Mother and her Cataract Surgery

Mother has been on the waiting list for surgery. She was quite impatient to have this done as her eyes had deteriorated to not being able to read the eye chart, only see three fingers held up in front of her, with the worst eye on her last examination. Well the day finally arrived.

I got Mother up and showered her early, as we had to be at the hospital by 07:30am. We went to the ward for day surgery and waited, as preparatory eye drops were intermittently inserted.  The risks had been discussed with her G.P., Mother and myself. (She was a general anaesthetic risk). It was important that she have surgery for quality of life as reading and watching TV were important past-times. At present seeing TV was even becoming blurred. Mother was last on the morning list, and became anxious about falling asleep on the table, as we waited. The surgery was to be performed under Local Anaesthetic and the decision to go ahead depended on Mother's ability to stay awake and very still as instructed. Mother was worried because she often fell asleep in the mornings, and if she did, would forget where she was and wake jumping and flailing about with fright!

I became concerned as I saw mother beginning to doze off while sitting waiting in the Day Ward chair. "She hadn't slept much the night before", I remembered. After a while I asked one of the nurses if Mother could have a bed to lay down on. This was not the normal routine for the Cataract surgery patients. They usually sat in chairs, then were wheeled to surgery and back in a wheel chair. Fortunately the nurse was obliging and mother was put onto a bed, where she immediately went off into a deep sleep. Being last on the list was working out well because Mother was now spending her waiting time having her morning nap. 

I woke Mother as time to go approached. Made sure she toileted so Mother could relax without worrying about that. She had taken her usual medication early and I knew the diuretic would have acted as she slept. (Important so she wouldn't get heart failure laying flat for the procedure).  Mother was wheeled on her bed to the Operating Theatre and provision had already been made for me to attend, (dressed in a theatre gown). Praise God, I had two months previously been asked to do holiday relief in Theatre PACU (Recovery) and was working there at the time of Mother's Surgery (I did thankfully have her Surgery day off though)! My faith told me He had gone before us preparing the way for Mother.

The Theatre staff were wonderfully supportive. Mother was assisted onto the table and there was a place made for me to sit and hold her hand. Mother was draped with oxygen being feed under the drapes to assist her. The "handsome young surgeon" (Mother's description) spoke reassuringly to her throughout the procedure. The eye was anaesthetised. Mother kept very still and focused throughout. The procedure went well, with Mother's clouded lens scraped out under the microscope and a prosthetic lens implanted in it's place. The surgeon announced he had completed and the procedure went well. Mother's eye was dressed. The drapes were removed and I lent over to tell Mother we were finished. She beamed at everyone and I took her home to recover.

I don't know what zone Mother had entered during surgery because the next morning she told me that when I lent over and to tell her it was finished, Mother was thinking to herself "that's my daughter and she's all grown up. Old now . . like a mother"!!!! I'm just glad she didn't say it out loud before my colleagues.

Mother had her eye dressing removed and examination first thing the morning after surgery. Praise the Lord, instant improvement! Mother can now read three quarters of the eye chart without glasses with that eye. She is very pleased. Blessings to all those involved. 

Getting Ready for Respite care

Mother needs to go into respite care, or should I say I need mother to go into respite care, so I can have a break during my week of annual leave. Her only experience of being in a Rest-Home was when she was unwell and needed an emergency admission to the hospital wing. When I collected her and brought her home to live, mother felt she had escaped and never wanted to return. Needless to say, to mention respite care brought a negative, anxious response from mother.

I had leave coming up and the issue couldn’t be avoided. The issue of getting mother into respite care worried me. I sought advice and other carers told me they just announced it when it was happening, to lessen time for negative reactions. This did not sit well with me. Although I could understand that in some cases it was necessary, I didn’t want to sow seeds of mistrust in my relationship with mother.

My plan was to introduce mother slowly from an unexpected angle. I checked out a neighborhood Rest-Home and made arrangements to take mother to visit, booked for day-care that day. I told mother the evening before, that she was invited for lunch to meet some neighbors, so she could make some new friends in her age group. That it would be good to extend her social contacts. I also said it was an opportunity to check out the place to see if it would do for future respite care.

The day arrived and mother was curious about the place. She saw it daily, as we drove past. To my surprise, she decided to walk with her walking frame to the Home, instead of getting into the car. After arriving mother was introduced and said a quick goodbye before happily going off with a staff member, to explore the place. She knew I would be back to collect her around 2:30pm. I stood there before leaving, surprised to find I was feeling a familiar feeling, similar to when I left my child on their first day at school.

