I mentioned on Friday a difficult situation that had just arisen. Thankfully it seems to be resolved for now, but it involved my mother-in-law’s living situation.

Most of you know she is in an assisted living facility. She is in overall good health, no problems with blood pressure, blood sugar, cholesterol, heart issues, or any number of things that accompany aging. But she has been steadily declining in her ability to move: getting up from a chair, getting dressed, etc. She had been having trouble walking to dinner with her walker and had in fact not been going to the dining room for meals. The staff will bring her meal to her occasionally, but they don’t have enough staff to do that all the time, plus they want to encourage residents to get out and interact with others. At her last check-up, my husband asked her doctor if he’d prescribe a physical therapist to see if some work along those lines might help her. Some of the problem is due to aging (she’s 83), but we suspected some was due to disuse — the more she stayed in her chair without moving, the less she was able to move.

I came into her room last Thursday when the physical therapist happened to be there. He had already done his physical evaluation and was trying to fill out the paperwork: his Polish accent and Mom’s hearing problems were making it difficult, so I was thankful I arrived when I did and was able to answer some of his questions or help explain some of them to her.

My husband and I were both stunned when the assisted living owner/director called that Thursday evening after 5 p.m. to tell us that, based on the physical therapist’s report, Mom would either have to move to a nursing home that weekend or we would need to hire someone to stay with her at night. The major problem in his report was that he recommended that two people transfer her to her bed. her chair, etc., and the facility did not have enough staff for that, plus regulations decreed that in case of fire each resident needed to be able to vacate the building with one aide in under 13 minutes.

Well, one can’t make a decision about nursing homes in that short a time, plus we felt the PT’s further recommendations that Jim’s mom not attempt to walk with her walker, get into bed, get up from her chair, or use the restroom without calling an aide were going too far and would only further decrease her ability to move. We couldn’t do anything until the next day, so Thursday evening we felt definitely unsettled.

Jim was able to reach the PT the next day and to explain our concerns and the repercussions of his report. He agreed to meet with Jim over at his mom’s, and Jim was able to demonstrate to him and to the CNAs there that his mom could get up from her chair if given enough time (the CNAs, at least the ones there, agreed and said it is a problem sometimes that some want to rush her) and could walk once she got stable.

We think perhaps the problems in communication coupled with the fact that Jim’s mom gets very nervous and agitated when something new and unroutine happens may have contributed to her not “performing” very well during the PT’s first evaluation. He had recommended a two-person transfer because, when they were trying to transfer her from place to place, she wasn’t helping much at all in moving herself and, though she’s a small lady, as just a dead weight she was too heavy for one person. But she may not have understood what he wanted or that she was supposed to be putting forth effort as they moved her. The PT agreed to meet with Jim at his mom’s for another few sessions, and he agreed that she could walk on her own, though he recommended someone walk with her (he left a canvas belt there to put around her, and an aide can walk with her just holding the belt to keep her steady and have something to hold onto and help her up with if she starts to fall rather than just grasping slippery clothes). He still wants her to call for help in using the restroom, but overall he could see she could do more than he thought at first, and he’s working with her on trying to strengthen and limber up her muscles. Jim has attended these first few sessions both to help with the communication and to have a calming influence on his mom, but hopefully after this week they’ll be able to handle things on their own. The assisted living director is fine with all of this reevaluation: she just said that once she has a final report, if it indicates their facility can’t handle Mom’s needs then she would have to act.

So we’ve gotten a reprieve, at least. We’re thankful that the PT was willing to listen and work with the situation rather than being austere and authoritarian.

But even though we’re hoping for some improvement with PT, since she is 83, at some point she probably will need more care. We had already discussed the need to visit and evaluate some nursing homes even before this came up, and now we feel we need to go ahead and do that very soon. Since nursing homes are much more expensive and Jim is afraid they’re more clinical and less homey, we’ve also discussed the possibility of bringing her here and hiring home health care to help with things like showers (the assisted living place has people who do that). We have a spare room Jim and the boys made in the garage: that’s where Jason and Mittu stayed when they moved here and it was just barely put together. Jim has painted and done a little more finishing to it since then, but we need to carpet it, and, if she were going to stay there, put a toilet in it. We also need to find out what Medicare/Medicaid will do in either situation. She has some money from the sale of her home, but we want to parcel that out carefully so that it won’t run out before she passes away and to have some in case of hospitalization or illness in her last days.

In all honesty, I have to admit I am struggling with selfishness over what it would mean to “my” time and routine and the probable need to put aside other pursuits to have her live with us even with the help of an aide. But we just want what the Lord wants and will trust Him for grace for whatever the needs are. It may be that her care would be our primary ministry for a while. We just really need the Lord’s wisdom and direction as to what’s best for her.

I know some of you have walked this road before us. I appreciate your prayers.