My mother's in rehab for physical therapy and not happy. She's mad and not cooperating. She tell me I'm not going to take her home, she's asked me if I'm trying to kill her and several other mean and hurtful things. The staff tells me this is normal and not to worry but it hard. She's has a urinary tract infection from the hospital which they are treating with antibiotics which is messing with her mind. I'm new to this and it hurts to see her in this condition. How can I get her to calm down and trust that i will take her home one day and to take the time to get better?
It sounds like your mom is exactly where she needs to be. It may be time to realize that she can never go home. My mother is 95 and in a great nursing home. My MIL is 92 and is an equally great assisted living.
No more worrying if they have fallen, been taken advantage of, getting bathed, dressed, fed, etc. They are both safe and that is the main thing.
If you are your mother's caretaker, think about what will happen to her, if she survives you. That is exactly what happened in our family. We feel that mother's neediness resulted in my sister's premature death, at age 69.
My MIL sold everything and went to AL, after a stroke. It made everything as easy as possible on her "kids" ages 61, 65, 68 and 70. :)
la55cagirl, thanks for the comment and question. I am having an extremely difficult time dealing with the death of my mom -- especially because I wasn't there. I am very depressed and having a hard time dealing with life. I had been with her at the SNF every day for over a month. Luckily we found a SNF only a mile from our home, and I was not working, so I went for lunch and dinner every day and we had four weeks to talk and be together, and although she really worked hard in PT, she was losing weight rapidly and the Ativan and Morphine made her worse, but she also had many signs that her body was shutting down. The last few days were extremely tough on her. She could not get comfortable and we wanted to bring her home on hospice, but because she still had over 50 days left on SNF, and needed constant care, my husband and the hospice worker recommended keeping her at SNF. Because she was vomiting (due to the morphine, or just to her body shutting down - not sure), the hospice worker also recommended changing her from morphine in a 1ml dose to a sublingual .5 ml dose of 10mg, ever hour as needed, and a Fentanyl patch (both can cause respiratory failure, which is what she died of). After 2 10mg. doses of Morphine over 2 hours, she was still uncomfortable and moaning, so I told the med nurse to give her the morphine every hour -- she really couldn't request it herself. I was so exhausted, after an incredibly physically and emotionally painful day, so I left at 10:30pm, and made the mistake of not requesting a student or someone to stay with her. I know the nurses observed her, but no one was sitting with her, or closely monitoring her. The ONLY thing I can think of to relieve my guilt for not staying with her is that she really was close to end of life. Her liver was shutting down and she was miserable - and she was DNR, at her request. If I had stayed, I would have stopped the morphine and she would have continued to suffer for another few days, or weeks. I know my mom wanted the pain to end and she was not going to get better, but one more day would have allowed us to say goodbye, and that is just something I will have to live with.
Was uncooperative there as well. And Medicare won't pay if you don't make progress. Fast forward a year. Mom is now 100% confined to a wheelchair as she lost all her leg muscles. Now she cries cus she is stuck in a chair and she is in a residential care home, waiting 6 years for me to retire. She thinks I will bring her home then to live w me. What she doesn't know is Im not.
I am so very sorry for your loss of your mother due to the OD and morphine. Sounds like we have both learned the very hard way- us both having lost our parents due to medication mistakes - that advocating for the elderly, especially when they are in a Skilled Nursing or Therapy Rehab situation, is vital. As you pointed out, they medical system does not always excel in communication among them selves and horrible mistakes happen often. And , the rehab PTs are often young and not empathetic to the elderly. How ironic and sad I find this to be. I wonder how you have found to deal with not being there when the incident with your Mother happened? I am very hard on myself because I was not there with my Father when the mistake with the Ativan occurred.
My sweet mom also had a very bad reaction to Ativan. She seemed fine at first, but then had severe delusions - yelling and screaming and completely not herself - which stopped as soon as the Ativan was stopped. I looked it up and found that this reaction is fairly common. Ativan is very strong, and should only be given to certain geriatric patients, and in very small doses, to see how they react. I strongly agree that an advocate is extremely necessary to be sure that the proper meds and treatment are given at SNFs. Although some of the caregivers were wonderful and took great care of my mom, the communication between RNs, LVNs, CNAs, Therapists and Doctors is poor - pretty much across the board. And Doctors are rarely seeing patients - if at all (my mom was seen by the doctor only once in 5 weeks). It is very important to make sure that patients get the proper medication, as I know they gave her contraindicated medicines for her condition. In addition to the Ativan, they gave her too much Morphine, and she OD'd and died. Had I been there, I would have asked them to stop giving it to her, as she was not in pain, just uncomfortable.
I found this article interesting: http://www.mdanderson.org/transcripts/delirium-palliative-care.html
I would observe the staff doing her PT also. Some of them are not very good at handling the elderly and really unrealistic regarding their stamina. They tend to be 20 somethings with little life experience and poor social skills. They can not relate to the elderly. If you have one who shows genuine interest in your mother , you and your mother will really be so fortunate.
Good luck.
Don't take it personally, but for your sake, just remind her you love her and wish she didn't have to go through this, but each day will get better and she'll be home befor she knows it...stay positive.
Take a break and keep conversations and visits short. Give her a few days to adjust and let the care team know you are available but you are stepping away a few days while they get mom on board.
Tell mom, you can't wait to get her home when she can walk on her own, feed and toilet herself, whatever and request care team reinforce that message everyday in rehab.
I'm very sorry for this terrible experience and the loss of your father, that is so sad!
I know in my mother's case--it would have been impossible (and I think many others will agree with me) to have had someone with their loved ones "watching" them to make sure their care was the best. This is why they are in rehab facilities or AL. Because we CAN'T be there. We really tried to give mother a ton of attention and time, but it was to the point that the therapists said our constant presence was just making her less likely to be cooperative and to adjust to the rehab facility. (If she didn't like the food, she'd call one of us and have us bring her something she liked). She really had a chance to socialize and do a lot during the days,, but all she wanted to do was lie in bed and "receive" visitors. I think there is a fine line between keeping an eye on the situation and practically living in. Most people don't have enough family, friends, etc in their lives to DO a 4-6 hr stint for weeks, months...again, I am very sorry for how things went with your father. That is sad, and no one should have to deal with that. Please don't beat yourself up over not being there.
My sweet father was recently in hospital for a fall, but he was recovering well. I live out of state and didn't fly in because I was assured by him, his caregivers and his niece who is a nurse in that hospital, that he was healing up and I didn't need to come in. At 94 my Dad's mind was sharp as a tack. But he did have chronic congestive heart trouble and got easily upset. But accounts even from Doctors said he was healing from the fall, but it was recommended to get him rehab for strenght so he could return home with caregivers of course. I agreed with the recommendation and he was moved to Rehab/SNF floor in hospital. That night he and caregiver said the nurses were not nice there. And his roommate was loud and yelling. My Dad was upset but I knew a caregiver would be there. But she got sick and didn't show. Dad had a panic attack, they gave him Ativan and he had a bad reaction to it. They called me, I flew out and 48 hours later he was dead. I don't blame Skilled Nursing/Rehab but I will tell you there is a particular culture and attitude to the people who work on these nursing units that is vastly different from the Cardiac or other floors. Even the Social Worker agreed with me on this. My fatal mistake was not being there and not having got a replacement for the caregiver who didn't show. Listen to your Mom's complaints closely and make SURE an advocate is there for her while she is in that unit.