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She broke her femoral neck two weeks ago and was doing amazingly well. Did not need hip replacement just screw. Said she never had pain in the hip but has complained about headaches and some shoulder pain. She is 87. Until a few days ago she was only taking pain meds at night to sleep and was chipper,doing well ini rehab etc. two days ago she complained to the nurse she was sleeping too much. I also noticed she had turned lethargic. Nurse told both of us she had started taking pain meds around the clock. I tried talking to the nurse. This really didn't seem necessary to up the meds". They want her to go home Tuesday and seemed to me they should be weaning her off the meds, not the opposite. Especially since she is not experiencing pain in the hip. The staff seemed clueless and mom resented it. Mom likes Vicodin and would take dad's on occasion. She really got mad at me once for not giving Vicodin to her when I had some left over from dental surgery. Am I the clueless one here? I think mom is just taking it to make the hospital time go faster. It does not seem to be helping on here recovery but actually hindering. Am I being a helicopter daughter or is this STOP.

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Are they sending her home with the pain meds? Is your dad still alive or does she live alone?

If there is an addiction issue or she has problems weaning off it once she is home, I think medicare has a home service for the first few weeks a patient is home. Maybe have a behavioral nurse go to the house and work with her to wean her off if she seems to have withdrawal problems once home.
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Thanks Sandy. She does live alone and somebody will be with her the first 48 or so. The charge nurse has told me they will have her on pain meds for a month. Yikes! I am not sure if I think she is actually addicted although she loves the stuff. Just incredulous that the doctors and nurses dont seem to get it. The hospital experience has certainly been an eye opener for me. I get she has been a handful with a lot of complaints, but the simplest instruction seems to get lost. Part of me thinks they just want her sedated. She went from chipper, sitting up in bed and moving about to sullen, lethargic, sleeping a lot. Ugh!
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Part of this problem is the nursing staff is always too small in hospitals for direct care. The main RN is married to the medicine cart and that is all they do. Plus there isn't enough LPNs so most of the "care" comes from unlicensed people with very little medical knowledge.

When an elder is in the hospital, you really need to be there most of each day to meet their needs and make sure they don't fall, and get something to eat. Trays are taken back to the kitchen staff untouched if the elder is weak or a fussy eater.
However, she will change in the hospital both from the fall and being out of her normal environment. Hospitals have a disorienting effect on the elder. If the hospital is overmedicating her to keep her from demanding the care she needs or wants, that could explain the mood change. Don't be surprised if she starts talking about trips she has taken which she imagined as a result of the drugs. I had this happen with my elderly father when a doctor from the hospital not his doctor allowed him to be sedated because he needed help walking with his walker to the bathroom or to use a bedside commode. Hospitals staff resent the elders who need care, they expect them to be able to walk themselves everywhere and not bother them.
However 90+ seniors need care with everything and this results in them overmedicating them. I had aides joking that my father was eating sugar packets on his breakfast tray after being over medicated.

However, before your mother comes home. Get a plan in place. She may have broken something else if she has pain. Perhaps they only checked her hip. Check her situation out fully.

Second, 48 hours isn't enough time to watch her after a fall. I would have her with a home health aide for a month or so to make sure she can live without help. You don't want her to have another fall. However, once they have a fall, they will have another. Having someone there will give her a chance not to break a hip.

She may need to walk with a walker for support and need a PT from medicare to show her how to use it effectively.

Her home or apartment needs to be checked for safety. Throw rugs and other things which could trip her need to be eliminated. Consider getting a bed rail so she has support getting into and out of bed. Medicare does not pay for this item but without it lots of seniors fall when getting into and out of bed.

This fall is a wake up call, mother is aging and things are happening. She is being to have mobility issues. Perhaps it is arthritis or she has light headed moments when she falls but something is happening. Some medicines can make the elder light headed. There is a reason the elder falls.

Good luck. You are correct that hospitals are not good places for the elderly and especially the fragile elderly.

