My Mother's Keeper: The Eye Doctor Appointment

For the past several years, my step-sister had been taking my mom to see the ophthalmologist. They had their routine; Cindy would drop her off for the appointment and then pick her up after it. Then, last spring, Mom called to ask if I could step in because Cindy was unavailable to help her. I was actually pleased that I would have the opportunity to see what the doctor had to say.

As a private geriatric care manager, I spend my professional life guiding families through the often twisted, treacherous journey that aging parents and their frantic children share. Often families are separated by distance and it’s my job to be their eyes and ears – an advocate for their parents and a source of support for their caregiving children. Here I was beginning the journey myself, though I admit that I didn’t know it at the time.

I sat through the eye exam with Mom and it seemed fairly routine. Then the doctor said to her, “You know, Mrs. Fastman, as I have been saying for the last three years, you should not be driving.” I almost fell through the floor, overwhelmed by a wild array of feelings. I recall panic, fear, anger, and embarrassment, to name a few. Here I was, a care manager whose own mom had slipped through the cracks. As I recall, the ensuing conversation went something like this:

Beverly: So doctor, what is the reason that my mom should not be driving?

Doctor: It’s the cataracts! Once they are removed, she should be okay.

Beverly: And how long did you say this has been going on?

Doctor:    It’s been the last three years.

Beverly: Did you report this to the Department of Motor Vehicles?

Doctor: No.

Beverly (to Mom): Tell me why you never mentioned the doctor’s position before.
Mom: Bevy, he never told me until today that I had cataracts! You know, I can’t understand why he keeps playing with the eye chart to make it hard for me to see! I see just fine. (Yes, it really happened that way.)

Driving is a huge issue. As kids, getting that driver’s license means independence and freedom and a leap into another stage of life. The threat of losing this ability hits people hard, with good reason. It also propels them into another stage of life, but one that isn’t nearly as exciting and expansive. It’s often experienced as a painful loss of personal identity, and most importantly, a change in the way they will be relating to their families and others. The experience is often one of dependency and a constriction of life. Yet, faulty drivers stand not only to injure themselves, but they also may hurt innocent victims. Here was a woman putting others at risk because of her denial of the need for surgery. And it was MY MOTHER.

As I look back upon the signs, I must admit that they were there for me to see. For example, when she stepped outside, she was afraid that she couldn’t see the ground and she could not see where to walk. She held on to people and at least knew that she could not drive at night. But I, like so many others of my generation, have great difficulty seeing what is before us. Nor do we want to. We, like our parents, want things to stay the same. We want our parents to continue on as we have known them. For me, I can’t even fathom a world in which my mom isn’t a phone call away. I still need her to be my mom. Because what’s underneath the feelings I have described is a whole lot of love and fear of loss.

In case you are wondering what happened, I spoke from my empowered geriatric care management position of knowing, which is the place to which I typically go when I am afraid. I told my mom in no uncertain terms that she had two choices: She could either fix her cataracts or stop driving. I also admonished the doctor for not alerting the Department of Motor Vehicles about enabling a patient to drive when the licensed professional is aware of the dangers. By law, doctors could lose their license for not reporting their findings in this type of situation. For some reason, my mom did not argue with me. Knowing her, I am still not certain why she listened. She told me that she would never allow that doctor to operate on her because she didn’t like him. I asked her whom she did like; she actually told me about a doctor whom “everybody in the building uses.” After checking him out, I concurred that it was a great idea. Five weeks later, she underwent surgery. Shortly thereafter, my mom was again behind the wheel, only this time she could actually see.

I guess you could say that the visit to the ophthalmologist was an eye-opening experience. A lot has happened since that doctor’s visit, but that was clearly the incident that let me know that I had officially become my mother’s keeper–her caregiver. We’ve been on a hair-raising ride together since then, but there’s still one thing that I know: I love my mom and I will do whatever it takes to get her the best possible care, to protect her autonomy, and to spend this time with her because this is the time that matters most – to both of us. I will have to deal with the challenging feelings that these experiences precipitate just like everybody else. Before I was ever a geriatric care manager, I was my mother’s daughter.

Tips for Caring

It is of the utmost importance that elderly parents are accompanied to their physician visits by an attentive third party every so often, on a regular basis. This person must listen with an objective, impartial ear to exactly what health issues are discussed. Understanding the complexities of chronic health conditions requires someone who knows how to ask the right questions. The issue is one of understanding the current health status of the individual, as well as following through with the appropriate course of action. Asking questions and following through can sometimes be the difference between life or death.

There are many reasons why our parents need help in this area. Sometimes it’s an issue of deteriorating ability to understand what’s happening, brought on by memory problems or comprehension problems. It can also be related to the psychological challenge of accepting the implications of what is being said. Any of us would find it hard to “hear” these things. Keep a record of your parents’ visits – what the doctor has said and recommended. If you cannot accompany your parents, ask someone else to do it, such as a family member or friend, or consider the services of a professional geriatric care manager. It’s amazing what you can learn.
 

Beverly Bernstein Joie holds a bachelor’s degree from Antioch University in Psychology and a master’s degree from Villanova University in Counseling and Human Relations. She is a certified geriatric care manager (CMC). Ms. Joie writes, lectures, and holds workshops regularly about caregiving and issues related to aging. She is the current president of the Philadelphia Chapter of the National Association of Geriatric Care Management. She also serves on the public relations committee.

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