Feeling guilty for not taking mom to the ER after her fall. Can that bring on more TIAs?

Yesterday the neurologist lowered Topamax to 25 mg once a day instead of twice a day for a week and then reevaluate.
Had visit with her primary doctor too yesterday, copied what Barb wrote and gave it to Dr. in privacy, it worked out perfectly. Her doctor agrees that her happiness and peace of mind is what is best and lowering it to see if it helps with confusion... Time will tell.
Finally found out that the "referral quote for a geriatric psychiatrist out of town had nothing to do with insurance, maybe it did I don't know yet, but they sent papers to be filled out to my mom at assisted-living instead of to me the first week in May.  Sometimes I wonder if these "professionals "know about this world of "aging". Needless to say, I have no idea where the papers are plus my mom can't find her checkbook, and has not paid her rent at the beginning of the month. The administrator contacted me yesterday needing payment so today I am on a search for her checkbook and then to a lawyer to get POA over finances 😶
Never thought I would have to be in charge of my mom's money, she was always so good at it.
When I arrived to her room to go to the doctor she was watching SpongeBob Square pants on TV 😫 😕😏🙃 and having a conversation with someone on the phone. When I asked her who it was she said "well it's you!" and started laughing

I really hate this disease or whatever it is I don't even know what to call it that she has I just miss my mom... even the one that used to get on my nerves I miss her so much. I know I will get over this rough patch but it really hurts right now.   She could care less whether she watches the news anymore either...bye bye FOX!

I'm very grateful for the help I receive here, thank you all so much 💜

I know things will get better and I'm very thankful she is feeling more peace now.

Thank you Barb I copied every word you said and have it ready to give to the doctor today!!😍Thank you for making it so easy and clear for me!

HolidayEnd, my mom acts like a child like age too sometimes...yes she seems very happy which makes me happy  but also realizes how confused she is but also thinks that's funny.  There have been issues with the DON in the past but have since been resolved but my mom never got past certain incidents but now she will speak to her and doesn't seem bothered by her since on this med which is great. The DON was constantly on my mom's mind and always had her agitated, I think it just happened to be her in the wrong place or something more than anything

My mom seems to have reverted to a young girl, talks as if she’s with her long ago family and is demure and giggling. Since she seems happy then I’m happy.

Everyone in my extended family has opinions on the antipsychotic meds mom is being prescribed. I don’t. There was an incident of mom accusing people of stealing from her and wandering into other people’s rooms when she was trying out a new med. That was not the right one for her!

So you don’t like the DON? Why?

"Mom's cognitive abilities, response time and speech patterns have all changed drastically since she started taking Topomax on May 28th.  She is having trouble getting words out, she giggles a lot and she is telling stories that don't make sense.  This is a drastic change in her mental status.  She's not anxious any longer, but it's heartbreaking to see her this way.  What do you think is going on, and what actions should we take?".

...I can't sleep, been awake since 2
Taking mom to her primary doc at 3 today...I need to make a list of all my concerns I've been observing since she started Topamax on the 28th. The staff at her AL are concerned also (not the DON...she likes this med for mom cuz it puts her in lala land therefore no problems or anxiety to deal with from my mom)
If I didn't know any better I would think my mom has Alzheimer's. It takes her forever to get out what she wants to say cannot decide what she wants to order off the menu for dinner, no sense of time really, giggles at everything, repeats and repeats trying to get out words and stares at me like she thinks it's funny. I want to write all the stuff down on paper ahead of time for the doctor to read so I don't have to say all the stuff in front of my mom but my brain will not work. Not sure how to shorten it up unlike how I am writing here right now. My mom almost asked like a little girl and tells me the craziest stories it's breaking my heart

Mom has Medicare and Medicaid

Depending on what insurance you mom has, I think I might call the insurance company directly and raise the issue that mom has been referred to geriatric psych; have THEY gotten the request and what the heck is the hold up?

Do you need to have a referral for specialists? Some insurances do; some do not.

