Gunda Zwerneman, far right with other locals during a Harlowton 4th of July celebration in the 1940s.
Gunda Swerneman during a recent orthopedic appointment.
“We probably see at least three falls a day from assisted living facilities,” the Bozeman ER doctor said.
"Unobserved falls?” I questioned, pacing the exam room.
The doctor did not reply, but returned to finishing his assessment of my mother before discharging her.
It was the first of January and it was my 94-year-old mother’s second “unobserved incident,” resulting in injuries at a private, corporate-owned Montana memory care facility since she was admitted August 2021.
Another fall in November had resulted in a broken nose and a gash on her forehead requiring 10 stitches. Mom spent a week at Bozeman Deaconess Hospital on oxygen.
After that traumatic experience, our family made the decision to remove Mom and transfer her elsewhere.
But, right before I picked her up, another incident, more injuries and another ER visit. This time facial abrasions and something wrong with her arm caused, as reported by a memory care aide, male residents lifting my mother from the floor by her arm.
“We are short staffed,” the aide said.
So had been I, with Mom and just I at home.
Last year, scheduled for long-put off hip replacement surgery with a several-month recovery, I needed to find another place for her
Family came together to help on the farm and also to come up with a plan to afford the best care available.
Based on solicitation by a staff member of an area facility and reading online reviews we thought we had found that place. At $6,600 a month for a shared room, incidentals and medications not included.
During a temporary respite stay at this memory care facility last spring, she suffered a more-than-15-pound weight loss. Her primarily doctor thought the drop was due to advanced dementia and ordered hospice services for her. Visiting Mom during dinner at the facility, I saw her served a full teriyaki chicken and rice dinner. I had requested a soft food diet for her due to dental issues
“Does my mother actually eat this food?” I asked the aide serving her plate.
“Well, she picks at it,” the aide said.
I asked Mom’s primary physician to order a soft food diet and also a daily supplemental drink for her.
Also at this time, I discovered that the medication list the memory care staff was using for my mother had a doubling error on the already large dose she was prescribed of potassium chloride for an electrolyte imbalance. A quick trip to Bozeman ER determined Mom’s kidneys had been functioning well enough to flush the toxic dose out of her system.
"She’s lucky," the ER doctor said that time.
We placed Mom as a resident at this same memory care in August, after my hip surgery as there were no other care facilities in the area that could admit her.
All seemed well, as was reported by memory care staff on the phone, as visits due to my recuperation and COVID concerns were limited.
Until November.
Back home now, Mom is frail and has lost much of her functionality.
Prior to placement she had been able to stand on her feet. Her legs are now atrophied and she refuses to stand.
She does not qualify in this condition for assisted living.
For three weeks Mom continued to cry about pain in her arm and could not sleep at night. She was also congested and coughing.
An ER visit at Livingston hospital last week determined she was positive for Respiratory Syndrome Virus (RSV), which is highly contagious and dangerous to the elderly. She was kept in the hospital for observation, but her arm pain was not addressed.
A couple days ago, a turning point when a Bridger Orthopaedic provider determined by x-ray and exam severe arthritis in Mom’s left shoulder was probably the source of her pain. The condition exacerbated by being wrenched at memory care, a cortisone injection was performed during the visit. The provider also assessed Mom’s legs to be flexible and her inability to stand probably due to fear of falling.
“This could probably be corrected with physical therapy, repetition to increase confidence and make her ability to transfer easier and safer,” the provider said.
That night, my mother slept through, and has not yet complained about pain in her arm.
So, let me start this again.
Three falls a day.
365 days a year.
Almost 1,200 falls in assisted living facilities in only one of the larger towns in Montana.
That is acceptable?
I am terrified to grow old in Montana.
Because I know what is acceptable.
Lynette Zwerneman has been her mother's representative and caregiver since 2008. She raises sheep on the family farm northeast of Livingston.
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