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Mom wanted more combivent inhaler (again) and I told her she needed to wait until 2 hrs after the Proair. That's how her pulmonist has it prescribed. So I was in the kitchen doing dinner dishes when I hear this sound of banging on the dining room table where she always sits. I step in from the kitchen and she's shaking and flailing her hands down on the table. I thought she was having a seizure so I pressed her medic alert button. She immediately stopped shaking and flailing her hands and shouted " I don't need them!! Tell them not to come!" I truly think this was a staged incident to try to get what she wanted....MORE MEDS! I'm about at my wits end here. I don't have Healthcare POA just financial and can't force her to go to the hospital or anywhere. Help me please anyone....

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Sure they can be manipulative, how else would dysfunctional sibs (another blog here) know how to do it, so welll???
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My aunt was an attention seeker and control freak. She is dead now, but she was always having a "heart attack" and my uncle would call me to come to their house. He would also have the First Responders (we live in a rural area) on the way. We had the ambulance take her to the ER on many occasions. She was what my daughter-in-law who is an ER nurse called a "frequent flier". Because of her age they were afraid not to take her in, but when she got there she perked up because she was the center of attention. They never found anything wrong with her heart. If she was ever left alone, she would stretch out on the floor and act like she had passed out. Never any bruises like she would have had if she had actually passed out and fell. I found a lady to stay with her when my uncle had to be gone and I couldn't sit with her either. She hid her purse and some jewelry and claimed the woman stole it. I found the purse under her pillow and the jewelry in a drawer. Old folks can be very manipulative when they want something.
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Purses, glasses, hearing aids, dentures - the bane of the caregivers life.
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OCD's are powerful too and sometimes the actions are their mechanism for soothing or calming, but as we all know, those mechanisms can and do go haywire.

When our 87 year old was released from the hospital (her OCD's have nothing to do with medicine, but) last April from a sinus infection that required, three days of breathing treatments, she would not stop looking for her purse (no purse). She spent the night tearing her closet apart and demanded hands on hips to be taken to her home, where she has not lived for three years, the only thing that stopped her from going was telling her she was going to have to walk there (we would go tomorrow, that her purse must be in the closet there...OCD made her look for for the purse for three more hours, until she finally went to bed.

Sometimes...in our effort to understand these situations, we can panic too, their behaviors do not necessarily follow logic...
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Most inhalers are powerful stimulants and yes, can trigger a seizure-like reaction. If the heart is racing call 911. She can't fake tachycardia.
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Thanks so much for the update and explanations. It really helps put things in perspective.

It does sound as though she's anxious generally; I think panic attacks may be what's happening. Can she be relaxed through listening to music? I've heard that some elders reject any attempt to calm them down, arguing that it either won't work or just aggravates them, but I suspect that's a gut response to someone suggesting that they need to be calmed.

Perhaps you could say you need to relax and want to listen to music, then try that when she gets panicky, or when you sense the anxiety starting to build. Deep breathing and petting furry critters can also calm a person down.

Why do you think she's anxious? Is she showing a lot of fear for her physical health at this stage in her life?

You're obviously knowledgeable and on top of the situation. If you have some insight into what precipitates the panic episodes, perhaps you can find solutions to those and work at the source.

Good luck, and hope the doctor visit goes well.
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Glad you had a better night. Looks like there is lots of manipulative behaviors going on as well as some compulsive medication seeking. Hats off to you - I know it is not easy and from your post it looks like you do a very through job of caregiving. She is lucky to have you.
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First off let me say that I did call medical help. Even though she stopped the behavior immediately after I pressed her medical alert button, I still had the EMT crew come to assess her condition. Her O2 level was 99, pulse 88 and BP 118/72. EMT's said they saw no signs of respiratory distress. Her visiting nurse had been here the day before and found all of the same vitals and said her lungs were clear and she was moving air well. She has a pulmonologist that prescribed Combivent Respimat 1 dose 4x daily and Proair 2 puffs 4x daily with them to be rotated on a 2 hr schedule. She had just had her Proair 45 minutes prior to the episode but wanted the Combivent on top of it. She will not use a nebulizer even though I asked her pulmonologist about it. She had used one about 2 yrs ago and stopped because she said it didn't help her. I have to lock her inhalers up because she will try to use them every 15 minutes if given free access. She used 3/4 of a months supply of Combivent in 1 WEEK. That's when we went on the rotation schedule. There is someone here nearly 24 hrs a day with her to give them to her. If I have to go to the store (2 minutes away) I schedule it so that she has 1 form of inhaler right before I leave and I'm never gone more that an hour. Usually not even that long.

