An unwavering commitment to care

She hasn’t cooked them dinner in a long time. Or told them what to wear. Or said the words, “I love you.”

But she is still their loving mother, and that’s why, now that the tables have turned, they take care of her the way she once took care of them.

Born and raised in Vietnam, Ba worked hard all of her life, first on her parents’ farm as a child, then alongside her husband in their business. Ba and her husband raised six children together. She was a devoted mother, always putting her children first, even when they were grown and with families of their own.

A series of strokes changed all that, leaving Ba unable to walk, talk, eat without assistance or care for herself.

Used to sticking together through tough times, Ba’s children took over her care. They all felt strongly she should not go to a nursing home, but this commitment to care was only the beginning. Kathy’s temporary leave from work to care for her mom while they searched for alternatives became permanent as the family tried without success to find a qualified caregiver who could also speak Vietnamese.

Uncertainty with how to care for their mother and a lack of understanding and support  from Ba’s doctor meant Kathy and her siblings struggled with her care. It was all so new to them. They didn’t know what might be an emergency and what to expect.

Spasms of loud, gurgled breathing sent them scrambling for the phone to call 911, certain their mother was choking. Difficulty eating meant she kept losing weight and what little strength she had left. Although Kathy could interpret Ba’s vocalizations, others couldn’t, so communication was often difficult and distressing.

Kathy stayed with her mother around the clock, even sleeping with her, sensing her mom was calmer when she was present. A brother and sisters took turns visiting their mother and providing Kathy with much-needed respite. But even with the family’s dedication, Ba’s health continued to decline.

In desperation, Kathy’s younger sister Rebecca, a Providence employee, reached out to Providence ElderPlace. Her department handled some of ElderPlace’s paperwork and she was aware of the program. She learned enough to become convinced ElderPlace could help her mother.

A commitment to family
Upon enrolling in ElderPlace, Ba was placed on the PACE at Home panel. Before Ba joined ElderPlace, Kathy had struggled to get her mother to the doctor’s office. Now, with PACE at Home, Ba’s ElderPlace doctor, nurse, therapists, dietitian and more, all with years of geriatric care experience, were soon at Kathy’s doorstep ready to help.

After a thorough medical exam, Ba’s care plan was developed. Part of this plan was to teach Kathy and her siblings what was happening with their mother and how to care for her.

ElderPlace clinicians were quick to share simple, but crucial, care techniques.

Ba’s nurse explained that the loud, gurgling, choking sound Ba produced was due to weakened throat muscles and neurological impairment caused by stroke. “Ba no longer remembers to swallow,” the nurse said. “When saliva starts accumulating, you need to remind her to swallow.”

Speech therapist Cece Dispenza explained the importance of pureeing Ba’s food to the consistency of pudding, thickening her liquids, waiting between mouthfuls for an observable swallow, and giving proper oral care to reduce her chance of choking.

Cece also helped with the challenge of communication. Although Kathy could interpret Ba’s vocalizations and anticipate her needs, other siblings had difficulty and felt isolated from their mother.

Teaching Ba simple sign language – like pointing her index finger up for “yes,” down for “no” – made a world of difference and allowed everyone to feel they could “talk” with their mother. Positioning themselves within Ba’s line of vision and allowing extra time for her to process information were two other simple techniques that greatly improved communication.

Kathy knew instinctively that exercise was important for her mom. Even before Ba joined ElderPlace, Kathy would try to support her mother’s weight while encouraging her to walk around the living room. But inexperience with proper transferring techniques and Ba’s ebbing strength made this a risky task for both mother and daughter.

Physical therapist Jean Kastner taught Kathy proper transfer techniques: how to communicate what she was about to do and how to support her mother’s weight properly. Simple home equipment – a seated pedaler and rubber exercise bands – transformed their exercise routine from precarious to safe, effective and even enjoyable.

Ba happily pedals twice a day while Kathy reads to her from their Bible. When asked if she enjoys her exercise, Ba will proudly show off her strengthened legs and give a “fingers up”!

Ba, Kathy and the entire family are doing better these days. Ba’s weight and strength have stabilized. The entire family enjoys interacting with her, thankful they can communicate with her once again.

“My mom will leave us someday, but we know that we are not alone,” says Rebecca. “ElderPlace will be there lending support along the way. That means a lot to us; it is a huge relief.”

The feeling is mutual as the entire ElderPlace PACE at Home team has expressed how wonderful it is to work with Ba, Kathy and their family. Chester North, M.D., Ph.D., is quick to point out it wasn’t only ElderPlace doing the teaching.

“We learned from Kathy and Ba as well,” Dr. North explains. “They taught us to never give up hope, that amazing things can be accomplished with a family’s unwavering commitment and a little bit of expert help.”

Little by little, step by step, Providence ElderPlace helps keep families together.