Later, when I arrived back at the Rest Home, I found mother was happily settled with a group. As soon as she saw me, she stood, turned to the others and invited them all to visit. I had a imagination flash of a raging geriatric house party in my absence, and suppressed the urge to laugh, as I suggested that it might be better for them if she visited them. We didn’t want anyone falling over in the uneven driveway.

Mother went off to her usual (Alzheimer’s) club the next day and told of her visit to the Rest Home. She enquired about it and other’s experiences, if anyone had been there. Mother came back with confirmed reports that the Rest Home was possibly a good place to stay. Some of her club attendees had stayed there.

During the following weekend, I took mother shopping. We found an electronic clock-calendar and photo viewer with a radio. I loaded it with just under 476 photos. Photos ranged from ancestors, mother’s childhood, marriage, children, siblings & children, grand-children and families, especially the babies in the family. I also added some of the garden and familiar home environment. Mother loves it. She has it placed on her bedside table and can see the time, day and date on one half, while the photos slowly rotate on the other half. She feels it says who she is and finds it is comforting. I decided it was time to tell mother there was a vacancy coming up on Monday and I would be able to take a week’s holiday, starting that week. Mother immediately said she would like to take her electronic photos with her.

During the afternoon and evening mother would mention different things she needed to pack. I reassured her that I could do the labelling and packing while she was at club, that I would take her when the time came and get her settled. Mother was excited. I said to her “is it like going on a school camp?” Mother answered chuckling, “yes, it feels like going on a school camp”.

What happened at the hospital today?

Mother has been on the waiting list for cataract surgery and has been anxiously asking how long she will have to wait, as her eye-sight has been clouding over. Watching TV and reading her favourite magazines were very important to her and becoming increasingly difficult to do.

I was contacted yesterday and told that Mother was finally on the surgery list for ten days time. She was required to attend the hospital for eye measurements and a pre-admission clinic today. So I decided last night to tell mother the good news that she finally was booked for surgery, and to keep the news of the pre-admission appointment for just before she needed to go. I knew that if I told mother about her appointment, the night before, she would be up 4:30am worrying about ‘what time she was going’ and have ‘would she remember to be ready’ anxiety. My strategy was to allow a restful sleep thinking her next day would be the usual routine. I did tell her that she would be having a pre-admission appointment sometime soon.

The day started as usual and mother happily went off to day-care. I told her I would be dropping in for a meeting later, which was true as the monthly carers meeting was in the afternoon. I rang the centre to inform the staff that I would arrive to take mother to an appointment later that morning, and ensure she would be there and not on an outing. This gave me time to collect all the medical history and medication information etc and fill out the necessary pre-admission forms.

In plenty of time before mother’s appointment, I arrived at day-care and told mother the hospital had made a pre-admission appointment for today and I would take her over now. Mother excitedly went off with me. We didn’t need to go far, as the Alzheimer’s day-care is in one of the hospital buildings.

We saw the medical technician first, who happened to remember mother from when she had worked at the hospital. Mother had numbing eye drops inserted and her eye measurement tests done after a preparatory explaination. Mother asked questions and was very happy to talk about her eyesight deterioration.  

We then walked down the long corridor and took the lift to the second floor where the pre-admission interview took place. Mother keenly shuffled along at a fair pace (a gentle stroll for me), and I joked with her that she was getting some exercise, offering for her to sit and take a breather if she wanted. But there was no stopping as Mother was on a mission. At last something was happening about her eyes!

At the pre-admission clinic, appropriate forms were checked, more were completed and questions were asked. Information on the surgery and follow-up was given and then time and date for presentation at the Day ward for surgery was given. The interviewing male nurse talked fast and mother giggled intermittently. I wondered how much information, or actually what mother was hearing. Lewy Body Disease often affects processing information heard. It can often end up received as a totally different message.  I was thankful to be there to hear and reiterate later as required. Then we left for the Laboratory and a blood test. Mother was taken in a wheel-chair to relieve her from a long walk back in the direction we had come. After the blood test, we went back to mother’s day-care and she ate a late dinner that had been kept for her. I went to the care-giver meeting and mother stayed for the early afternoon, and then went home with her usual transport.

After I had been home a while, mother seriously said she wanted to talk to me. I sat down and waited. Mother asked what had happened at the hospital, as her eye-sight wasn’t any better and she looked disappointed. I slowly explained that she had eye measurements for the replacement lens to be ordered for surgery and then she was checked to see if she was fit enough for the surgery. “But what happened to my eye? My eye isn’t better!” mother exclaimed. I repeated the information, emphasising that she had eye drops for the measurement test, then a pre-admission check. “You haven’t had the surgery yet” I said “it’s in preparation for surgery in December”.  Mother finally got it. “So you mean I haven’t had the operation? I thought I had the operation.” “No mother”, I gently said “did you see an operating theatre, were you in one? It was just some eye tests and lots of forms.” Mother sighed with relief as her eye was no better and she had thought the ‘surgery’ had failed.