And no she is not on an anti-depressant, but does take Ativan for anxiety. Which is a whole other issue. She will throw a fit to try to get more of that too. However it was making her dizzy and so we had falling incidents. All in all she doesn't take that many meds. She even wants to overdo it on Tylenol. I have to lock that and the Ativan up also. I have to give her the Ativan and watch her take it or she will and has tried to hide it.

I do have an appointment to see her PCP on Tuesday to see what he suggests. He is out of the office this week and they had to squeeze me in at the end of the day for an appt.

And yes we do have air conditioning, no one smokes, and I can tell when she has gotten her doses in her lungs. I don't just hand inhaler to her and walk away. I watch and listen to be sure she's getting the dose. If I see that she hasn't inhaled correctly, I will have her repeat a puff just to be sure she had gotten the full benefit.

It wasn't that she just said "no don't call" she was screaming it at me. And she has faked things before. I have learned that she will scream, cry, cajole, throw a tantrum, call me names, try to bargain and just about anything else to get what she wants.

I know I don't need a POA to call an ambulance, but if she says she's not going to the hospital or anywhere else they cannot transport her against her will.

I appreciate all the helpful insights from all of you and will definitely raise these issues with her PCP.

All that being said, we had a fairly peaceful evening tonight.
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One of my teenage nieces and some friends were in a bit of trouble, especially one particular friend. My sister was questioning her daughter about it. "What did she do next?" "Umm ... I don't remember. I think I sort of blacked out." "Well you better black in right now young lady and tell us what happened or you won't be allowed to hang out with her." "Blacking out" seemed a very convenient excuse to get out of an uncomfortable situation. But ... the very next day Niece blacked out at home, in front of her parents. OMG! They called the ambulance. She was diagnosed with a seizure disorder. Turns out she had been having these "spells" at school but never told her parents. You can imagine how awful my sister felt for not taking her seriously.

Anyway ... the fact that your mother came out of it so immediately and refused medical attention does seem to indicate that it wasn't a real seizure, but it sure could have been a real panic attack. I'd think better safe than sorry. If it ever happens again (and let us certainly hope it doesn't) calling paramedics might be safest and worthwhile. If is is "fake" that will probably be the end of that behavior. It if was a panic attack, it would be good to know that, and for both of you to learn how to deal with panic attacks when they happen again. And, of course, if it is a seizure you will not regret immediate action.

As others have said, get her to her doctor at the earliest possible appointment.
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Yah, but she came out of it immediately and said NO to the actual urgent medical attention, as that was apparently not her DESIRED consequence of the behavior. I think she wanted what she wanted, and she wanted daughter's attention.
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If the pulmonary meds contain cortisone I agree that they could be giving her energy. If cortisone weren't so bad for the body, I'd take it all the time for the energy. Obviously my doctor wouldn't give it to me and I would have better sense than to take it if he did, but that could be the case with her.
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I've been thinking about this issue. If she were on painkillers, narcotics or other controlled substances, I could understand the need for them. But I'm not sure that pulmonary medicines produce that kind of addiction or desire.

Nor am I sure that what she had was a seizure or fake. If she was short of breath, it could have caused panic. If you've been a swimmer and miscalculated how long it would take to get back to the surface, arriving there and gasping for breath, you'll know it frightening it is. The flailing might actually have been a panic attack.

