How do we get the hospital to keep mom?
89yo parents. Mom has been on hospice care for a year. Dad is at his wit's end. Mom had a major personality change starting three weeks ago. Aggressive, violent, threatening. My first thought was UTI but it was dismissed.
Hospice was in the process of the paperwork at their home on Wednesday to put her in emergency respite care because dad needs a break, when mom picked up a can of pesticide and sprayed him in the face (this is an example of the behavior he has been dealing with for three weeks). This dq'd her from respite care so the hospice nurse sent her to the ER. They discharged her the next morning, said nothing was wrong with her.
Yesterday (Friday) was horrible. She left feces all over her room, while dad was cleaning that up, she went to other rooms and spread it all over walls, chairs, counters, you name it. She tried to push him down the steps, she hit him in the back enough to take his breath away. When the hospice nurse arrived, mom was outside half naked yelling and screaming (dad was inside cleaning up feces). They sent her back to the hospital, hospital called dad at 9:30 last night to come pick her up. He refused (doesn't drive in the dark and has trouble staying awake). He picked her up this morning, she is combative, refusing to take the meds for the UTI they now have diagnosed.
Nursing homes are closed, hospital won't keep, and she may very well kill dad if left in their house. Any suggestions? There is an appt Monday for a nursing agency to come in, but at $23.00 an hour, my dad isn't willing to pay for what is needed -- round-the-clock care.
Hospital decided to transfer her to a "behavioral health facility" (new word for psych hospital, I guess) on Tuesday. Both Wednesday and Thursday mornings she had choking episodes (that's new, didn't have that before) that resulted in trip to the hospital. She came back to the facility after the Wednesday episode but was kept overnight after the Thursday episode and that is where she is now.
She has spent more time at the hospital since being sent to behavioral health center than at the center. No psych eval has been accomplished yet. I spoke to staff and was told she is calm and peaceful. I forgot to ask if she is being treated for UTI. I was also told she is funny. When asked where she was, she responded, "I am here." When asked where "here" is, she responded, "The nut house." I also asked if they were having trouble communicating with her since she has expressive aphasia. They said she is speaking quite well and have no problem understanding her. Hmmm . . .
When offered dinner Wednessday night, she was only given a plate of pureed food, which she refused. She asked for a cookie and they told her no, so she went to bed without dinner. I wonder if that contributed to the choking on Thursday morning? (She tried to eat too much at once, had a mouthful of small bits of sausage when she was only supposed to take one small piece at a time.) Also, Dr. Google tells me that choking can be a result of UTI. Untreated UTI leads to dehydration, dehydration leads to dry mouth, dry mouth can result in choking.
Hopefully mom will be back at the center today and they can actually accomplish the psych eval and get the process moving. And I am praying that the bed stays open at the rest home.
(Thank you, BarbBrooklyn, for your suggestion to post my update as a reply.)
Even though you can't edit your original post, it is probably easiest for you to simply post an update at the top here rather than replying to each in individual. ((((Hugs)))).
Probate guardianship as she is a danger to herself and others. There can be an
immediate short term comittment for evaluation. The hospital is not likely equiped to handle her long term anyway -They should have had this done after
second incident. The UTI was a consideration -but if it did not work something else has to follow. Nursing homes generally can't handle her behavior even if they
were open to new patients. Probate ordered institution and care is the only solution I see here for the time being. I am an attorney now; previously a registered pharmacist; but mainly speaking from some personal experience in both professions.
Here is a helpful Medicare website:
https://www.medicareinteractive.org/get-answers/medicare-denials-and-appeals/original-medicare-appeals/original-medicare-appeals-if-your-care-is-ending
https://www.medicareinteractive.org/get-answers/medicare-denials-and-appeals/original-medicare-appeals/original-medicare-appeals-if-your-care-is-ending
I just saw they stopped treating her for UTI?? Your sister the nurse should somehow get on this to insist they complete the treatment or have your father as her POA insist - your mother has rights- and your father - on her behalf - can say yes or no to anything. It never ceases to amaze me what they don't know at the hospital. It took an experienced nurse to realize what was happening to my grandmother in law.
I saw your issue is now being handled and I would stay on top of it since you can not trust providers to do right by your mother. Definitely hospice was finally helpful with your advice but they should have sooner told you to exit hospice and have her taken to an ER even if in Maryland
Good Luck
When they want to discharge her tell them you can't snd aren't able to take care of her and do not design her out.
They will find a place for her somewhere.
Because he was going to arrange for her to go to assisted living.
She died in jail.
Old age and death isnt what Hollywood depicts...saintly, calm elderly folks gazing upward at the light and being held by their adoring children.
The best depiction of an actual death that I've ever seen dramatized is that of the Mother Superiour in Poulenc's opera the Dialogues of the Carmelites. It depicts a woman of great faith, dying, in pain, agitated and violent, a doctor who will not increase her medication because it might tip over the line and kill her. She dies, gasping, losing her faith and thrashing. Hard to watch and terribly accurate.
I think that dying in a nursing home, with professional care and hospice at your side with morphine to ease pain is EXACTLY what I want.
I would not want to burden my husband or my children with caring for me if I became violent.
I want to encourage you to keep her in the facility. Dad can go visit and then get a break from the situation. Bringing her home is just not fair to dad and she obviously needs more care than he can provide, making it unfair to her as well. You said he is traumatized, that doesn't just go away and he will not be able to relax with her in the house, putting him at greater risk of having a serious medical event. Please encourage him to keep her in the facility. She can go back on hospice and stay in the facility getting her needs met, he can sleep knowing she won't be after him with a knife, win-win.
I think I'd be grateful for that, actually. The poor man need a rest.
2. Dad. Can't handle situation. It's too much.
Nursing homes are open. And non covid patients are preferred.
The situation needs intervention now. Both parents need help. Call home health. They can send a nurse to evaluate her and totality of situation. Tell them urgent. It's the job of home health. They can facilitate transfers, services. Doctors and their offices are more responsive to them than to patients and families. They are available 24/7 for calls.
My father is traumatized. He has hired professional cleaners to come in and clean up all that mom left behind. He's done seven loads of laundry in two days as he keeps finding soiled clothing throughout the house. A cleaner comes today and carpets are scheduled for July 2. I hope that as things settle down, dad will be willing to bring mom back home eventually and hire the in-home care that has been needed instead of trying to do it himself. But that will be his decision.
My father is traumatized. He has hired professional cleaners to come in and clean up all that mom left behind. He's done seven loads of laundry in two days as he keeps finding soiled clothing throughout the house. A cleaner comes today and carpets are scheduled for July 2. I hope that as things settle down, dad will be willing to bring mom back home eventually and hire the in-home care that has been needed instead of trying to do it himself. But that will be his decision.
Do you not see the need for psych meds for folks with demented and broken brains so that they can live in some kind of peace with their loved ones?