Mother said later when settling for the night “I still don’t know what happened today. I thought I must have dozed off and didn’t remember having the surgery.” “No mother, you didn’t have the surgery” I said. “What were those drops for?” she asked again, “Just to numb you eye for the measurement tests” I said. She then chuckled “and it was just pre-admission” she finished.

Adjusting to Change Stage 1

Life has changed dramatically since Mother came to live. My dreams for this stage of life were to work and make the most of the latter years of my working life, spend time with the extended (now adult) family, develop relationships with my increasing numbers of grand-children and have a life that involved more leisure and time for me (autonomously & free of dependents)! Well, all I can say is that has not happened yet...

All the while Mother and I were on a learning curve. We did not know exactly what we were dealing with or what to expect. This meant that to enable me to support her, I needed to become more informed regarding Mother's condition. Liaising with the Ministry of Health NASC assessor, the Clinical Staff (while Mother was in Respite care), along with relevant websites were very helpful for this.

Routine was the first priority when Mother came to live. Establishing a routine met Mother's basic daily needs and kept her safe. It is important for aiding memory, establishing a sense of being cared for, building security, and lessening confusion.

An Agency supplied care-giver support-worker to assist with showering & dressing, give breakfast, and supervise taking morning medication was the most practical assistance I could get that freed me to go to work or have a break if rostered off. At least I could rest assured that Mother would be up, dressed, fed and ready for her day. This was planned to happen in time for Mother to go to Day-care.

Weekly Doctors visits were required and thankfully I found a Doctor for Mother that had a special interest in Dementia. He was  involved in establishing our local Alzheimer's Day-care. All Mother's medication required careful review. I knew from my nursing experience that the elderly become very sensitive to medication and often as a result do not require the 'normal' doses they were commenced on years earlier. This was the case with Mother. Some of her symptoms were impacted upon by her sensitivity to  medication. Her medication was selectively with-held or decreased, due to her dehydration and low blood-pressure initially and needed to be carefully re-introduced, at reduced doses, as the reasons for needing them were prioritized.

I was through Mother's Doctor, that we were introduced to Alzheimer's Day-care. What a lovely supportive place. Mother and I had explored other interest groups that Mother could go to, but she was very reluctant. Absolutely refusing them to be truthful. I now realize that the people attending these groups often did not have the same struggles or understanding of what a Dementia sufferer had to deal with. The Alzheimer's Day-care, in contrast, made it immediately safe and relaxing for Mother, with no pressure or expectations put on her (to remember names for example). It was a haven to socialize with others, have therapy and feel supported, not alone in their often similar daily fluctuating struggles. Mother loves going and it has become a 'family' to her.

That was the basic plan of adjusting to a life of being responsible for Mother.

Mother came to Live

I hadn't seen Mother for some months as I had been diagnosed with a melanoma on my face and underwent surgery.
It was a scary time, wondering if I might be disfigured, or possibly going to die if not contained in time. My future had a shadow of the unknown over it, I felt. I have three married sons, lovely daughters-in-law and six wonderful grand-children. Would I be around for their 21st',s or weddings I wondered? The grandchildren are still  young, one is eight, the others are all between one and four yrs old. Just the delight of seeing them was great therapy.

During my time off work, post surgery, I thought it was time to visit Mother. She always told me she was fine when I rang. My sister lived in the same area & assured me she was keeping an eye on Mother.  I thought I would give Mother a surprise visit. I did informed my sister that I was coming though.

What I found was shocking. Mother was in her bathroom, naked & disorientated, not knowing where her clothes were. It was obvious she had a urinary infection which had caused her sudden mental deterioration. Mother had also lost a lot of weight, while her fridge and pantry were full of food. I investigated what had lead to this...

Mother, it turned out had early dementia, and was very good at unintentionally covering up. After I had Mother assessed, I then had the sad task of putting her into a respite hospital bed, in a home for the elderly, to give her the twenty-four hour nursing care she needed to get over her infection. It also gave me time to assess how she would recover as Neighbours reported they were worried about Mother being left alone, saying they didn't think she was coping. It appeared my sister was caught up in her own life business, and had been ringing instead of visiting. Mother, it seemed, always put on a bright response, so happy, in the moment, to hear from one of her children.