The fact that you posed this question tells me you question whether your assessment of the seizure was in fact fake. Go with your gut, be safe. All in all, an immediate visit to the pulmonologist is in order. If there is something amiss and she needs more meds or more often and doesn't get them, you'll regret it if anything dire happens to her.
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I have seen patients fake seizures for meds but it is usually for narcotics, not an inhaler. I would insist that her MD be called and maybe see if he can tweak her meds. Have you ever tried a placebo? If she is med seeking it may help.
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My mother did this. I was pretty sure it was fake. She was upset that I had not refilled her antidepressant when she wanted it refilled (we still had some, she still had hers). HOWEVER, I am not medically trained and a seizure is important and should not be ignored. I called 911, even though I was pretty sure she was just pissed off at me and faking it. She started to say no no, don't call. I let her know, calmly (internally I was not calm, I was pissed off also). They came and found nothing wrong (even though she produced an "episode" while they were assessing her). We talked with the MD and got instructions for what to do next time (which weren't very glamorous or attentive for her). Luckily, she did not do that again. To calm myself, I reminded myself that she was coping the best she knew how. Her OCD type need to be in control of everything, her histrionics, were much like an illness. She needed so much love and attention that nothing was ever enough. This only got worse as her dementia increased. (She finally died from a blocked heart valve. I did not know she had this problem, because she did not want me to have access to her medical information, even when living with me.)

So, try to think of her actions as the best she can do right now. She might now be able to describe why she wants the inhaler. Get a list of questions and record them for the MD next time she does this. It is hard to think clearly if you are having trouble breathing. If that really is happening, the objective questions might give the MD a clue about what is happening.

Also, having used pills and inhalers in the past, they amp up your energy. If that is what she is seeking, is she on anti depressants, or meds that slow her down too much? All stuff to consider clearly, when you set aside feeling manipulated. You will probably still feel unfairly manipulated, I did, but with a plan to follow, you will know what to do even while having these feelings.
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Hugs to you, Nennie86
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My mother in law thinks she needs medication for everything! We just recently found out that the sleeping medication she takes is actually really harming her but she threw a fit when we stopped it. Whenever there is something important that we talked about and we try to talk about it again she says, "I don't remember. I must have had a seizure." If my husband and I go out during the day even just to get groceries, without her, when we come home her voice is low, she acts like a victim and says, " I think I had a seizure." Now we go shopping late at night after she has gone to bed. I can spoke the "fake" seizures now but I always proceed as normal with them just in case and let her know when I feel they are fake. I don't say, "that was fake" but I ask her over and over again about it to see if she falters and she knows, she knows......I hear you........
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You do not have to be a POA of healthcare to call an ambulance (covered by insurance) our 87 year old is quite the "Sarah Bernhardt" and asthmatic, I would suggest getting one of those spacers that goes with asthma rescue inhalers to be sure they are actually taking the medication...that is also a possibility, since I had to take the medication, myself, I know she was never taking the medication ito her lungs, she was puffing it into her mouth only!
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Is she on oxygen and if so much (liter)?

I agree - call her pulmonolgist today and get an appointment.

Also, do you have a/c? If not, I hope you use fans to cool the air. It's harder to breath when the air is warm and the humidity increases.

I would also consider getting a HEPA air filter. We got one for my father and he bought one for me. I use it when the air gets stuffy - it helps remove not only the stuffiness but air irritants as well.

You said you think this was a staged incident. On what did you base that conclusion? Has your mother "staged incidents" before? Is this part of her personality?

With respiratory issues, it doesn't pay to guess. Find out - ask her pulmonologist for a thorough workup, including using the breathing booth (can't remember what the test is actually called).

Does your mother use a nebulizer at home? If not, ask about that?
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I take it from what you said that you QUALIFIED to make this assessment on "MOM"?????
Get to the physician...do you suffer from breathing difficulties??
You have COPD???
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I think you need to see or talk to the pulmonologist if she's having trouble breathing on her current meds.
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