Parents caring for the parent support thread (Part 2)

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1146

The daughter is probably a SAHM/grown children, while the brother is still working. Can the brother get his wife to care for the mom at home (if his wife is SAHM/grown children)? I do think the mom was living in some kind of independent living and maybe her own home still. I know the daughter wanted the mom to stay at rehab but the brother used the line “mom doesn’t want to stay there, and we shouldn’t make her stay there”. I did try to converse with the brother on the phone, but in a way he was like my own brother who often caved to our mother inappropriately.

Families ‘struggle’ when it comes to troubling and disruptive medical situations. Some elderly parents revert to child and sometimes it is more clear cut on how to handle. Family ‘dynamics’. I have seen where a son is married to a gem of a wife who goes well beyond what anyone would expect, but that sadly is often not the norm. Some ‘sandwich generation’ are needing to be involved with their own family, have demanding jobs that they cannot afford to lose, may have grandchildren responsibilities…

Our facility has return patients out of their choice, return families selecting our facility again. However it is not ‘home’.

1147

You absolutely were right to fight for the mother to have the rehab to be able to get up the 3 required steps at home.

My mom had a bad car accident and they wanted to discharge her too soon from the hospital as well. My older sister was there but didn’t know how to handle with correct language, so I got on the phone with the nurse (I was in another state) and described that mother was unable to safely ambulate w/o 2 person assist and she could not be discharged to home. A chief MD (he was dressed in a tux and stopped in to evaluate before his downtown function) allowed the extension. My younger sister arranged a week off of work (and I piggy backed and arranged a week off of work) so once mom was home, we cared for her while she needed one assist.

1148

Agree about the room at rehab - usually our admission staff does pretty good with having a room close to the nurses’ station for those that need it, but we have had patients move with better room availability too or with patient/family request on moving (some actually want the end of the hall/quiet and more private).

1149

The rehab staff at our facility is ‘contract’ - they are actually very good – they rent the space used, and work well with all levels of patients then qualify for rehab days after hospital ‘event’. Sometimes communication by family before or during PT/OT/ST evaluations ‘happen’ - of course Covid has been terrible for in person communication as well as full use of rehab facilities (no use of the large PT room and equipment during Covid). The individuals working with the patient may be PT assistants (trained and skilled but not making out the PT plan) or OT (for showering, etc). So getting whatever plan implemented with those services, along with the 24/7 nursing, aids, housekeeping, meals – the medication nurse may be charge nurse for the unit or during the day the charge nurse is a level up (a M - F person).

Patients/residents can be complicated situations and what is going on at the facility and how the facility responds to patient/family concerns and needs. One aide in an ill mood or not functioning as a good employee at the moment may cast a negative picture. However there does need to be some meeting of the minds on what can and may be accomplished during the rehab stay, which may include the family trying to find placement as the patient cannot safely go to the situation they were in before the hospitalization.

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1150

Also my mother DID go to rehab briefly. HOwever I distinctly remember discussing home PT, OT and nurse while she was still in the hospital because we had to decide. MY mother has nearly constant home health nurse and PT these days, until she no longer progresses, it stops, then it comes back. MA BC/BS.

1151

On the meds list and the wisdom of checking it, we learned the hard way. FIL was in the hospital overnight for an infusion and they gave him every med on his list, even the optional ones. He was on a lot of anti-constipation meds. It was a mess, think dairy queen gone awry.

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1152

Would anyone have any suggestions of identity theft protection services for seniors? My plan is to periodically review credit card/bank account/investment accounts with her, and freeze her credit (that she doesn’t use anyways). Plus, I was thinking some sort of identity theft service might be helpful, but I want to make sure they aren’t scams themselves or not useful.

1153

I just froze our credit with all credit bureaus. That seems best as it can be selectively unfrozen if we are ever in the market for credit.

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1154

I also got credit monitoring for my mother. I dealt with one credit bureau but it covers all three, $24.95/month…

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1155

If you froze all of her credit, would you still need the credit monitoring?

1156

I froze 5 credit bureaus(the 3 major ones and 2 more that I read about on bogleheads). I don’t see need for credit monitoring.

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1157

^^Yes! When my mom was in the hospital for surgery, her post-procedure med list was expanded to include a stool softener, since she’d be bed bound for a few days etc. SOP for post-surgery.

However all those meds were carried over on her chart back to the AL. I had to go in and sit with the nursing manager and tell her which meds were “typical” and which were related to surgery and she had to get a doc to sign off on which ones could be dropped.

I understand the concept of bringing home the hospital list, in case new things were added as a result of the hospitalization, but at some point, someone also has to look at the big picture of what the patient is on.

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1158

After my father was hospitalized and spent some time in rehab, he came home with a HUGE list of medications, plus of course he had some from his regular doctors. Took them all to the pharmacy (where the pharmacy asst happened to be a college classmate of mine). She went through the lists, made many calls to doctors, and cut the list from 40+ medications to about 10. Many were duplicates with different names, different doses, no longer needed.