Mother was assessed as needing Nursing Home care. She was not initiating, forgetful, not eating, had faulty reasoning, had frequent falls and was vulnerable. She also has a medical history of diagnosed severe Aortic Stenosis, HTN, IHD, CHF, Arthritis, Gout and is on Warfarin for Atrial Fibrillation. Mother was dehydrated from her hot Unit and lack of fluids (it was Summer). On top of this, Mother was still taking her antihypertensive medication! Luckily not every day, as I could see missed days in her blister pack, due to her forgetfulness or confusion over what day it was. The Pharmacist assistant confirmed this was not a recent development. She had observed mother disorientated weekly when leaving her blister pack medication and often medication was not taken.

I initiated Power of Attorney over her health & Welfare following the doctor and Home's advice. Mother, fortunately had set it up years ago, for such a time as this. She chose me because I was her eldest daughter and a Registered Nurse. The assessor informed me Mother was no-longer able to cope living alone. Sadly she could have been having support services three times a day to keep her in her unit, but could not be left alone at night now. Mother told the nurse in the Home (in my presence) that what was worse about being confused was that sometimes she woke not even knowing who she was! Sometimes she found herself on the floor not knowing where she was at night. I was shocked and saddened to hear how Mother had been silently suffering, while all the time putting on a bright smile and pretending she was OK. How many others with early dementia struggle this way?

While Mother was in the Home, I sorted out a place for her at my house. I gave her the largest double bedroom so she could have her bedroom furniture on one side, and sitting-room furniture in area by the window, similar to her lounge in her RSA Unit. I hoped this would be familiar and assist Mother to settle in.

I then collected Mother from the Home and had the task of informing Mother and packing up the Unit. Mother was just grateful to be being cared for, relieved from the responsibilities that go with living alone and glad she didn't have to go into a Home. The rest of my siblings (four brothers and sister) were slower coming to terms with Mother needing care. They were not so supportive as they needed time to adjust. It was a very  stressful time.

I knew I needed to get Mother home and settled into a stable routine as soon as possible to prevent further deterioration and maintain her health. She had to be my priority. I couldn't bear to think of putting her into a home. Ideally, I want to be there for Mother for the latter years of her life. So Mother came to stay :)

Introducing Mother

Mother is a sweet unassuming 86yr old and now lives with me. She used to be a nurse herself, worked until retirement, then went to the sea-side to live. She loves the sea, her Father & brothers came from a line of sea-farers. She has famous ancesters, first whalers & great chieftans who met & intermarried when NZ was being discovered. This was before European colonization & westernization. She is of Te Atiawa, English & Irish origins. Some of her Tipuna were famous carvers & their works remain to this day.

Getting back to Mother. . . she grew up by the sea...Island Bay, Wellington in fact. Mother also once owned her own fishing boat, with her companion Bob. They brought the boat up from Wellington to Gisborne years ago, through the worst storm imaginable. Mother said her & Bob were able to find some shelter along the East Coast, but she was so afraid of the huge swell & towering waves that she cryed out to God to save them & has faith that He heard her since.

Mother has fine features, big brown eyes, olive skin that shows her Maori ancestry and a strong will. She is caring and kindly, looking for the good in everyone and does have a tendency to worry. Mother spent her child-hood as her own mother's right-hand cook & care-giver to her three siblings, being the eldest of four. Mother didn't enjoy the chores and child-care responsibilities assigned to her, which had the later effect that caused Mother to avoid her grand-children when young, fearing being caught up in child-care again.


As a teenager, Mother went through WWII. She was the youngest in her battalion, and has many fond memories of her time in the WAACs where Mother made many friends, most have died now. Mother endured the Depression, becoming engaged & married during those years. After Mother's first love & fiancee was killed, Mother said she met and eventually married my father to get away from home. It was against her parent's wishes, but Mother can be stubborn when her mind is made up.

She paid for it though. Six kids later & 25 years of misery, Mother decided to do her nursing training so she could support herself. That was when she met Bob, an old friend of her brother's. Bob gave mother the courage to leave Father, who was obsessive-compulsive & very controlling. Bob was drowned years later in a fishing boat accident.


Mother carried on with her nursing and then care-giving after retiring from nursing at 65yrs old. She remained single even though there were offers of marriage. Mother moved to a RSA retirement village and loved it there. She was very social and hospitable. Mother also remained friends with Father, whom she said felt more like a relative/brother. He had remarried twice and is now no longer alive. Unlike me, Mother is an extrovert & loves being around people. She follows the lives of people she meets with avid interest. Mother lives very much in the present, moving from moment to moment.