Even after the home health aide leaves, get a medical alert button on her.
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Can you speak directly with the doctor? Is there a family doctor who knows your mom? Ask about switching her to tramadol from Vicodin - not addictive and better for elderly patients. If your mom is addicted that is a whole other issue.
Are they keeping her busy? Is she bored or depressed?
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Bone pain is so bad. I am an R.N. who has worked with this all of my life. I am now 68 & still working. Tramadol is not the drug of choice. There may be more going on with your mom then you know. If it was me, the only pain medication that I can take is Morphine, I go into cardiac arrest on all others that have been tried on-So, since I choose not to die, I do not take any meds at all. If I had gone through what your mom had, you best believe that I would be on morphine. In the rehab hospital & at home. She is 87, 20 years older then I am.
Get her physician involved in her home heal5t6h care & get a Rx. for home health too so that someone besides you can over see this issue. Like a home health R.N. The nurse can be in contact with the physician to come up with what would be best but Vicodin sounds ok to me for what she has been through.
But I am here & you are there-get help with what your doing. She will need something.
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Moondance you are so right. there is much more going on than meets the eye here. Has her shoulder been checked out? She may have broken something there when she fell. Another possibility is that she has had a stroke since she has been in rehab, This is very common after broken bones and could explain her change in mood.
She sounds way too fond of the Vicoden. That is a problem for the future. For now I would expect her to need some pain medication for at least a month but at reducing amounts as time goes on. Do not allow her direct acess to the meds as she will probably take too many which will mean she is accidentally taking too much Tylenol which is part of Vicoden and can lead to kidney damage and failure. she probably needs someone living with her for the first 6 weeks so plan for that. she needs help with bathing,cooking cleaning laundry etc. She will be capable of heating food in the microwave and making drinks but beyond that she needs help, When using a walker it is not possible to carry plates or drinks.
I had a hip and knee replacement done at 68 so I do have experience of the difficulties. I was much younger and determined to recover fully but at times there is complete exhaustion and all you want to do is sleep. I would get in my recliner and ask my husband to bring me a cat to purr me to sleep!!!! i did enjoy the side effects of the Vicoden too. I had the bottle by my chair but also pen and paper so I could write down the time of the last dose. You can be very forgetful when you are in La la land. Be prepared to step up to the plate you will be needed.
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I am on pain meds for a chronic condition. When this started my doctor told me after two weeks you are addicted. Mom was in assisted living, on 26 medications, and miserable. We moved her to independent living (much less expensive), called for a consult from her HMO doctor, and now she is happily on only five daily meds.
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First I would check to see what meds she is on. When my mom fell and broke her hip, she was placed in rehab at a nursing home and they started to give her some drugs to make her less demanding. Eventually she started hallucinating and became totally paranoid and had a complete personality change. I finally insisted (as her power of attorney for health) that they remove her from all meds except her heart meds and within 24 hours she was back to her normal cheerful self. This is such a very difficult and common problem because the places are so understaffed and they want the elders to simply lie in bed and wait. It was a horrid experience. Also, once she is home the Vicodin might make her unstable and she could fall again, which is the last thing you want. My 80 year old stepmom just had hip replacement surgery a month ago, and is just now able to get around on her own comfortably.
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You can't "GET" that doctors or nurses don't get it? They never do get it. They are doing a job and don't care even a little bit about your mother. She is just another number to them. Someone to deal with on their shift. Sad but true. You have to be the one to help your mother. If something sounds wrong it most likely is. They love to sedate patients because it makes them easier to deal with. Again sad but true.
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An excellent surgeon once told me "If an aspirin doesn't handle your pain, you are trying to do too much, too soon." Excellent advice!
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Sounds like your mother is requesting the meds around the clock, and they are giving them to her - who are they to say if she is truly in pain or not if she says she is?? If you believe your mother has an addiction issue, you should definitely bring it up with the resident doctor and ask that they begin weaning her from them.
