I was at the nursing home during lunch yesterday. The day nurse said she was not having a good day. She had been agitated and trying to go for the door, etc. I went in to find her sitting behind the desk with the nurse, eating goldfish. The nurse quickly “invited me “to eat lunch there, even skipped making me pay for it lol. I think she was happy for my help. Mother was very medicated and ended up falling asleep during her lunch. The facility NP came by and we talked about changing the scheduled meds to PRN. But trust me they’ll be needed all the time anyway is what I thought. I left after lunch, having put mother to bed, which is unusual for her. But she wanted to get in her bed.
facility called me at about 9 PM. She was having a very bad episode. The staff could not control her. She had gotten out of bed and ripped her mattress off the bedframe. Had climbed in the bed with another resident. It was unfortunately a float nurse there. I did not know what else to do. We tried speaking to her on the phone and she had some paranoid thoughts such as the nurse didn’t want her to talk to me. I told her that was silly. The nurse had called me to talk to her. But she just had that mean out of control voice. Really something I’ve heard so many times over the years. My husband was due to be at work at 5 o’clock this morning. But he went ahead of me to the facility while I got myself together here at the house and let my mother’s dog out for a potty break. arrives there to find her in her wheelchair in the hall, still frequently trying to get up. He was talking to her gently she likes him. I have no gas in the tank. I just looked at her. I made some quick text and phone calls and have arranged a private aid to sit with her from seven in the morning to midday today. Then she’s going to come back at 6 PM tonight and sit all night. I had already scheduled the social worker meeting for this afternoon. I strongly suspect they’re gonna tell us we have to ship her out. Psychiatric unit or something. The Caregiver set up is not ideal. It’s not someone with an agency, therefore the documentation will not be Medicaid compliant. So this will probably come out of my pocket for tonight. Just waiting to see what happens at the meeting today. I’d also already set up an attorney meeting for Thursday. I’m about ready to start telling people if there is not a solid path to keeping her in a facility forever with it paid for by Medicaid. I’m out. It’s time to get a court appointed Caregiver or guardian or something. Surely if this is not a path to having her documented incompetent, I don’t know what is.as a sidenote, during these episode, she won’t wear her oxygen and stuff. When they got her back to bed, they were going to just put her to bed without it. I asked the nurse to check her and her saturation was 85%. So her nighttime meds kicked in and she fell asleep. I sat there at her bedside for a couple more hours and wondered how one 77year-old person whose lungs are on their last “legs “can cause so much chaos in my life.
As long as you continue to show up, this will go on.
And to be honest, I would have long ago stepped away from all of this and told any callers that I am not involved with my mother.
She should long ago been handled by competent trained caregivers under guardianship of the state.
I would move four states away to escape all of this, myself.
I sure hope I recommended to you long ago, O, the book Never Simple by Liz Scheier--if not you need to order that ASAP. That poor woman spent decades of her life attempting, along with the social workers of the City and State of New York, to intervene for her mentally challenged mom. It NEVER WORKED. The woman died old, alone and in squalor. Her daughter stood witness, her life captive to this for decades.
Up to you entirely, but I would have long ago stepped away. Not everything can be fixed, but it CAN be prevented from swallowing up your own life, which is what it is doing now.
Draw yourself a big fish swallowing a little one. Get the picture?
You say your mother is in a nursing home. Does she not have hospice care? They will keep her sufficiently medicated. Nursing homes aren't allowed to use physical restraints anymore. Psychiatric facilities are though. You would be doing both your mother and yourself a favor by having her go for a psych evaluation in the hospital. Tell the nursing home that when she is getting out of control they are to call 911 and have her taken to the hospital.
This is not for you to have to handle. The facility she's in is collecting big money for her. It's their job to deal with her explosive and violent behaviors. They accepted her at the nursing home she's in. If they are unable or not equipped to deal with her, they need to do their jobs and find somewhere else for her to go, or send her to the hospital.
I'm so sorry for what you're going through. I think you're giving yourself the best advice when you say about a court-appointed guardian. This will probably be the best way foward with your mother's care.
You have your own husband and family including an autistic son to worry about.
Even if you don't have DPOA, you are her next of kin. If/when she lands in the hospital and you get a call, ask the doctors if she's competent to make her own decisions and sign consent forms. If they say that she is competent then there's nothing for you to do but to stay away. If they say that she isn't competent, see what the doctors recommend in terms of treatment but also make her DNR/DNI. A DNR/DNI merely states that if her heart stops beating or she stops breathing that she will not be resuscitated or intubated.
There may come a point during hospitalization that palliative care should come on board her case. Palliative care consults often happen when the patient is practically at death's door and have suffered through futile care. It's better to get them on board sooner rather than later so that she can be transitioned quickly to comfort care, if necessary.
All too often old, sick, demented people are kept alive using medications, pacemakers, or even surgeries when they should have been allowed to die ages ago with whatever dignity they had left.
Ultimately, you need to decide what you are willing to do for your mother who, from everything you've written about her, is mentally ill and has a poor quality of life. But until she's deemed incompetent by a doctor or judge, there's nothing more you can do that's going to make her get better.
Your Mom’s increase in behaviors may be due to hypercapnia . Too much CO2 in her blood . Even if her O2sats aren’t that bad , it doesn’t matter , with her COPD she may not be expelling the CO2 , it gets blocked from leaving the lungs . Didn’t you say she was on a BiPap machine in another post ??
I’d have her sent to the ER to determine if this is respiratory acidosis/hypercapnia . If it isn’t then I’d have her then sent to geriatric psych ward .
If it is hypercapnia , you are looking at end stage COPD causing her confusion , restlessness , paranoia on top of a mental health or dementia issue.
This is beyond what you can handle now and you should not spend your own money .
Have them call the psych NP that you mentioned and get Mom transferred to geriatric psych .
we just got a new lab result in that I think is very meaningful. Her pro BNP is 1120, which is about nearly quadruple what it should be. This has to do with heart failure and fluid balance and kidney function. I’m sure Alvadeer could explain it better. But I think big bad things are brewing.
See All Answers