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Just an update - my mother fell again, remembered nothing, woke up on the floor of her bathroom, scooted herself to the phone to call sister-in-law who came over and helped her get up then left. Caregiver arrived shortly thereafter and began cleaning mom’s wound with peroxide and a washcloth. No one called me, no one called EMT’s. I went to her this morning and found her arm a God awful mess, her thin skin bleeding and sloughing, her face bruised. I wish I could post the photo but it would make you sick. Took her straight to Urgent Care who sent her to ER for work-up. Medical team was astounded. Of course brother is out of town. His negligence has to stop.

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While you are at the hospital, ask to speak with a social worker about your mom's living situation. If no one is available, ask for the number of the SW department so that you can call to discuss next business day. Hopefully, she gets admitted!
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Maybe SIL didn’t do anything because she knew the “caregiver” was coming? Don’t know. But the paid professional “caregiver” really has to be taken to task on this. She should have called someone...911, you, brother, SIL, somebody when this occurred. I had to reprimand Moms privately paid aide at the NH when she didn’t ask for malox when Mom had a tummy ache! There’s absolutely no excuse for a caregiver not to follow up on a fall.
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I have a different take on this.

Is it possible SIL said " I need to call 911" and mom said, " oh, no, don't do that, I'm fine".

Caregiver cones and says " Mrs. B, we need to get you to the doctor" and mom say, " no, I don't want that".

TWillie shows up ( did she call you, or was it your day to come by?) . Did mom ask to be taken to Urgent Care, or did you insist?

Is mom playing a game here to foment discord?

TWillie, if mom wants your attention and is going to be the cause of your not getting back to work, she needs to change POA and set up a caregiver agreement with you. And go to an endocrinologist. Hopefully, she gets seen by one at the hospital.
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Sounds like some changes are needed in lines of communication, at least, Do you know why her blood sugar doesn't stay stable? Does mum take her meds and eat properly? Is it still safe for her to be alone at night? Has the point come where she need an overnight caregiver? Does she need to be in a facility so she can be better monitored? It looks like an evaluation of her situation should take place in consultation with her doctor.
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Rocketjet, tried to respond to ur post but can't.

Just curious. Is Malox on Moms chart to be given when needed? I am assuming it is because that is the only way the aide could have requested it.
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Joanne29, yes malox is on her chart to be given as needed. Her normal aides employed by the NH know to tell the LPN that she has a tummy ache and the Lpn would administer it. But my private pay aide I hire occasionally to be with mom at the NH didn’t know to tell anybody. I found out later that she hadn’t eaten and figured out why not. Got that corrected.
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Barb, you are so intuitive. Been getting the truth out of mom in bits and pieces. Said the caregiver offered to take her to doctor and she said no. SIL says she looked her over good before leaving. That would have involved taking off her robe and examining her body which she did not do. At the very least both of them should have called me even if they didn’t now claim to know how serious it was ... and let me make that determination. Barb, mom called me later that evening and after caregiver left for the day. ER doc did not admit her but strongly talked to her about seeing endocrinologist. Brother is away training for pilot position flying international. I did speak to him tonight and he talks about assisted living for her. I just don’t know if he can realistically make it happen while trying to further his career. He is in a state of denial if he thinks an endocrinologist alone can turn this around. Food has to be cooked for her and regular meals and snacks provided 6 x day. It is a full time job.

Thanks ladies, and more updates to come as I also have to do wound care to keep her arm from becoming infected.

T.
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Barb, p.s. Mom went willingly with me to urgent care and hospital.
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Glad brother is thinking about AL for mom. I think that's a big step forward!
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TWillie, were you able to speak to a social worker while at the hospital?

You and your brother need an Independent, professional assessment of your mom's needs. Call her local Area Agency on Aging and ask for an appointment for a needs assessment. You and either SIL la brother should be there so that there is no question about what is recommended and why.

