The doctor's recommendation--that her occasionally feisty, 85-year-old mother be placed in a skilled nursing facility--was out of the question for Esma Lucy, 59.
Even before a fractured pelvis and partially paralyzing stroke left Marie Nihem helpless three years ago, her daughter had always taken her everywhere.
But, when Lucy, who moved to Mira Mesa from Michigan six years ago, made the decision to care for her mother at home, she had no idea how difficult it would be.
Her mother lapses in and out of dementia, is blind in one eye and has a cataract in the other, she wears dentures she hates, rarely speaks and is incontinent.
That's the easy part.
Accustomed to the "finer things in life" from 26 years working as a paralegal, Lucy didn't expect to have to give up her job in a San Diego law firm, or spend every weekend telling her new husband to go out on their boat by himself. But it came to that.
After a year and a half of utter frustration, Lucy took a major step forward: she enrolled her mother in an adult day care center.
It was like being released from prison, she said. "I could go shopping again, have some free time."
After struggling with the commute to different centers, Lucy now takes her mother five days a week to the Sam and Rose Stein Adult Day Care/ North Coast Alzheimer's Center in Encinitas.
Finding day care appears to be compatible with going back to work, Esma said, but it isn't.
Between waking her mother at 6 a.m., washing and drying her hair, fixing her breakfast, dressing her, changing her bedding, driving to the center, taking her to doctors' appointments, searching for lost uppers and doing her laundry, there's not a lot of time for a career, Lucy said.
"It's horrible," she said, her brown eyes flooding with tears. "I'm going to be 60 years old in February. I'm at a stage where I need to think about my Social Security. I should be working now, because I want to retire when I'm 62," she said.
Simply going out for a movie can seem an insurmountable problem. "Who's going to take care of mother?" Lucy asked. "I have spent hours on the phone trying to figure out where to go for (respite) help."
Many places don't take people in her mother's condition short-term, Lucy said. In other instances, the cost can be prohibitive, the inconvenience not worth it or the level of care inadequate.
When she and her husband wanted to go to Michigan for a week recently, Lucy was elated when North Coast's activities director, Jan Manno, invited Marie to stay in her home. It was an ideal arrangement because Manno could take Marie to work with her. But, Lucy already wonders what she will do next time.
Then there's the money. Marie's Social Security, earned during her days as a sales clerk in Michigan, always runs short. "I'm using my savings," Lucy said.
"They have to find a better way to take care of the disabled, because it drains the people who take care of them," Lucy said, her eyes misting again.