Find out if there is a geri psych team that services mom's AL. My mom felt more comfortable, I think, because the geri psych who visited her every few weeks was a fixture at her IL and visited many of the residents. There wasn't the stigma of "oh, I'm seeing a psychiatrist" type of thing.

Topomox is apparently often prescibed off label for bipolar, so it may be having a "mood lifting" effect on your mom. The neuro needs to know that. It may not be a bad thing; just needs to be recorded that it's her reaction to this particular drug.

Bella, I have to tell you that once my mom was dx'ed with mild cog impairment, which explained her "toxic" anxiety (and got my brother to stop saying that mom was just having a pity party and "doing this to herself") I stopped worrying about her being prescribed psych meds.

I frankly didn't care if she was overmedicated or not (other folks, the docs and NPs worried about that). I wanted mom NOT to be anxious, scared, crying, wringing her hands. I told anyone who would listen to me that I'd rather mom be overmedicated than in psychic pain. She didn't deserve to be that way.

Her neurologist prescribed the Topamax for her tremors in her hands. Primary doctor called for a referral I guess from insurance?   for a geriatric psychiatrist and I am still waiting for a phone call for an appointment and that was on May 1.  I have called four times since then to the primary doctor to see if they have heard anything about an appointment yet and they said no it's still on referral.
I will call the Neurologist to report symptoms tomorrow and the primary to see what the holdup is for the geriatric psychiatrist

So, who is prescribing the topomax? Did the doc explain why s/he was prescribing that particular drug?

If you are concerned that mom is acting loopy, I'd put in a call to the office tomorrow to report what effects you are seeing.

Given your mom's anxiety and agitation and mood seings, you might want to consult a geriatric psychiatrist in addition to the Neuro doc.

Well, I have given my mind a break of trying to figure out what kind of dementia my mom has or whatever it is that's going on with her for about a week now. It has given me a bit of relief to not obsess over her condition but it is on my mind a lot.
Mom started taking Topamax on the 28th of this month and she is mellow as can be. Finding the right words to say is a real struggle for her or making a decision about something. It's almost like she is high on marijuana... she giggles at everything and acts like she's in La La Land.  I have never seen my mom so happy and carefree... the lines on her face have even diminished from no worry. She even surprised the DON that she hates so much with a nice hello yesterday and told me that my step brother made the comedian Roseanne a chair along time ago. There's more odd things she's been saying...
I'm almost reluctant to let you know here that this is starting to worry me even though I've been told it takes a while for the medicine to kick in. I imagine you will tell me to sit back and enjoy the "happy mom" who is now experiencing calmness, non-anxiety, less paranoia etc etc!  It is very nice but at the same time very alarming to me because it such a drastic change!
I need some advice please because I need to know I'm doing the right thing for her and that this is normal, I want to have a peaceful Sunday in my mind and just know that my mom is OK on this medicine  and not just getting drugged up😕

Thank you golden23💜

bella - you are doing fine - just fine - with a very difficult and puzzling situation. Be sure to look after you too. There comes a time where looking for more answers reaches a point of diminishing returns - more and more time and energy spent on gaining very little more knowledge and relief.

I think part of your search is part of you grieving the changes in your mum which are also losses. You see your mum declining and want to be sure you are doing everything you can to help her. but inevitably, over time, as will happen to all of us, the decline continues no matter what you or the drs do. The searching is part of grief as is the sadness. Give yourself time and space to process this. And give yourself time to "enjoy" your mum as much as possible, and to enjoy your life apart from your mum. ((((((hugs)))))

If she didn't want to go to the ER, then that's that. Nothing you can do about it. You did what you could.

Hugs back, thank you Countrymouse
😢

Hugs. I know.

The trouble is that our wanting to know does not mean that science has the answers to our questions :(

...mostly, I love my mom and want to know what's wrong with her and  why her body is doing what it does.
It makes me sad😢

I don't necessarily need "a label".

