Mom is losing her memory, in bad health and lives alone. I feel she is a danger to herself. She is currently being seen by a pain mgt doctor, spinal issues and long term prescription drug use. Smokes, has poor nutritional habits and is getting more confused daily. She has extreme outbursts and overreacts to most things. She does not trust outside help and makes it difficult to be around. My life has been on hold for several years now and I need help.
for the issues you have with feeling your life is on hold---I'm right there with you, had a horrible day with my mom, dealing with her doctors & her pain....all the while, one of my jaws is throbbing from a bad toothace. I can't manage to get my own needs addressed because I am so "put-upon" to take care of her stuff.
Good luck!
I was able to get mom to open the door by calling her and telling her that I had gotten a phone call at work about her not cooperating with the county. I said they have to come check on all the elders and she has to let them in or they will break down the door. They have to follow the law and she can't stop them.
Mom's mental illness was in full gear and her dementia was still in early days, but definitely present enough to degrade her quality of life. She had paranoid delusions and beliefs that they were going to hog tie her and carry her away to kill her if she opened the door.
Somehow, I was able to persuade her to open the door by saying they just want to check on you to make sure you're getting all the benefits you're supposed to have. *That* is what I think convinced her - the prospect of getting government help or money. Yes, I know I'm going to hell for these lies, lies, lies to my mother. Sometimes one has to do what one must in the name of the greater good.
Sandwich: I've pulled that line on my mom before: When a home nurse or social worker comes by: "Well, mom, they're coming to help you. They just want to make sure your needs are met; it's a good idea, and it helps you stay independent in your apartment longer." Then she'll agree and let them visit once or twice, say they're snooping around, and then tell them not to return!
Every time I've been at the hospitals, the nurses comment on how strong the dosages are -- "strong enough to knock out an elephant" is how one put it. I've mentioned it to my mom's doc, too, and told her a couple of the falls that sent her to the hospital could be tied to the Xanax. The doctor keeps giving it to her anyways. My husband has wondered if we could report the doctor for being so generous with the Xanax.
You'd think, with it aggravating dementia, it being taken improperly and with it being strong, the doctor would at least address cutting the dose. When my mom was at a facility recovering from her latest fall, they cut her xanax by half to try and ween her. Once my mom got past the mean stage of getting less dope -- and getting hostile with me for not smuggling her pills in to her -- she actually became much more pleasant and clear-headed for the last week or so at the assisted living facility. Then she went home and got right back onto her cigarettes and Xanax and turned mean and loopy again. The pills aren't the whole problem, but I'm convinced the Xanax and the cigarettes are a huge part of it.
I've hoped my mom would get a new doctor because she says this one "doesn't know much" -- the woman doesn't specialize in aging issues, so she has tried to send my mom to specialists for heart and neurology but my mom won't go. So she gripes about this doctor but goes back mainly to get more pills.
On one hand I want to get mad at the doctor but I know she has to follow the rules of the hospital she's part of. My mom goes in and the visit takes an hour because my mom rambles on and on about unrelated things (I'm sure the doctor wants to hear all about her trip to the Netherlands in 1961) and it's a confusing mess. Then when she tries to direct my mom to try therapy or see a neurologist my mom pitches a fit about the costs or says "I've lived too long."
The doctor has a limited amount of time and she's probably just trying to get through the day and I assume help people who really will follow through. It's not ideal, but I get that. I don't like it, but I understand that she's limited in what she can do.
My mom had another major incident the other day. She called 911, ended up in the ER but after a day there she was let go and they called her a cab. ( we had an argument so were not speaking, I believe this was another one of her stunts to manipulate as the nurse called me and said mom told everyone she has nobody and nowhere to go) I explained the situation, mom has taken a cab home from the casino plenty of times so as long as she is stable and couldn't be bothered earlier with letting me know what was going on then she can get home on her own.
Well… later the homeowner security guy called me and said she was confused and disoriented but he got her to go back inside her condo. (She still has not called me and she knows my number because she normally calls it 10 times per day)
I decided to go to bed and follow up with her in the morning. At midnight the police call me to come over as she called them 1st saying she was disoriented but when they did not get their fast enough she called and said someone was breaking in.
I went over there and she told me she just wanted to see me and has no idea why or how she got to the ER. The police wrote up a report and said next time they would hold her on a 5150. She said she couldn't remember my number, the entire time looked very confused. I told her then she needed sleep ( I think she is deprived of sleep as her home was a mess with medical papers everywhere and bills) At this point its usually a drug abuse issue as this has happened before right before she decides its time for rehab. Anyway… that is exactly what she mentioned to me the next day. She wants to get off everything! Today will be day 3 no smoking! Her brain petscan is this am…wish us luck!
But I don't get why they give out Xanax to old folks. A friend's mom, who is 88, has it, too, and she pitches a fit about it, but not as badly as my mom does. Old people who are on tons of medications already probably don't need a potent dose of Xanax. But I suspect some docs think, oh, they're old, let them enjoy it. I get that, but I don't think they realize that it creates problems for the family. My mom has gone to the hospital once or twice a year for the last four or five years and had to stay there several days each time. I'd say at least half of those stays might very well be tied to Xanax misuse. So, this "oh, they're old" attitude is stupid. It means family is driving around, the parent is racking up medical bills (in my mom's case, at least, since she always cancels her supplemental insurance), and all this other drama. A simple pill to calm a person ends up causing tons of stress for everyone else.
She would not have hugs or social interaction from anyone else. It had to be medical and procedural to "count". A prescription in hand was as valuable as a love note to the rest of us. It's due to an illness event in her childhood, but this is the way she was. Other interpersonal encounters irritated her to no end.
When doctors started to be evaluated by how many people they could put through in a day, they stopped having time for the "relationship" part of the visit. This did not go over with my mom AT ALL. It's hard to be a hypochondriac when nobody will let you perform.
The anthropology student in me wonders why we couldn't put that "visit time" back into geriatric visits on purpose. It doesn't need to be the doctor who sits through the story time, but a different person. It could really be a behavioral assessment through observation, that feels like visiting time to the patient. It could be a way to pick up on changes before they turn into a crisis event.
I think there are some cues into the person's situation that can be gleaned during that time. Do they tell the same stories each visit? Is the story now changing with different facts? Is the story mixed up compared to the past version? Is the person struggling to find words? Is the story more confabulation than truth? Is the process of relating the information (telling the story) becoming frustrating? Is the patient becoming paranoid or delusional? Is it getting harder to talk?
For some patients, having this time and attention is very calming and reassuring. That's why mom made a career out of going to any doctor she could. I believe it may make them more receptive and cooperative with the next part of the visit that could involve procedures. Just a hunch from an unqualified lay person!
A woman gets a pap smear and a nurse is present to make her feel safe and comfortable, but why can't there be an extra person there for a senior's evaluation, or even a person with some kind of mental illness.
It'd be worthwhile to have some extra observations noted. A doctor's already busy enough trying to address a host of medical issues in 15 or 30 minutes and prescribe meds and give referrals.
Some kind of case worker would be good.
In my mom's case, I'd love it. Maybe there'd be more support for getting some mental help or help for dementia then. "Hey, she always mentions she's lived too long. Maybe we can give her a different antidepressant or encourage counseling." Or, "She gets confused and goes on about a feud with a neighbor and it doesn't add up. Let's look into this confusion and obsession a bit more..."
That's such a great idea. Oh, how I wish it were policy!