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Lizann gave you good advice on what needs to be done at your mom's residence and you need to do it BEFORE she gets home. She might pitch a hissy fit that you did it without her, but it will be done and over. If you wait until she gets home she will fuss and fuss while you are doing the work. Area rugs and throw rugs and even bath mats are a trip hazard. For the bath buy a small rug with a non slip back that is used only when she gets out of the tub or shower, then is hung up. Borrow a walker and walk it through the house. Are all the furniture pathways wide enough for a walker? Does the toilet seat need to be raised - or rather, would a raised toilet seat be more comfortable and easier for your Mom to use. Does she ever climb on a step stool to reach things in a cabinet? Things need to be moved for easier access. Even closet rods might need to be changed so there is no stretching. Medical professionals and nursing homes do want their residents to get well, but they also are aware of patients complaining about being in pain and not being helped with medication. It would be ideal if you could have someone with your Mom for a month, as a precaution, and a great idea if it was someone who is a trained caregiver who can make suggestions for making life easier, or at least safer for your mom. Good luck. It isn't easy having someone you don't know living in the house. And, if you do have someone there, be prepared for household supplies and food to be used faster, much faster. Especially cleaning supplies, laundry, room sprays, etc.
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Ok...what the comments show here, that the elderly are over medicated in hospitals. I know that for a fact, for what happened to my Mother. For several days, my Mom was getting better and talking about going home and all the things that needed to be done. A few days later, when I come to visit, she is like in a coma state and not responding and I can't figure out what happened, so suddenly.
I thought she was maybe restless, because she wanted to go home, and they gave her meds to calm her down. The next day when I saw her in this condition, I lost it and inquired, "what the hell did you do to my Mother?" The nurse stood there and stared at me, while I yelled it two more times. With no response from the nurse, I threatened to call 911 and THEN, she left the room to get someone. I can't bare to re-live the rest of the story, but she stayed in that condition another day or so and then died. After her death, I got copies of her records, to only go in shock, to realize they over dosed my Mother. She received medicine, that was stated in her records, that she was allergic. Found out they gave her pain meds (that she had refused several times, when I was with her) that had interacted with the med she was given, that she was allergic too. I find out, after already in a commatose condition, she was given morphine! That is all it took and my precious Mother died. I am trying to go after the hospital and all that were involved, in giving my Mother medicine, that caused her demise. I always kept check on medicine given to my Mom. All these meds, were given to her, without my knowledge. There was never any communication on the staff or Doctor's part, on what they were giving her or anything. I ALWAYS, questioned anything, that was given to my Mom, but all the meds were given to her, when I left.
I need help in starting a petition or some law to help the elderly, from getting overdosed with meds, in order to keep them quiet or whatever the purpose is, so the hospital staff, doesn't have to deal with him. Too much of this is going on, and NEEDS to be STOPPED!
RCW6532 was 100% correct, when they stated, "They love to sedate patients because it makes them easier to deal with." Does anyone, have any suggestions, on help to stop this abuse on the elderly, which in my case, caused my Mother's death? I am overwhelmed with grief, because I know, that I could have had my Mother awhile longer, if she wasn't over medicated.
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A similar thing happened to my father when he was in rehab. He went in fully alert and stayed that way for several days. Then he had days that he barely opened his eyes and said things that bordered on hallucination. This was even with my mother being there basically around the clock. When we got home, we noted that on one of his medications, it was printed to "sit up for at least 10 minutes after taking this medication." Of course, that did not happen; my father was always in a prone position after taking this, and all other, medications. Once home, and he was on his regular medicine regimen, as prescribed by his primary care physician, after about two weeks, he mentally came back to himself. I don't know WHAT they do in rehab centers, but this was our experience with my mother staying with him around the clock, even overnight. And she did question what they were giving him to cause the lethargy, and almost incoherence.