I am an only child and her only caregiver besides the care she gets which is little at her assisted living.
I am the one who answers her phone calls every day and tries to console her when she's crying and wondering what is happening to her body.
I'm the one who has to report to her doctors all of her symptoms. I'm not trying to become a medical doctor through this journey of care for my mom, I am only trying to find her some relief and comfort. I'm there for her on her good and bad days.
I'm not OK with doctors throwing meds out at her experimenting which ones work best because they don't know what's wrong with her.

True, doctors don't have all the answers but they sure do love to push drugs !

Well. From cursory reading of Binswangers information - you learn something every day, eh - the fact that the symptoms come and go seems to rule it out, don't you think?

Bella, I do think you could quite easily drive yourself round the twist trying to give your mother's condition neat, tidy labels. Sometimes, you know, doctors just don't have all the answers. It's best to handle what's in front of you - enjoy the good days, be there for her through the worse ones.

In case you have read a bit about my moms symptoms and medical history (numerous TIAs), I was wondering if you may suspect Alzheimer's? I don't understand why she cannot make her legs work or get out of her recliner one day and the next day be fine...it does not make sense to me. I cannot get any answers from her doctors, still waiting from a referral for a psych visit... her MRI said possible Binswanger disease

No, it isn't how vascular dementia works. Au contraire.

Alzheimers is the one that does a bit of a descending roller coaster act, with good days and bad days being part of an overall downhill trend.

Typically, vascular dementia is described as going in steps. Level periods of months, weeks, with no real change, then a marked deterioration in one function or another, or several, and then the next plateau; but no real recovery of lost abilities.

Having said that, energy levels can vary a good deal. That might have something to do with it - she'd had several good nights' sleep in a row, plenty of rest, enough to eat and drink, maybe a bit of sunshine, just happened to wake up full of beans?

Yeah, you're right.
Having hard time understanding the fact that one day she's practically disabled and the next us quite capable.
Is this how vascular dementia works??

Bella, you're going to have see the funny side.

"Sit down! Where's your walker? Stop rushing around! Give me those pillows! What's *wrong* with you today?!"

I am afraid that the difficulties and risks you've noticed piling up will be back quite soon enough. Meanwhile, as far as you can, enjoy your mother's good days as you might enjoy good weather in the fall.

Uncertainty is very stressful, I do feel for you. If everything followed a smooth, predictable path at least we'd know what we need to do to help.

Sooo, visited with mom today. To my surprise she just returned from a trip to Walmart with her sister...full of energy, not using walker or wheelchair ( that I've been fighting to get for 2 wksbecause she has a great fall risk)...getting the neurologist to write down the correct diagnosis to get a dang wheelchair was ridiculous, it took 10 different phone calls back-and-forth between him and the medical supply store!  She was  buzzing about in her room like she had new legs on! Her bed needed clean sheets on, I offered to help, she refused and did it herself! For the last month she has been acting almost totally helpless...could hardly get out of her recliner without help or to navigate with her walker. No sign of the tremors that she was having, she starts that new tremor medicine on the 28th and her voice does not sound shaky either.
I'm confused. She almost seems a bit manic and I have noticed this cycle before and this was also before she started Lexapro, this manic behavior. I get exhausted worrying about why her body is acting the way it does, her moods, paranoia...I know it's probably from the TIAs!?!?...and then yesterday when I seen her it's like nothing is wrong... it really messes with my head.
I think I have become a control freak,  trying to figure out what is exactly wrong with her and getting every little thing that she needs.
 Not liking myself for wasting so much time and energy this last month on this.   How do I know when to just step back and know that I have done enough...