One doc doesn’t know what the other has prescribed.

1159

I had the same thing after one of my father’s hospital stay. When he returned home, he didn’t have the strength to sort his meds into his weekly pill box. My husband, a physician, and I spent over an hour going through the meds and trying to figure out the duplicates, the not needed any longer, etc… Dad was just taking meds prescribed, but not sure what some of them were; this was an intelligent man, but trusted what doctors A,B,C,D and E were giving him, not knowing that some were the same or to be taken as needed.

Because both my husband and I have almost all family members in our city, no one stays at the hospital without another family member there to be an advocate. When a doctor makes rounds in the early AM and talks to a half coherent patient, it is a wonder anyone knows what is going on. I have always stayed with my dad when he had been hospitalized to make sure I knew what was going on. Luckily, my husband can play the “I’m a doctor card,” and can talk to the head nurse or the physician to sort out any issues.

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1160

My FIL’s meds were so messed up after a hospital stay & rehab. He had Parkinson’s & was well aware of his dosage, but the doctors refused to listen - and his personal physician would not help (maybe couldn’t, I don’t know). The family got him out of rehab as soon as possible, but he suffered needlessly. Same thing happened with the first hospice at the end of his life - that doctor also ignored the dosage that worked for him. A new hospice was engaged, and they listened.

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1161

My DH had a cardiac ablation procedure on Tuesday. The nurse we had, I would give her a 6 on a scale of 0 - 10. She never introduced herself and almost behaved rudely. Her badge just had Nurse showing so we didn’t know her name. The nurse that handled things during main one’s breaks was friendly and helpful. I only wasn’t available in his surgical pre and post area during his prep and his immediate procedure ‘recovery’ - I am still a licensed RN through this year. They tried to discourage someone at bedside “the chair is not very comfortable and many find it more comfortable in the waiting area.” Ha. I got a lot of my book club book read. This nurse also tried to say a med was OTC which it was not (and I corrected her). He never got the tylenol the NP ordered (his back was aching while he had to be in same position for the hours after the procedure). I am waiting for a ‘survey’ and I believe I will call the nurse over the dept for some ‘customer service’ feedback. The nurse spent minimal time, rushed in and out, rattled through what she had to do for instructions for DH to sign off. When we left, DH thanked me for being there.

As much as possible, a patient advocate is helpful for observation and making sure things go as they should. Especially with thin staffing, as many units are for cost saving measures.

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1162

Yes we have had good nurses with my son and not so good ones. I’ve actually called and complained about my son’s care a couple of times. To not give him a drug by IV because they want him to take it orally when he’s catatonic is nuts. :cry:

I am really dreading going down to Austin for my dad’s surgery on Monday. I’m tired from working a lot of hours. I hope I don’t have to fight the system.

1163

My mother is in bed all day 5 days out of 7, not eating. I tried spoon feeding ice cream, her favorite, and she asked me to stop after three bites. She complains about “something wrong in my head,” sometimes pain, and when sitting weaves and shakes.

Her anemia seems to be returning after only two months after iron infusions. Hemoglobin went down from 9.7 to 8.6 in one week. If it continues at that rate she will have a breathing crisis in 10 days.

She was in the hospital a year ago with hemoglobin 7, unable to breathe and had two blood transfusions as well as iron infusions. She had iron infusions in October 2021 and January 2022.The latter caused continuous vomiting which zofran helped.

Yesterday the AL could not get her out of bed to get her booster. When I arrived the nurse and aide said “oh good, you are here” as if I could get her up. Mother was shaking and crying and did not want to get up. That’s fine with me and I changed her shot date to Sunday.

I met with hospice yesterday, and they were “on the fence,” said she could live more than 6 months. Whaaaaat??? The aides are all saying yay, yes, get hospice, she is suffering! I am speculating the hospice org. is short on staff or funding!

I will continue with Palliative Care until I no longer feel a need to check CBC, Hospice said they could allow blood transfusion with preauthorization. We are not sure we even want to do transfusion or hospital.

In a tough spot, Her suffering does not seem to be related to anemia, though it could be. With vascular dementia at 95, who knows what is going on in her brain.

Day after day she lies in bed moaning, calls me crying. Despite her AL and Palliative (very infrequent) I feel alone with figuring this out. I see her every day but resting today.

PCP appt. was cancelled because they made mistakes in scheduling blood tests. Meeting with NP at PCP on the 14th.

1164

I’m so sorry!

Is there another hospice program that can give a second opinion?

I hope that your mom can be made comfortable ASAP.

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1165

I just talked with the hospice that is part of the system that the AL is in and they will take her. I have decided to ask for one more blood test next week. We need to decide on whether we would do a blood transfusion, which hospice will allow if MD preauthorizes as part of admission.

My mother needs more help than she is getting! Hoping this works.

Thanks!

ps was hoping she could make it until late spring and get some sun on her face, but if she can’t get out of bed, that isn’t going to happen…maybe via wheelchair!

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