T he call came at midmorning. A siren wailed in the background.

My husband’s 90-year-old mother was being transported to the hospital. His younger brother found her on the floor of her kitchen after the downstairs renter heard her calling for help.

Paralyzed, slipping in and out of consciousness, Grandma Bessie clung to life.

We reached the hospital four hours and hundreds of miles later.

Two days passed in the critical care unit. She rallied.

A week later she was moved to a Life Care Center to begin rehabilitation.

For a woman who prized her independence above all else, the stroke that paralyzed her left side was a crushing blow. Still, she was adamant about going home and returning to work.

Although she had the personal resources to afford it, she did not have long-term care insurance because she had always insisted she would never go to a “nursing home.”

Before the stroke, she spent weekday afternoons in the gift shop she owns in partnership with her 58-year-old bachelor son.

Home is a multilevel structure. On the outside, it looks kind of OK. Inside, her living quarters were cluttered, filthy and showing the impact of three cats that didn’t always use the overflowing litter box.

She consistently refused to have family members or anyone else clean for her. The family was told by social workers that, legally, she could live as she pleased.

The situation frustrated her family for more than a decade. When do adult children and grandchildren cross the line, become the parent and make unpopular choices?

For five weeks after the stroke we watched her struggle to regain the use of her body. Gradually, she was able to return to normal eating. Daily therapy helped her move her paralyzed arm and leg slightly.

“I am going home,” she announced.

The assisted living plan at the life care center perfectly suited her needs. She’d have 24-hour care, good food, company and lots of activities. If some real estate holdings were sold, the proceeds could finance her care for many years to come.

In fact, we recently learned, she transferred all her assets and property to a corporation linked to her son’s business so she could qualify for free home health care services. Ethical? I don’t think so. Legal? Apparently.

Going home required a complex round-the-clock support system. She is incontinent and unable to sit up without support. She cannot prepare her own meals and needs help with medications. Sometimes her mind is clear; sometimes she’s very confused.

A hospital bed was installed in the living room.

To manage Bessie’s full-time care, her younger son arranged for equipment and services available to low-income seniors.

A caregiver gets her up in the morning, dresses her and uses an automated lift to move her into a recliner or her motorized wheelchair where she spends the day. Another caregiver comes in for a few hours midday. She serves Bessie lunch and does simple chores.

Meals on Wheels comes once a day

Physical and occupational therapists visit weekly. Still, Bessie spends many hours alone with a telephone, TV and her cats.

There are no trips to work although she wants desperately to be there. Without a significant improvement in her condition, that will never happen.

My husband’s brother has moved back into his mother’s house. During the day, the telephone at her side ties him to her as surely as the umbilical cord did at birth. If he’s not at work, he’s home with her. That is what she wants.

Although he was anxious to please her and let her live in her own home, he understands now how much that decision has cost him.

We make the 400-mile round trip once a week and take home-cooked meals, but it really doesn’t give him much of a break.

We all want to stay at home as long as we are able, but would we insist on that if it meant our children had to give up their lives to take care of us?

Isn’t that why those who can make provisions to prevent that situation?

Home health services are excellent options for semi-independent senior citizens, but assisted living in a full-care center may be the best solution for someone who needs 24-hour care.

The best gift we can give our children is to plan for such catastrophic events and make thoughtful choices for ourselves. Better to do it now while we are healthy and clear-headed rather than wait until impaired mental and physical health makes us the “children” and someone else makes the choices for us.

Linda Bryant Smith writes about life as a senior citizen and the issues that concern, annoy and often irritate the heck out of her now that she lives in a world where nothing is ever truly fixed but her income. You can e-mail her at ljbryantsmith@ yahoo.com.