Vital help for caregivers
There are countless daughters out there struggling to keep their frail, elderly mothers in their own homes, desperately trying to find ways through the morass that is the healthcare system.
Virginia O'Connor was one of them.
Her mother - a murder-mystery and crossword puzzle devotee - was slipping away. There was a heart condition. Arthritis. A stroke. Hip replacement surgeries. She needed help with bathing, meals, medications, and her many doctor visits.
The mother, also named Virginia, desperately wanted to remain among her own things, so the daughter gave up her Cape home and moved into her mother's West Roxbury home.
But then the elder O'Connor began staying up at night and sleeping all day. She grew confused, depressed, easily agitated. Alzheimer's descended.
The younger O'Connor, a hospital billing manager, gave up her job. But even though she had worked in healthcare, she - like so many others with sick parents - was still overwhelmed and couldn't handle her mother's care.
She needed in-home help but didn't know how to find the right person. Her mother's monthly checkups seemed to be over so quickly, and she wasn't sure what questions to ask the doctor. She had no idea how her mother's prescriptions were working together.
There seemed to be services available to coordinate care for the poorest seniors. And for those in crisis - in the hospital or just released. And for those headed into assisted living or nursing homes. But not for O'Connor, 84, who fell into none of those categories. Her daughter exhausted herself trying to pull together all of the pieces of her mother's care, even as she grieved the loss of the lively former schoolteacher who raised her.
Then she happened upon a magazine story that mentioned Dovetail Health - a company that oversees elders' care.
A Dovetail pharmacist, nurse, and personal care coordinator made regular visits to their home, checking all the elder O'Connor's prescriptions for potential interactions, flagging a heart medication because it was exacerbating her confusion. They provided a home monitoring system that relayed her vital signs to their Needham headquarters daily, allowing Dovetail workers to check for irregularities, a couple of times catching troubling symptoms before she might have needed hospitalization.
They helped the younger O'Connor find home-care workers and walked her through the steps to take control of her mother's affairs. They gave her questions to ask her mother's doctor, and sent regular reports to the physician's office in advance of her monthly visits. And they checked in with the daughter, week after week, to make sure her mother was well.
The younger O'Connor went back to work part time. She felt she had achieved something huge: fulfilling her mother's wish to be safe in the home she loved.
"My mother has benefited from it," she says. "But they were also nurturing me."
O'Connor knows she has found this relief only because she is able to pay Dovetail's fees, which run between $250 and $650 a month.
Many others can't afford these services. Amazingly, they are not covered by insurance.
Which is ludicrous when you consider how much more expensive it is to provide an elderly person with a hospital bed - on average about $20,000 per stay - than it is to provide this kind of support, which can help avoid the hospital.
But the whole crazy system is weighted toward the expensive business of managing crises, and not prevention - even though the latter ultimately costs less.
A company like Dovetail shouldn't be necessary. But as long as the healthcare system is a maze, and ordinary people are left on their own to find ways through it, case managers like the ones the company provides will be vital.
They have given the O'Connors some peace. Shouldn't that same peace be available to every son and daughter tending to their parents in their final days?
Yvonne Abraham is a Globe columnist. She can be reached at abraham@globe.com. 