Our loved one fell multiple times in a matter of months in her home, but the only time she went to the hospital was the last and final time she fell - when her alert button called the medics FOR her and we strongly suspect she lost consciousness as well. Most of the previous falls were more like sliding down to the floor - as opposed to falling off of something. Oh yes, we were guilted into "why" we didn't have Mom checked out each time, but we felt like she was not injured & her falls were more due to her carelessness/recklessness as opposed to having a medical reason for the falls. Honestly, our biggest problem was getting her up off the floor after these falls - not truly whether or not she was hurt. She would become a dead lift in these situations and it would take hours to get her up off the floor. She did not come home after she was taken away by ambulance after the last fall. She's now in a facility in a wheelchair. Like your family member, ours is too unsafe with a walker to have one anymore. Extreme fall risk & she's even managed to fall out of her wheelchair - but she always has an excuse as to why that happened & why having the walker would be better. She is only allowed to use the walker in therapy under close supervision. She, of course, does not understand this & believes once she gets her walker back she can go to an apartment.

Thanks all!
The bump on her head went down fast that same day...no soreness anywhere...got lucky... next time I will push for ER but if she refuses it what more can I do?   Since I am POA, will I be in trouble if I don't make her go ?   She is still competent although sometimes I think not!   Has good days and bad days.
Still waiting on wheelchair...yesterday I called the medical supply store and they still haven't got the proper information from the neurologist stating all the reasons why she needs a wheelchair in order for Medicare to approve! If I hadn't of called yesterday to inquire on status of wheelchair  the order would still be just sitting there doing nothing. I called the neurologist office again to send over the proper information yesterday, and today I will have to call again to make sure that got done. Aggravating!
I'm about ready to go buy her one myself !
 I looked at them at Walmart for $150, looks kind of junkie.   At the medical supply store they are  $350  or rent one for $30 a month.
Any suggestions?

HolidayEnd ... The OP did immediately call in the paramedics, and *Mom* refused to go to the ER. The paramedics had no authority to force the issue. Short of physical force on the OP's part (dangerous from both a medical and a legal standpoint), that ER trip wan't gonna happen.

With the TIA situation, they just come and many times cause the fall as the person loses consciousness. My mom recently fell at AL. The injuries suggest, to me, that she got up to visit the restroom (didn’t call for assistance) had a TIA and fell on her face. No reflex of the hands to catch herself and cut her forehead and injured her pelvis. She’s doing better now.

TIAs happen. BUT, a severe blow to the head might cause coma or death. It’s best to take the fall victim to the ER. Better safe than sorry. But your incident happened a while ago? Just take this as a lesson. Your actions won’t cause a TIA. Stop the second guessing and guilt!!!

Can you bring in an outside caregiver for a few hours to reassure her that care is available where she lives?

Mom told me today she wants to go to a NH. 
 
A CNA told her that it's cheaper in NH than where shes at in assisted-living.   That was how she started this conversation by talking about the cost and then went on to say how she thinks she's going to keep getting worse and needs more help.   Still  waiting on a wheelchair... she has trouble getting up and down and around with her walker, is afraid she will fall again. Has trouble with her pajamas when she needs to go to the restroom ( the way she describes it is she's taking her pajama pants clear off and then has trouble getting her legs back in them) and does not want to use her call button. She thinks the staff at her AL isn't capable of helping her with what she needs.
Do I brush this off as her dementia talking or try to grant her wish. She hasn't really even gotten an official diagnosis yet of dementia  although the MRI kind of suggested it.  She has always hated this assisted-living and complains about something every day.  Even at the neurologist the other day I told him that she wanted to go to a nursing home and he looked at her like WHY?  And then asked her, what makes you think it will be any better there? (as far as care).   She said, well I probably won't but she think she needs more care than what assisted-living will do.

If nursing home is what she needs I don't even know where to start.

Bella
My mom has had many falls and nearly every time I've taken her to the ER - I kinda suspect her dementia was brought on from hitting her head so many times - but except for the falls which resulted in broken bones, there was not much to be done

Just last week a woman in her facility fell backwards and hit her head and had a big bump on the back of it - staff put ice on it and monitored her during the night -

The thought of spending 12 hours in the ER is nearly unbearable now - it was actually a bit of relief when mom went to a wheelchair from her walker