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My mother has been in an ER regularly for the past fifteen years. Ten years ago, it was often attention seeking with the doctors telling her that there is nothing wrong with the exception that she was gorging on junk food. In the past five years, it has been the real deal because she has congestive heart failure and is now on oxygen 24/7. We recently moved her to a new AL because the other one messed up her meds and put her in the hospital. The ER visits are now almost weekly with hospitalizations for a few days for respiratory issues and complications from warfarin. I am self employed and can’t pay my bills when not working. I also have employees for whom I am responsible. I love my mother more than anything, but I am burnt out from it all. I no longer see my friends. I am afraid to schedule any necessary business trips because the ER calls always come at that time. Last Saturday, I had just saddled up my horse for a ride to decompress. Wouldn’t you know, but the ER call came right when I was ready to mount the horse. I feel so selfish, but I broke down crying. My husband is a gem, but he is as worn out as I from this. We can’t even travel six hours to see his family for a weekend because we are afraid to leave. My siblings do not come. Any suggestions? Mom is 91 years old. I know she is not going to get much better, much as I can dream. I just can’t fold a business to be off this much. I almost lost my business last year because of this. It is starting up again.

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Mince, ELEPHANT IN THE ROOM...Exactly. Hard to talk about but it’s the reality we must face at some point. Some people might visit my folks and say WELL THEY SEEM HAPPY.....But it’s really no kind of life, dragging through each day, get your meds, being dressed, fed, bathed....My mom never wanted this but her dementia has now killed her reasoning. It’s just survival instinct now.  Could go for years.
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Hello,

Im sorry your life has become the merry go round of doctor/ER visits that never seem to accomplish much. One of the reasons I put my father in a NH was because I would have had to made three 100 mile round trips to the clinic to manage the Warfarin every week.  Add that to other practicioners, grocery and medicine runs.....insanity.

Here is the elephant in the middle of the room that NONE of us want to talk about. At what age or condition is there no point in constantly running to the hospital or doctor for the magic pill that will restore "normal". After running literally tens of thousands of miles running to the city multiple times a week, it was time for skilled nursing, yet "comfort care"....make him comfortable, but no heroics, no surgeries, no procedures.
I think the running after doctors with poor tangible results is part of what makes most caregivers burned out and exhausted.

Just thoughts, this angle of thinking is definately not for everyone. Good luck to you..and saddle up....the outside of a horse is good for the inside of a person.
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The differences with AL and NHs is that you will have an on call M.D. or APRN to handle some of the crisis in house. Also diets are better regulated since ALs tend to make offerings of food that are mainly one type fits many. She is at that revolving door stage meaning that you may also want to look at hospice in the near future. It may be time for the NH
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Hi Two Worlds,
I can completely understand the ER trips. My mother put me through that too. Gosh, can I recall all the wasted time for rediculous complaints. Ugh.

It sounds like your mom would benefit from a nursing home rather than assisted living. The personnel there would be better trained to medically assist her.

I know getting the Warfarin dose adjusted to the optimal range can be tricky but, after all this time, can't they get it right? Is she taking her own meds or someone is giving them to her?
Can her doctor put her on some of the new blood thinners that don't require weekly blood tests and titration? Less problems for sure. My hubby did real well on them.

I don't see any reason you need to go to ER every time she goes. They can patch her up and send her back to AL or NH without you stepping into the hospital. Have them call you when all is said and done with a report. No need to leave work to get an update. Besides getting discharge instructions, which you give to the AL, was your presence really needed?

It is too bad that we all can't stop life to attend to our loved ones, but we can't. How much help are you going to be to her when your business collapses and you're in the unemployment office trying to find work.

This sounds weird but, at one time, I needed "permission" to quit a job I hated. Not from anyone in particular but I needed to know that, if you're not happy, it doesn't matter how many years you have in or what the benefits are, you NEED to be happy.

Consider you've been given permission NOT to go each time to the hospital. You're not a bad daughter for not going. She won't hate you. It'll all turn out OK.

Now go for a ride on your horse and have a glass of wine when you're done.
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You are not selfish. You are burned out. Sometimes it's called "compassion fatigue" which just means burned out. What would have happened if, after you got the call from the ER, you mounted your horse and went for a ride anyway?