As an aside, just because your mom says that SIL didn't check her out thoroughly is no proof that she didn't. Your mom is no longer a reliable reporter. Keep that in mind before passing judgement on others.
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Twillie, is Mom taking blood pressure pills?

My sig other had fallen because when he stood up from a sitting position he passed out for a couple of seconds. Turned out that the doses for his blood pressure pills were too high. Once lowered, he no longer had that dizzying feeling standing up.

Just food for thought.
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Barb, I talked to my brother and sent him the photo of mom’s injuries. He told me that his wife told him she looked mom over good and didn’t see an injury. I’m not judging.

Did not get to talk to a social worker- stayed by her side in the ER while she was being treated.

Taking her to endocrinologist ASAP.
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Is your mother insulin dependent? Who administers her medications? Does someone check her blood sugar regularly?
An elderly person with questionable judgement on insulin should be in a supervised setting. I think to pursue AL or some type of supervision is appropriate at this time.
When you take her to her endocrinologist bring her glucometer with you so he/she can check blood sugar history. Every meter has that capability these days.
Someone should be checking your mother’s blood sugar 3-4 x per day, and certainly before giving her an injectible insulin. Her aide should be able to do this if she’s a CNA.
As for the wound, those take so long to heal. Try a vaseline type dressing in the beginning so when changed it doesn’t slough off new skin.
Good luck to you!
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You post says she has sudden drop in blood pressure. Some people get that on a regular basis. I have had it a few times, as has my brother. I'd explore Postprandial hypotension. Some people get these drops in blood pressure after a meal. Other times, it just happens. It's hard to predict. I'd have her doctor discuss things to do to stop the fainting. Like, if you start to feel faint, you immediately lay down, head level with body and wait for it to pass. If you try to keep standing, it will force a fainting. If you mother isn't able to manage, she may need around the clock supervision, but, still, even someone else being in the house, she could still faint.
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I’m doing a lot of research. What is happening to my mom is she is on Lantus long acting insulin injected at bedtime. If she has not eaten properly she is hypoglycemic during the night. Sugar is spiking after meals during the day to 340-400 range. She is small 124 lbs. GP is the prescriber and only prescribes 1 test strip per day. That is not enough. She’s using an old Accucheck monitor. Yeah I know she’s gone hypoglycemic on me many times and I have to call EMT’s. And yes I know she needs round the clock care. That’s why I fight with my brother because he’s been letting her live alone under the guise that he’s taking care of her when he’s actually delegating it to his wife and while she might be a decent person she’s not taking care of my mother like I do.
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I was told that Lantus should be given in the morning so it is working when food is being eaten. Taking it at night has her sugar drop when no food is coming in. It is a long acting drug but not a 24 hr drug. But everyone’s system is not the same. Let us know what the endocrinologist says.
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97yearoldmom, research shows that Lantus is FDA approved for taking at bedtime. But there is evidence to support that it should be taken in the AM. Seeing endocrinologist in the AM. Thanks.
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Twillie
Please do let us know what your mom’s endo says about the Lantus. My husband takes it in the morning. I’m sure each dr has their reason for the time they suggest. The explanation I gave was what we were told he should do and why. I hope your mom isn’t very sore from her fall.
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Twillie, good luck today and let us know how the endo appointment goes!.
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Update: I’ve taken mom to the endocrinologist this AM. Definitely Lantus is to be taken at bedtime. I took her monitor and my blood sugar recordings and it didn't take doctor long to figure things out. She took blood to see if mom is producing any insulin. She counseled mom that she cannot re-use her lancets and needles like she’s been doing among other things. In a brief private conversation she told me mom needs insulin injections at mealtimes but she won’t allow her to self-manage it. Thus she wants the POA (my brother) at the next appointment in 4 weeks. I then had to take her back to the ER because her wound bled during the night and nightgown was stuck to her skin and urgent care wouldn’t touch it.

We did speak to a social worker and wow it was like a counseling session - my mom got to express her thoughts and emotions. While we didn’t get any long term care plans in place at least I’ve got her to accept my help for a little while to get through this.

