by the end of the day, and described how she was able to color with “lots of other people,” and listen to music all day long.

Other decisions and struggles are less easy. We have that POA that Mom signed a while back. To be put into effect, it needs only a doctor’s letter indicating Mom’s inability to make decisions for herself anymore. But her neurologist refuses to give us a letter. He wants us to take this signed POA to a lawyer at first, who will then send him yet more paperwork to sign. He also mentioned something about this having to go to court first. I’ve got a mind to call him and say, “Dude! If we had money for an attorney do you honestly think Mom would be on Medicaid?” Besides, we went through the same thing with my mother-in-law, and all it took was a doctor’s letter. So I can only assume that this doctor is fearing for his own liability; he did say that some folks make their parents sign these POAs so that they can take over property, finances and homes. Again, I say, “Dude! What property? What finances? To be Medicaid eligible you’ve got to literally be dirt poor, and a tour of Mom’s house will take two seconds.” In fact, earlier this week my sister discovered that there was $275 dollars missing from Mom’s account, and this was a disaster because frankly, that’s nearly half of her monthly income! We found the money, but not before I spent a long anxious night wondering what happened to it.

I understand that we live in a world where fears of liability trump common sense, in some cases justifiably so. But I also know that sometimes people don’t do right by others simply due to fear of liability.

I grappled with that very issue last night in making the mammogram decision. Suppose that we say our mother will never again have a mammogram. Suppose that in a year we find a lump in her breast that a mammogram would have found, and it turns out to be breast cancer, and that cancer takes her life. Will I be able to live with that for the rest of my life?

On the other hand, as I pointed out to my sister, even I don’t like mammograms. Those of us who subject ourself to this yearly exam endure it because we get its importance. Mom doesn’t get it. She no longer understands why we would inflict that kind of pain and discomfort on her. And if she were to be diagnosed with cancer, would we really put her, with her cognitive decline, through a treatment that might very well kill her anyway? It is highly unlikely, though I can see where some would be quick to critique us, to say that we need to preserve her life at any cost.

But we are the parents. And our decision on the mammogram is no.