I cared for my dad in my home. He had a lot of medical issues. He had to have regular procedures to draw fluid off of his belly due to liver failure. It was an all day thing plus getting him ready to go, getting him into the car, etc. One day when we were at the hospital the stress of it all just got to me and I broke down crying. My dad was in some room having this procedure done and all I could do was wander around and cry. We were at a Catholic hospital and I am Catholic and I wandered around looking for a priest or a nun because I was so beside myself. I was finally brought to a nun and I poured out my heart to her and she told me that the hospital provided a service where they will come by van to pick up patients and take them to their appointments. I got my dad signed up for this and I no longer had to get him to the hospital myself. Plus, he was gone for 6 hours on these days and I could take a nap or have lunch with a friend or just hang around the house and do nothing.

Your mom goes to the ER frequently because of her health issues. What would happen if you didn't go to the ER each time? If you waited until your mom had been admitted to a room? Or if you didn't drop what you were doing to run to the ER and instead looked at your watch, realize that she's going to be there a while, and go to the ER when it was convenient? Like in an hour or two?

What happens if you neglect your business over and over? One day your mom won't be with you anymore because, as you said, she's not going to get better. When your mom's gone what will be the state of your business? It's like when adult children quit their job to care for their elderly parent. Someday that parent isn't going to be around and that adult child will have no parent to care for and be faced with having to look for another job after being out of the job market for who knows how long.

My aunt is 94. She lives in an independent living facility but she's hardly independent and refuses to move to an assisted living facility. My cousin is her main caregiver. He's retired and he and his wife love to travel so they do. They leave for Australia tomorrow. He puts as many safeguards in place as he can for my aunt but he will not give up his life to care for her and he makes no apologies for it.

You have a responsibility to yourself. It's called "self-care". Riding your horse is self-care. Not running to the ER every time you get a call is self-care. Self-care is not selfish. You have a priority to your husband and your marriage. You have a priority to your business and your employees. You have a priority to your social life, your friends. The next thing on your priority list can be your mom. Make sure all of your other priorities are in order before you go running off to the ER on a moment's notice. It isn't necessary that you be on call 24/7. When the hospital calls you inquire as to how your mom is and then decide if you really need to get there as soon as possible.

You have every right to have a life of your own that doesn't have to be lived in between ER visits.
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I’m 12 hours from parents who are in assisted living. Between them there have been 5 ER trips in 3 months. Not to mention dentist, ortho center......I haven’t been there for any of this. There’s no family around. My folks are fine, at least as much as possible given the dementia and health problems.

After a couple pointless ER trips I came to  an arrangement with the staff to call me before any ER trips. These places have CYA policies and tend to over do it with the ER trips. So we avoid my poor mom spending all day on a gurney in ER getting all the tests, X-rays after a fall. Now, nurse at AL checks her out, calls me and we decide how to proceed.

A bigger issue is end of life directives and quality of life. How long does your mom want to keep up the battle? Does she have end of life directives in place? She’s 91. Are all these interventions worth it?
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As someone who is also at the breaking point, I understand. While reading your post, I found myself wondering if Mom needs to be re-evaluated. It sounds like AL is not enough for her any more. My own mother began calling 911 regularly (once giving the fire medics the wrong number for me, causing me to visit every ER within a 20 mile range to find her). When she had a raging UTI and was hospitalized, the staff was savvy enough to test her and tell me, from her results, that she could no longer live on her own. She went right to an SNF and eventually wound up in the Alzheimer’s unit.

Sounds like your mom is ready for a Skilled Nursing Facility too. Even if her medical needs are not immediately life-threatening, she sounds like she needs to be monitored 24/7. I don’t mean babysat, but just be somewhere where they can handle her health needs without calling 911. After the first 3 times the SNF had my mom sent to the ER and called me and I went running over there to find nothing was wrong, I told them just to keep me updated. Hard-hearted? Maybe. But I also care for a bedridden husband. I knew the SNF was on top of Mom’s “situation”.
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If your mother was diagnosed with congestive heart failure five years ago, I would have expected her primary care physician to have got a grip by now. That she is still needing *hospitalisation* to be stabilised and have her warfarin (warfarin? Goodness!) adjusted is not impressive. And definitely not your fault. You've changed facility; what about considering a change of medical personnel?

Who calls you when your mother lands in ER? And what for? What, apart from moral support and "proving" that you love her, does your presence contribute to her care?

I wonder if you should hook up with TinyBlu. The similarities are that you're both paying inordinate sums of money to ensure good care for your parents, and yet you both seem to expect to do most of the barking, and you're both being driven round the bend by it.

You love your mother very much. You can't "just" anything - detach, step back, delegate. But that is the kind of thing to work on, focusing on what there is to be done and whether or not you are the person to do it.
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