Thank you – that’s exactly how I see it, but I think siblings who are caregiving can’t see the forest for the trees.
I spoke with my mom at length, and it was actually so much worse. They did run the car in the garage, but realized that was bad, but then couldn’t get the garage door open. He was exasperated that she didn’t know how to disengage the opener; I consoled her that even if she had, she couldn’t reach it. But here are two elderly people in the pitch black rapidly filling garage trying to reach a pull cord…
They got the door open, couldn’t get it closed. Had to leave that for daylight, still couldn’t. Preferred sibling gave them lessons, got the door down. He and I agree that we need to address some things but I just don’t know. She responds well to flat out forbidding (I have insisted she stop thinking that climbing ona chair is something she can ever ever do) Some days it seems like doctors see what they want to see. Siblings and I are chatting about whether to tell his doctor about this whole incident, or just let it go.
@greenbutton- trust your gut. The tendency to minimize challenges or missteps is great on the part of change resistant, fearful elders and we want to believe them that things are manageable and that incident by incident, we can coach them through every eventuality. Yet judgment is an issue each time and so is reliability. Important to see the big picture of what ‘time’ it is for your parents as it can be hard to contextualize in the moment. The Dr may be helpful with that and also be an important ally in the process of tending your folks’ needs accurately, as well as helping family get on the same page.
Examining what resistance we may have to acknowledging seniors’ limitations is important. What will need to change? How can they be safe? What responsibilities will fall to you and local sibling? Are there financial constraints? Is looking into resources daunting? How cooperative are your parents likely to be? Discretely check out very basic things in their home and paper work: food, organization and cleanliness, financial/paper work and bill paying ability, mobility and architectural challenges. Take a drive with them at the wheel. It helps to put assumptions aside and confirm what is going on. Not about a “gotcha” moment, but compassionately assessing needs and normalizing that most folks need to tweak things with passing time. At varying points, I had to get real about my parents’ capacity declines. They were like the duck, calm on the surface and paddling frantically beneath the water. I share this with empathy. There is tremendous relief in synching parents’ circumstances to their needs. Hang in there.
Your dad should be able to get some tanks of O2 he can use in case of power failure so he doesn’t have to have that particular concern in the future. It is covered by Medicare. It could be smaller tanks that are more maneuverable or a larger one. Someone should call his MD or O2 provider about options.
Preferred sibling went out and bought them a battery backup to keep next to the bed, good for hours and followed it up with a lecture about doing a better job not panicking.
Dad does not have dementia – he’s just cognitively fuzzy in specific ways that doctors are unlikely to notice. We’ve not been impressed with their general doctor, and are wanting to avoid any fallout where Mom decides the better course is to tell us nothing at all (lest we tell the doctor). So right now, it is a lot of watchful waiting.
Local sibling has decided to take an extended trip while preferred sibling is also away, but did change a bit so I only will take a week from work to stay with our parents. They protested, and I told them it was really not something we were going to negotiate. Dad does not drive, and hasn’t for at least a year. Physical therapy eyeballed the house and remediated a few things. We creep along, taking notes and comparing them.
I find this true with my dad. He does not have dementia but things can make his cognitive functioning go wacky - low Oxygen in his blood, an infection, being in a different place (hospital, etc.), etc. Also, keep in mind that all people panic a little when things happen (like the power goes out). For the elderly, the panic might be more extreme.
Ugh, a not so great primary care doctor complicates things. Both of my parents & both of my in laws had doctors we urged them to replace. No luck. MIL is the only parent left, and she finally has a new doctor … only because my SIL told her she would not drive her 3+ hours to appointments with him. The new NP she is seeing immediately diagnosed some things we had suspected. That generation seems less likely to question the competency of doctors than our generation (even when we children try to get them to think critically about their care - or lack thereof).
My parents really liked their internist. He attended all our weddings and their birthday and anniversary parties over the decades. The MD was slipping since his health started declining. Fortunately he retired and we switched both parents to an excellent geriatric who I find very easy to work with and my folks liked too. She’s easy to reach by phone or e-message in medical records software, which is much better than how challenging it was to reach prior md. So glad we have transitioned to this MD.
