My alarm clock this morning was my moms Memory Care calling to say that they came in this morning and found my mom sitting in her recliner and she has a black eye. "Did I want to come get her and take to dr or should they call an ambulance for transport?" Sigh.
Well after a day in ER, I'm sitting with my mom in ICU. No problem with her head, but she has 3 broken ribs.
Because of the dementia and them wanting to monitor for pneumonia which can apparently happen if you don't breathe deep.
I took her to a regular dr at first, but she would just close eye and not let her touch her. Just leave me alone. Or no! So we called ambulance to take her to the ER, because I almost didn't get her out of car at doctor she was being so obstinate.
The paramedics came in, and it was showtime to the max. Talking to them, let them check her joints, take bp. Got to ER and she told the nurses she was so nice.
Then I guess she ran out of gas and it was back to fighting everything they tried. They took her temp under her arm and I have never heard her yell that loud. Just leave me alone and don't touch me. Would not take any meds by mouth. Please, Please. Its been a horrible day.
She's resting now, probably a combination of the hadol they gave her when she wouldnt take sundowning pill, and pain med and exhaustion.
She can have one visitor during the day and it has to be the same person. But they are making me leave at 8pm.
And I had to do the hardest thing I've ever done, sign a DNR order. My sister and I have been discussing it, and we dont feel CPR or intubation is in her best interest at this point, but man it's really hard to sign that paper.
I've never had any experience with broken ribs, whats the recovery like?
I dont know how long they will keep her in the hospital.
Now, yes, they are right. Worst case is pneumonia. With cracked ribs, we can have a LOT of pain, and pain with every breath. This causes us to "splint" our breathing (what we call it) and not take a deep breath. The lungs get pneumonia and that can be lethal.
Hospitalization of the elderly often leads to confusion. The tendency to splint the breathing leads to less oxygenation of the brain as well, and that is contributory. I certainly wish you all good luck. Sadly these ribs are going to hurt for a while.My worst fear for her is when she gets out and tends not to take deep breathes.
Just read your update. I am so sorry. I hope the antibiotics go to IV now; she is unlikely to tolerate them any other way. And they will work much better.
Mom is not doing well. Ran a fever, so on an antibiotic for pneumonia, probably exhabarated by the nurse crushing up her anxiety meds in some pudding and her choking and possibly aspirating the food. She spent the second day extremely restless, and combative, pulled out ivs, yelled no and leave me alone, and please, please, and help me, all usually with her eyes closed. Although she would occasionally open her eyes and try to speak to me. Had some dips in her blood pressure and they added fluids as she could not take anything by mouth.
Next day, added oxygen, some lidocaine patches on ribs and she is sleeping all day. They can only occasionally get her to react. They backed off on pain meds, took her off the anxiety stuff. Still not normal, vitals stable.
Made the decision to sign DNR, and agree not to ventilate. But had to make the choice to to a nasal gastric feeding tube to see if getting more calories would perk her up. Took them three tries to do it. She kept blowing the ivs so they did a PIC line. Now they are going to do a 24 hr EEG and brain MRI. Cat scan didnt show any issues. Had to move from purewick to catheter, because she was retaining fluid.
When she does rouse when they do something, her grip is strong. They had to put mittens on to protect the tube iv etc.
I felt I had to give her a chance to make it; which is why I agreed to feeding tube temporarily. But now I question whether I should have just opted for palliative care. Because after all this hospitalization and trauma, I'm afraid of I she does pull through, where is her mental state going to be in?
Iit wasn't perfect, but she was doing ok in memory care. Monday she shared cupcakes with the ladies, now shes alone in a hospital bed. The hospital let's me stay from 8a to 8pm, but no one overnight. They moved her out of ICU this morning to a regular room on the neurology floor, since she was stable. Scared me, they woke me up at 630am with a phone call to tell me.
We will see what the doctors say in the morning.
Sending you a bazillion hugs!
I know shes hurting and confused. They have her in adult diapers, which she doesnt get. And then when she goes in them gets upset and cries, because she thinks she wet the bed. She was trying to get up last night, because she needed to go, and they were going to try to help her do that, but then I worry that too much moving around will make the ribs worse.
And it also makes me sad as I had gotten permission to take her out for a few hours for a 90th bday party at my house on Sunday .
Ggetting ready to head to the hospital in a hour. I didn't sleep much. She has never been in the hospital where I couldn't stay overnight with her
I'm sorry that you keep going through these difficulties with your mom and that it's been a horrible day for you.
When my mom and I went over those issues at the age of 89 when she was just diagnosed with Alzheimer's, she told me she wanted a DNR, she didn't want to be on a ventilator and she didn't want a feeding tube. When she nearly died in April from severe dehydration and COVID, I was prepared for those things to be in place with the hospital, then rehab facility and finally at her new ALF in their memory care unit with hospice care. She's doing amazingly well and even got involved for the first time with a craft activity today. We thought she was near death at least 3or 4 times since being in the hospital. I will honor her wishes - she left me a note saying "Do for me - not to me." That's what I'm doing.
With your mom, I know the broken ribs is what's making the rest difficult. At this point all you can do is wait and see how the healing process goes.
I will be praying for you both and the situation at hand. May God give you strength as you find yourself doing some of the hardest things you've ever had to do.
My mother wound up cracking a few ribs a while back when she fell in her apartment at the ALF and didn't tell anyone (this was prior to being in Memory Care). She was complaining bitterly for months about pain on her side, so the doctor wrote a few orders for Icy Hot patches which she was having applied on her ribs a few times a day. Nobody knew at the time what the problem was; she is very good at hiding the truth. When she was hospitalized in May of 19 for pneumonia and had a CT scan, that's when the doctor saw that she'd had broken ribs (and sternum bones) in various stages of healing!!
I guess pneumonia developing WOULD be something to watch out for, because it's very hard to take a deep breath when it hurts so much to do so. Shallow breathing can easily lead to pneumonia, especially with the elderly. Generally, it takes 6-8 weeks for ribs to heal and there is nothing that can be done to speed up the process or to 'cast' the bones, wrap them, nothing like that. Unfortunately.
I think you did the right thing by signing a DNR, hard as it is to do. CPR on an old person is brutal, as the doctor explained to me when I was fighting to NOT have a DNR signed for my dad. I went ahead and did it, after the CPR process was explained to me, and my mother also has one in place for herself.
Wishing you and your dear mom the best of luck with her recovery.