I’ve come to realize that her sugar spikes at meals are making her practically psychotic. Last night was real bad so talking to social worker and doctor today was a start to getting some help I hope.
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TWillie, I'm so glad you got mom to the endocrinologist.

Will your brother be able to go to the next appoinrment?
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I’m confused. Social Worker told me mom is competent to make her own decisions about living arrangements. So why did Endocrinologist say she wants POA at next appointment to discuss mom needing insulin injections in a supervised setting? Can’t the financial power of attorney make decisions where the agent is going to live?

Mom’s condition is getting worse. She almost fell even using the walker trying to get to the bathroom. She is peeing all night long (kidneys trying to excrete sugar) and I could hardly manage to get her on the toilet she was so limp. I put her in a diaper and forbid her to get up. I’m on constant alert, it’s very hard to sleep.
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Well, your mom hasn't been found incompetent to make her own medical decions by two MDs. The social worker can't make a determination of competence, she can only go by what has been doctor verified and court-ordered.

It sounds as though endo doc sees that mom can't care for herself and she's prepared to tell POA that. This is a good thing.
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So my mom has been in my home for nearly two weeks - is on Home health care and has had visits from social workers. She still either can’t or won’t answer the question who is her medical power of attorney. I honestly don’t want the job because she is uncooperative in her care. A social worker for Sixty Plus came to visit her and determined that the only person mom is going to listen to is SIL. But SIL is the one who found her on the floor injured and never got her any help and didn’t call me. I was at the end of my rope and reported this to APS. Don’t know if anyone was negligent but my mom is certainly self-neglecting. She wants to go home and ohhh how I would love that but we have to hang on till she sees endocrinologist again. I believe that doctor is working to get her in LTC. I’m not sure what to expect from APS investigation if anything. They did come to my home to evaluate her - wound is healing and I’m giving her excellent care but it’s wearing me out and can’t go on indefinitely.
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P. S. I don’t actually want her to go home - where she will suffer another crisis. I want her to go to assisted living for LTC. The uncontrolled diabetes is the catalyst. Not sure if we are going to find assisted living that can administer insulin - could end up being sliding scale. For now I am charged with the duty - 4 x day.
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Perhaps she is at the point of needing nursing home care? It must be such a challenge for you to care for her when she is not so willing to care for herself. And now you must be so tired, having her at your home.
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Twillie, I wonder how much anyone is going to be working on LTC for your mother, because she's in your home now, and YOU are acting (for now) as the LTC. And I'm sure it makes everyone satisfied but YOU. Be careful...this is how we see so many temporary caregivers become the permanent caregivers.

The only impetus the medical folks have to find LTC options is when the elder needs to be discharged and there is nowhere for them to go because family refuses to be the caregiver. The temporary solution all too often becomes the permanent solution.
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So, TWillie; Did you talk to the APS and SW folks about taking your mom home to her place? Are they advising you to do that?

Since your mother is not cooperative and clearly does not want your care, and has NOT been judged incompetent, it seems as though you should deliver her to her home and notify your brother and SIL in writing, via certified letter that she is back in their ballpark.

I know this sounds hard-hearted. But if your mother doesn't want your care, you really shouldn't be ruining yourself financially to provide it.
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Barb, SW said to get her back to her home (that’s what mom wants anyway). Endocrinologist told me to tell her “we’re working on it” and keep her here with me because she can’t go home with the insulin new endo prescribed. That’s why I thought with doctor involved and APS involved maybe she would get placed in a nursing home. I’m dreaming right???

She would probably function well in AL if a caregiver gives the insulin correctly. But she doesn’t want to pay for AL. Trying to get money from her to buy some food and her necessities while she is here has been hard enough. Stingy!!!
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Did I ever mention that she threatens killing herself by insulin OD? That’s why endo won’t let her take Humalog unsupervised because I told the doc what’s been going on.
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