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I agree with Veronica, if she was sitting up and interactive, but now lethargic, I would want her checked for stroke. I would WEAN her off the vicodin carefully and check what other meds she is on. As for Tramadol, "Tramadol is a reuptake inhibitor of norepinephrine and serotonin and a weak μ-opioid receptor agonist" which means it does have an antidepressant effect. It is a scheduled drug, it IS addictive and must be carefully weaned to avoid side effects. When I took it after knee replacement, it would relieve the pain without making me groggy. Ask the MD.
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One thing to remember when it comes to prescription pills, some people have side effects from the *fillers* that are used in the pill.... each pill manufacturer tends to use a different set of fillers, so try to see if you can get the next refill using a different manufacturer, pharmacies can help you with what is available.
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Thank you so much everyone for your answers and support. I am feeling overwhelmed and very alone right now. My only other sibling that cares about mom buzzed in after a week in Mexico to declare we need to get mom out of the hospital immediately. Of course who will take care of all this? Me of course. Even his wife who I love dearly seemed on board. The good news is he also warned mom about pain meds. There was a good nurse on this weekend and she seemed to get it and mom did not have any pain meds today. She did have an anxiety attack this morning and tonight. She was given atavin which she take at home for anxiety as needed. But at least they got her off the pain meds for a day. She determined to come home Tuesday against the recommendation of pt and I feel stuck with scrambling about tomorrow and maybe Tuesday getting all the equipment and possibly organizing short term care that maybe everyone else will resist. have removed all the throw rugs. I don't think I can take any more my head is exploding thinking about all the things I have to do this week. I have talked to all about getting some live in help but no one will agree to pull the trigger. I have checked out a local place that seems fine but can't get anyone else to agree to it. She is also having a low sodium problem which is a concern if not monitored. So part of me thinks she should stay in the hospital and the other part thinks the hospital is killing her. And I am overwhelmed with all of it up and incredulous my brother and sil seem to think it will all just work out or more specifically I will work it out. Help!
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My heart goes out to you. If your mom has the resources, please hire some help from a home health agency. See if doctor can write it up so Medicare pays some of it. Ask your brother to step up and let him know how stressed out you are.
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Liz, make sure you know EXACTLY what they are giving your mom in the rehab center. My dad fell and hurt his shoulder at age 87 and was placed in a nursing home for rehab. When he was admitted we told them specifically NOT to give him Ambien. He took that stuff years ago and became addicted. While he was on it he did some very strange things while asleep, including calling the cops to report crimes he was dreaming about. Well, one night in the NH he fell during the night and cut himself badly enough that he ended up in the ER. After that they started giving him Ambien so he'd stay asleep. They did not tell his family, however, so we were shocked when we'd see him during the day and he'd be completely disoriented. It was an Ambien hangover, but we didn't know that since we had told them NO AMBIEN!!! Long story short, it took a couple of weeks before we figured out that they must have been giving him something we didn't know about. Once we found out, we were so angry we pulled bim out of there, took him home and started outpatient rehab for him. Nursing homes and rehab centers are notorious for giving elderly people meds just to keep them docile.
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Thanks again to everyone. Spurred onward by your comments I kept calling my brother and SIL until they finally called back last night. They were at dinner. Told them I couldnt do the 24 hour home care even if part of me would like too, and would they buy in to bringing in the home health care people? SIL said she would and brother was in car. Let's see if that changes. They do care about Mom but I am left with the bulk of the work and then open to criticism if it doesnt seem to work out. As I said, brother did support her getting off pain meds. I am going to call the nurses station this morning to reiterate weaning her from the pain meds and try to get in touch with her primary care physician. She is on blood pressure meds which she never needed before but it shot up and stayed up while in the hospital. She has been taking atavin as needed for anxiety, an iron pill and a shot to prevent blood clots. She also takes lexipro at night which is apparently aggravating the low sodium issue. Thanks again to everyone that has commented and offered support.
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