I feel hopeless today

I'm feeling really hopeless today. I'm saying today, but I've been feeling really down for a while. I feel like my mom's situation has taken over my entire life and it's not getting any better.

Here's an update about what has been going on with her: I've been getting calls (and I say "I" not "we" since my brother and sister have been MIA...especially my sister) from the rehab about my mom's hygiene (from the previous posts) and just about how she has not made any progress. Everyone is frustrated with her at rehab because she openly admits that she is going to drink the moment she gets out, even though she has cirrhosis and it is going to kill her...quickly.

My mom's good friend (who is a Dr.) wanted to know how much of this "unwillingness" (to shower, to understand that drinking will kill her, etc.) is from mental illness (bipolar disorder) versus brain damage from drinking. I'm going to copy and paste some email exchanges:

FROM MY AUNT...

On Mon, Jul 25, 2011 at 9:40 AM:
In particular you need the result of any imaging of the brain (CT scan, MRI) and any update on your mom's psychiatric diagnoses now that she has been on medications for some weeks/months including prognoses and recommended therapy (not just meds but post-discharge support recommendations). I would be very interested to know about the degree of brain atrophy present and its pattern. As we discussed on the phone, there are some distinguishing features between the atrophy of senility or natural aging and that of chronic alcohol abuse (called Wenicke-Korsakoff which you can read about here). The atrophic changes are irreversible and, particularly if they are of the classic alcohol related type, would be helpful in attempting to predict her future function capacity. While this may in fact be bad news it would at least let us try to play the ball where it lies rather than wonder.

MY RESPONSE AFTER SPEAKING WITH THE NURSE AT REHAB:

Date: Wed, 27 Jul 2011 12:01PM:
So I just spoke with the psychiatric nurse and she said that Mom refused the spec scan, so they don't have anything to go by with that. But she did say that she spoke with the Dr and other nurses about mom (they all remember her) and she said that they all strongly believe that mom has irreparable damage to her brain and that she will never be able to understand that she can't drink or anything like that. They said she doesn't think mom will get any better than this. It's been almost 90 days of not drinking and if she was going to improve, she would have.

I asked her if she thought any of this could be bipolar related and she said that she couldn't say for sure, but she thinks it's damage from alcohol. She believes mom will never be able to live independently again.

She said mom could always go see a specialist for a brain scan once she's out of gate lodge, but she thinks mom will begin drinking immediately and things will start to deteriorate before we could even get an appointment.

Not sure what the next step is.

MY AUNT'S RESPONSE TODAY...

Date: Wed, 27 Jul 2011 1:00PM:
I'm afraid this is pretty much what I was thinking but I wanted to hear what her caregivers thought and hoped there would be an imaging study to confirm. For someone with radiology training like me I always want the clinical picture and imaging picture to support each other. Your description of your mom's conversation and behavior suggests a concreteness that is typical of chronic alcoholic encephalopathy or brain damage as we discussed before. This is irreversible. Honestly, I think chronic institutionalization is the only way to keep her alive. While not a pleasant environment from a normal person's point of view she has demonstrated the ability to establish a routine in such a setting at ECMC and these other places despite her complaints. This would cost money for a private setting and would certainly suck dry her remaining assets then end up with her as a ward of the state if she outlives her assets. Or you could consider legal advice as to how to distribute her assets to you kids and go right to ward of the state type status. Or you could follow her brother's thought as to finding her a small rental apartment where she can't get herself or anyone else in too much trouble and let her just finish out the process with her drinking. It is not likely to take a great deal of time if she is left alone. This both sounds and feels harsh to me but I do not see any "good" option here. She has done too much damage. I think the effort was worthwhile because none of us was ready to see her die in May which was about to happen. Also we all now know that we have done what could be done to try to save her.


So, now I'm here. I feel so depressed about all of this. I don't want to institutionalize her (and don't know if I could even if I wanted to). It feels unacceptable to me to let my mom go back home, get an apartment, and then drink herself to death. Soon. I can't imagine not calling my mom, not seeing her, not sharing things with her, not having her in my life. I do not feel ready to let her go. I'm 25 and my mom is 55. She is too young to die.

I talked to my boyfriend and he doesn't really want her to come live with us. I'm sure not that's really a viable option anyway since her health insurance is only good in New York State and I live in Colorado. She might never be insured again if she moved out of New York.

Do I move to New York? Leave my life here? My boyfriend, home, cat, support, job?? I feel hopeless. I have no idea what to do and I have 2 weeks and one day before my mom gets out of rehab. I need to figure out it and I have no idea what to do.