
On the night of February 25th — Oscar night — my active 86-year-old mother who has lived alone since my dad passed in 2009 took a bad fall in the upstairs bathroom of her longtime San Francisco home. From her injuries, it seems she hit her head twice; once on the toilet and once on the floor. I’m not completely sure how it all “went down,” so to speak, and, of course, neither is she.
What is clear is that the event physically resulted in a lot of blood that required immediate stapling of the back of her head, bruising of my mom’s entire right side of her face and neck, and a couple of large contusions on her right cheek.
Applying towels to the back of her head, she managed to get herself back to her bedroom and called 911.
Allow me to forego sharing much detail of the ensuing two weeks, save to say they involved three-day hospital stays each at San Francisco Zuckerberg/General Hospital and California Pacific Medical Center, the diagnosis of a moderate concussion/TBI (traumatic brain injury), and a 10-day stay at CPMC’s well-regarded Acute Rehab Center on its Davies campus.

What I wish to reflect on in this writing is how my mother’s fall was the catalyst for a new chapter of my life.
You can probably imagine that the days of my mother’s hospitalizations were filled with emotion, worry, uncertainty, stress, and lots of questions. It was also a time in which my brothers, sisters-in-law, a niece trained in physical therapy, and I sprang into action and support in a cohesive way as we sought answers to the questions that suddenly and emergently surfaced as a result of Mom’s fall.
Because we had to make some big decisions. Fast.
There are some events in life that can be characterized as “game-changers.” From my perspective, these include (yet are not limited to) having a child/children, major illness, marriage, divorce, and death.
Now that my mom has fallen, I would count this as one of those events.
Before the fall, my mom walked regularly, drove locally, went to lunch and other outings with friends, and managed the house she lived in for 60 years.
Fortunately — and somewhat remarkably — Mom sustained no orthopedic injuries from the fall, and she improved greatly with treatment in acute rehab. Yet her concussive injuries posed a more complicated situation whereby she could not live alone, nor would she be able to drive for the indefinite future, if at all.

And this is precisely the point where the game changed.
To the uninitiated, it might seem simple enough that either someone — a member of the family perhaps — simply live or stay with Mom, or Mom live or stay with someone until she “got better.”
But now that I have been “initiated,” I have learned that it is not nearly that simple.
I learned that my mother needed much more than simply someone living with her.
I learned that my mother’s former living environment — my childhood home — was no longer safe or appropriate for her.
I learned that my mother’s former lifestyle after the fall was not a healthy situation for her going forward.
So back to those big decisions.
As events unfolded that first week, what became clear to all of us (and when I say “us” from here on out, I am referring to my family members I spoke of earlier) is that we needed to find an environment we could provide for Mom upon her release from Davies Rehab that provided support, community, safety, security, loose structure, and social/mental stimulation.
A tall order in such a short period of time.
My sisters-in-law (one of whom flew out from Chicago) jumped right to the task during my mother’s second week of hospitalization. They toured and interviewed five communities in SF and Marin County, ultimately selecting one that seemed ideal: The Redwoods in Mill Valley. A beautiful area, lovely facilities, a caring and professional staff, many class offerings, activities, field trips, and assistance as needed.
And, remarkably enough, The Redwoods had several vacancies.
We secured with a deposit one of the nicer studios that had a lovely northeastern view.
And on the Friday morning my mother was released from acute rehab, I drove her across the Golden Gate Bridge to The Redwoods where we met my sister-in-law Susan and awaited my brothers who packed up a U-Haul van with some furniture and belongings from my mother’s home.
By that Friday evening, Mom was settled in her new studio.
That was quite a day.
Now that Mom has been living at The Redwoods for almost three weeks and I reflect on the events of the past six weeks, so many feelings, realizations, and teachings have risen to “my surface.” Some rise quietly and peacefully, others more painfully.

Allow me to candidly express what has arisen without explanation or qualification.
I feel strangely unmoored and vulnerable, even afraid.
I feel alone. And at the same time, supported. If that makes any sense.
I feel grief. About so many things.
I feel relief. Relief from the worry I was harboring (but didn’t realize it) for such a long time about Mom living alone. Relief that my mom is now in what I consider a better place.
I feel grateful.
I realize that my mother is incredibly fortunate to have the means and ability to transition into such a safe and caring environment. An environment that is inaccessible to the vast majority of aging Americans, including myself.
I realize that the “sunset chapter” of life in today’s America is filled with challenges and unprecedented opportunities for a growth that is essentially uncharted and a little scary.
I realize how strong I am.
I realize much more deeply and viscerally than before how interdependent and interconnected we all are and that the quality of all of our lives — from birth to death — depends largely on how deeply we understand this; as individuals and as a collective.
I’ve learned how blessed I am to have been born into my family of origin.

I’ve learned that humility is perhaps the most valuable — and yet most undervalued — of qualities in our society.
I’ve learned the vital importance of speaking truthfully. And listening respectfully.
I’ve learned that the choices we make in every moment matter.
And I’m learning to live more fully just one day at a time.
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Very inspiring. Taking care of our aging parents has been the biggest challenge & the most eye-opening experience of my life. Thank you for sharing. This was beautifully written.
Margaret, thank you so very much for your response. I so appreciate your resonance with what I wrote, your candor, and your journey. It means the world to me, especially since as I was writing this piece, I had to really draw upon my courage. You have made my day. Apologies for my delay in responding to you.
Beautifully written. Thank you for taking the time to write this down and share with us. Looking back at the last three years of my mother’s life (she passed away on Nov 14, 2014 at 86.5 years), what I am most proud of is how my three siblings and I communicated and coordinated efforts to make decisions together for Mom’s care. Some periods, we’d have weekly conference calls coordinated at 9pm — the technology set up by my brother. As a nurse, I had tremendous input that was respected — but we collectively agreed on the important decisions. Mom did not have a major “incident” that precluded a shift in her living situation (gradual onset of dementia, living alone in the family home in SF). But, we, as her children — and me a nurse, were keenly aware of other incidents of injury and falls, and vulnerability of the situation. Ultimately, we coordinated with Mom’s Primary Care MD at Kaiser to present Mom with the choice of having someone live with her to assist in her care (cooking, laundry, sleep at night), or move to an Assisted Living residence. Mom had always said she wanted to stay in her own home, but when presented with the option of a home caregiver (“who’s going to sit across the room and look at me all day”) or move to Assisted Living, she chose the latter. So much more to say, but thank you for writing about this and prompting me to write.
Mom moved to Assisted Living, then memory care, and the last three weeks of her life, to my home where my husband and I, and family cared for her. A beautiful, precious time.
Thinking of you and your Mom.
Kathleen, it means the world to me that you have shared your and your family’s story, and so beautifully. Thank you so very much. Kudos for your courage and wisdom to respond to your mom’s situation proactively. It’s so gratifying to hear about someone else’s experience around this issue. It feels only right to share with you that now that my mother has been at the Redwoods almost three months, she is flourishing there. She looks better than she did before her fall, she’s eating better, she’s socially and mentally stimulated, and she’s meeting people. She admitted to me recently over coffee that at first she was angry at us, and of course then she realized why it was for the best. I told her to keep in mind that all of us worked in great cooperation around her fall event, so that should clue her in that we couldn’t all be wrong, lol. It’s like we’ve all gone on this massive journey in just over three months. The journey, of course, continues, but I’m relieved we have all emerged whole after the first critical part. Thank you again, Kathleen. Hugs to you…