Another thing is so many people focus on the less-capable person, when both of my parents need contingency plans. I had mom give me all her log ins for everything – she was puzzled because she is very capable with their finances, etc. And I said yes, but what if she gets pneumonia or the flu or whatever, how do we help Dad? And she was all “oh, good point, here’s my stuff”
Ugh, my father is back in the hospital. Confused - won’t eat or drink or take meds because he is scared the King is trying to kill him. Hopefully, I talked him into being cooperative. The weird thing is that when he makes up these ridiculous stories he sounds so confident and with it (more than other times when he is not confused).
@kiddie, my dad had post-anesthesia psychosis after hip replacement surgery (I think he was 88) and he had such a vivid sense that we had been in a car accident and the driver’s side door of his car was sheared off that for the rest of his life, he could never quite believe that it didn’t actually happen. For sure at the hospital they will know that your father is in no danger from the king.
Is this hospital delirium? My mother had that. They had to hire an extra nursing assistant to sit with her. It went away when she left the hospital (even though she didn’t remember her assisted living AT ALL!).
Yep it is some form of hospital delirium, he had it the last couple of hospital stays also (as well as once when he returned to his assisted living). It manifests itself in different ways - this is the second time he was outright paranoid “somebody is out to kill me”, other times he was just plain hallucinating (telling me a complete story of where he was and what was happening when all the time he was just in his hospital bed.)
The doctors and nurses don’t seem concerned about it, except when it stops them from treating him (because he won’t accept meds, or food, or drink.) The nurse called this morning to tell me this was happening, so I would get him to be cooperative and take his meds (and eat and drink).
@kiddie my dad was postop (hip replacement after a fall) and tried to get out of bed to go to the bathroom. The nursing staff had to restrain him, and then gave him one dose of Haldol which broke the episode–the next day he was very sleepy and the day after that he was fine (except for vivid memories of the “car accident.” This was around 2011, not sure of the protocol now.
My mother kept yanking her nasogastric tube out, OR tried to lunge to the sink to drink, which would have choked her. She had 24/7 supervision.
When she got back to the assisted living, she called me for a few days saying she was packing and ready to go home. That part was more a memory issue then delirium. It can be hard to tell the difference!
My kid had a brain injury and was in an induced coma for a week or so. Thought she was on a boat in France, slapped me when I gave her the wrong drink, confabulations for a couple of weeks and amnesia for a few months. So it isn’t limited to age. But clearly happens more easily, via disorientation and normal anesthesia.
My mom had episodes of delirium that came out of nowhere. I vividly recall talking on the phone to her during her episodes. I could usually get her back in touch with reality by asking her to describe things in the room & describe what she was sitting on. For some reason, that eventually helped. Not every time, though. I feel for you, @kiddie.
We were at a medical conference and H attended a session on ICU psychosis and delirium. All the activities and noise and disruptive sleep and different routines as well as meds contribute to it. One younger patient talked about how she had been a successful professor. Once she went to ICU and had the psychosis and delirium she was never able to return to work as she had been doing before and sadly had to retire as disabled.
It often resolves in younger people (and in the case of my elderly mother too) so I wonder if the reason your friend was in the ICU in the first place is the actual reason for the disability.
@compmom — the woman who spoke at the conference had been perfectly healthy before her icu visit. She has never gotten back anywhere near her former baseline, sadly.
My dad had hallucinations after about 6 days in the hospital–he was there a bit longer. I am totally convinced it was from lack of sleep. They woke him up continuously. The doctor even finally wrote orders to let him sleep and quit bothering him. Nope. In at 2 am to turn him or want to give him a bath. Absolutely ridiculous. Doctor rounds, meds, bp checks, physical therapy, room cleaning, dietary in to take orders, dietary to deliver meals, change of shift introductions, social workers etc. We took him home instead of to rehab afterwards just so he could sleep without interruption.