When I was growing up I would always hear comments from my father mostly, but even from my mother, along the lines of: "...When I die, just throw my body in a ditch..." and of course "...I will never go into a nursing home!" But then, the reality of chronic conditions and progressive diseases along with old age came. What happened next was every bit as excruciating a crucible as any military training or life-and-death situation could ever be. Finding myself on what at first seemed like the wrong or "Forbidden" side of everything my parents had expressed and explained earlier in life, I soon realized that the reality of chronic conditions just do not allow for any comfortable decisions by anyone.
Starting with my father, diabetes was something he had coped with all the time I was alive but apparently he was slipping further and further into the non-compliant type of diabetic who thought he could will his way through needing to monitor his insulin or glucose levels and watch what he ate. Little did anyone know, at least any one in my family, that diabetes causes other side effects just as deadly as the disease itself, specifically artery blockages due to plaque build-up. Even the most compliant, disciplined diabetic must watch for this and keep regular check-ups with both his doctor and most likely a cardiologist to avoid massive heart attacks. My father found this out in Las Vegas when a massive heart attack hit him while he was eating dinner. The eventual prognosis was near total blockage of one coronary artery and significant blockages in the other three.
A massive chest-splitting bypass surgery later, and that problem was alleviated only to run into the other thing diabetes does to you: hampering of the body' ability to heal itself. At this point a staph infection made it necessary to amputate his big toe thus rendering him barely mobile. All this happened to a man who was still not a pound over weight, who swam mile long races as a boy, and had the most amazing bone-crushing grip of any adult male I have ever known. All this culminated in a prolonged period of about 13 months where his blood sugars would flux between low readings of about 15 to near comatose states of 1400. These ranges of blood sugar were not possible without permanent coma and death but fortunately for him, the most amazing modern advance for diabetes treatment are computerized insulin & glucose pumps that are nearly impossible to flumox and on 10 different occasions brought my father back from the abyss. But eventually even this was not enough and he finally slipped into a diabetic comma one October day and never came back. The amount of specialized care, doctor's visits, on-site nursing at home and other services we willingly did and of course the act of actually burying him all flew in the face of the bravado of previous years.
My mother's fate was quite possibly worse: Alzheimer's. With her, there were no sudden calls to 911, no dramatic metabolic problems, and no violent swings of behavior or massive heart attacks. Instead there was just a progressive yet extremely cruel fade-out that began with occasional confusion in between long periods of knowing exactly what was going on in life that led to the eventual dismantling of all mental faculties ending with a person laying in bed mentally unable to summon any will power or focus to even lift a hand. My mother was also a very active person, having done snow skiing, water skiing, and being a fan of ballet and broadway. It was during the in-between zone of this cursed disease process that the real boogey-man came: wandering off either on foot or in the car and ending up completely lost. That was the most scared any child will ever be, realizing a parent - quite possibly your first concept of God as a child - has wandered off to points unknown and may be confused, frightened, or already dead - an especially likely outcome if an Alzheimer's sufferer is driving when they become confused.
Skilled nursing homes were the only means I then had to safeguard what was left of my mother's well-being and health. No one can be mentally acute enough to go to work during the day and be able to chase someone around the yard or neighborhood at 2:00 am, 3:15 am and then 4:30 am and then 5:00 am. Alzheimer's leaves no room to negotiate. It is a case of you either make that choice to do the unthinkable and place your parent in the Forbidden Twilight Zone of a nursing home with an Alzheimer's care unit, or be exposed to the certain reality that they will kill or severely injure their persons and quite possibly other people as well and that blood would all be on your hands.
The outcome of all this is that I for one am no longer worried about having had made decisions that in earlier years would have flown in the face of what my mother and father said they'd want to have happen. As the one who had to provide the care and protection, any consideration besides what would keep both them and the general public safe was irrelevant. That did not make the decisions any easier to cope with at the time. But in hindsight there is a kind of peace in knowing that when faced with seemingly forbidden decisions, the right choices were made. Many forbidden zones have to become practical options when faced with diseases that do not allow you or anyone the luxury of any easy choices.
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