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Tomorrow, my grandmother is having her other knee replaced and is still giving my mother grief about the whole physical therapy thing. I helped my mother out by letting her know that she can talk to her doctors. What my grandmother tells them and what she tells us are two different things and by my mother talking to the doctors, the doctors have a more complete picture even though they can't tell my mother anything. I know that my mom is overwhelmed and nervous.

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We have noticed a decline when she got sick about 5 years ago and developed kidney problems from being dehydrated but her first knee replacement a couple years ago, there was more of a decline. Mom and I visited her at the rehab she picked out. She wasn't there a couple hours and she was already whining. The color scheme didn't suit her, nothing in her room suited her. She was livid that they didn't give her a walker or wheelchair. The nurses told her that the rehab people had left for the day and until she is assessed tomorrow morning, she won't have a walker or wheelchair until then. She is telling everyone that she is leaving rehab in 5 days and going back to her house and live independently. I suggested to my mom that if that comes to pass, grandma finds her own ride home and sets up the help she needs. If and when something happens, it's not on mom.
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Oh, I see. Still, people who are difficult, stubborn and insistent can also become incompetent. It might be difficult to see it coming, since some of the symptoms are the same. She may refuse to go for a neuropsychological evaluation, but, what about other facets of her life? Is she able to run her household? Is she able to pay bills, balance checking account, properly take medication, bathe, dress appropriately, and specifically manage her own healthcare? If she's wavering, contradicting herself and confused, then......I'd wonder why. If she is indeed competent, I'd allow her to decide on her rehab of choice and deal with the consequences. What's the worst case scenario if she ends up in the same rehab that she disliked before?
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Ever since I could remember (I am 35 and grandma is 88), she has always been the type to only hear what she wants to hear and if it's not what she wants to hear, she will make it into something she wants to hear. She has always been someone who doesn't listen to anyone and will talk over you. She refuses to be checked out by geriatrics to make sure she doesn't have dementia or something like that.
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From what you have been describing about your grandmother's behavior, comments, concerns, etc. that she may not be processing the information correctly, remembering things correctly or able to really participate in her own health care choices. Is that right? I'd consider that if that is what is happening, she may not be able to effectively make sound decisions. Is she forgetting what is discussed? I'd be open to the idea, that she's not going to improve with time. She may continue this way. If someone becomes incompetent, their HC POA steps in. Is that what your mom is doing? The doctors should be able to figure out that something is amiss with grandma. They intend to proceed with surgery anyway?

Would your grandmother be behaving this way if she were thinking clearly? If not, then, I'd try to adjust to the possibility that she just can't and won't. It can frustrating.
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