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My 90-year-old mother has dementia and can barely walk. She does fairly well at home in her familiar environment and our desire is to keep her happy and as comfortable as possible for as long as possible.



Last week she had a follow-up with her cardiologist. Although I transported her as carefully as possible, the whole episode left her disoriented and unable to even walk the next day. I decided I could not do this to her again, especially for a checkup where they just listen to her heart and send her home again.



Unfortunately, the doctors require checkups to refill her prescriptions so I'm trying to figure out what people do in this situation. She's on Medicare and TRS insurance, so I'm currently checking into the home visits but no one can tell me about the specialists.



If anyone has any experience or information that I can begin my search with, I would be more than grateful.

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Thank you all for the insightful comments and advice. I just got off the phone with a local medical facility that provides house calls which I believe is what several of you were referring to. I agree completely about stopping the specialist and concentrating on keeping her 'comfy and relaxed at home'. Thanks to all of you who took the time to reply. I feel validated in my decision and am hopeful this HC program will be the answer to our problem...will keep you updated as I learn more.
Blessings to you and yours.
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InFamilyService Mar 2022
Good luck to you and we are all here to help each other and make our lives easier.
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Why are you trying to make her agony last longer? Her mind has died already and her body is giving up too. May be it's time to realize that her time to go is around the corner. No doctor specialist or wonder drug is going to make her younger and healthy again. One has to listen to Mother Nature more than to the doctors. They also know that they can't fool Mother Nature, but as long there are people and insurances willing to pay for their services, they will try to keep her heart beating to the last, even after her body has already turned into a carcass. Look for hospice service
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CaregiverL Mar 2022
Best advice, TChamp
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I'd drop the specialists if it were me, and see about getting the visiting PCPs to come into the house to see your mom. My mother lived in Memory Care so her doctors came there to see her, thank God, which was one of the many reasons she lived in MC to begin with; she was wheelchair bound and weighed 190 lbs, so there was no way DH & I were schlepping her around in the car; it was impossible. Specialists did NOT go to the MC, however. But when mom was in the hospital the last time in 2019 and I saw what the 'specialists' did NOT do for her, that's when I made the decision to stop using them entirely. With dementia at play, along with other health issues, the last thing I wanted to do was extend her life and/or give her more meds to take and trauma to suffer. And that's what these doctors DO: they cause more trauma with tests, and poking/prodding, etc.

If there was an urgent need, the ambulance would take mom to the ER for a few tests, but she got shoddy treatment there too, I found. If it wasn't "Covid" related, they gave her the bum's rush & out the door she went after a blood test for CHEST PAIN!

You can always hire a wheelchair accessible taxi service to take your mom to the doctor, but be forewarned that it's very expensive (in my experience) and you'll need to hire the van roundtrip.

Leave mother alone to get the minimal PCP care and medication; let nature take it's course while you allow your mom to stay comfy and relaxed at home. That's my suggestion. Otherwise, you may wind up extending her life by a few months or a year and what kind of 'life' is it that you're extending ANYWAY, with dementia at play? IDK about your mother, but mine was in a lot of pain and plagued with Sundowner's and ready to leave this life for the next one anyway.

Wishing you the best of luck.
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Specialists don't do anything at this point other than order blood tests, listen to her heart, and write a prescription. Any primary care doctor can do that.

Consider getting a consultation for hospice. Contrary to what many think, they won't take her off her medications and "let her die," but you'll have the weekly services of a visiting hospice nurse and a hospice doctor who'll prescribe her meds.

The nice thing with hospice is the nurse will really get to know Mom and will be able to tell you if the meds are no longer doing their job or need adjusting. My mom was on hospice for seven months and all her heart meds were refilled every month.
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You need to speak directly with the specialists.
Truth told, in this condition it may be time to stop with specialists. Palliative care may be the answer if you want merely the medications to prevent complications of such things as weakening pump/heart and CHF, blood pressure control (which monitoring can be easily done at home and is a more accurate measurement than a confused senior in pain and distress, and etc.
In the palliative care community the doctors are familiar with seniors who can no longer make it in.
In lieu of going that far, speak with the professional about learning to do in home BP and heart rates, about zoom calls, and let them know the problem.
Best to you. Were your Mom in an ALF facility many of them are connected with MD groups and advantage programs in which they are visited in the facility itself. This was the case when my brother was in ALF.
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Remote telehealth appointments from your home. This is the greatest thing that has come out of having covid.
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My mother 85 lives in her apartment on a senior living campus. We discovered "Visiting Physicians of Jacksonville" and changed her insurance to cover this geriatric physician. He does her monthly check ups in her apartment. I found a mobile lab service, x-ray & ultrasound that provides services in mom's apartment. What a relief to me and mom, who is wheelchair bound.

She also is enrolled in palliative care and was eligible due to her dementia. This offers another layer of support.

Check your mom's insurance and see what is available. You may not need to change her insurance.

Her primary can probably prescribe her cardiac meds like BP meds & lasix.
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I do telemedicine appointments for my mom which work for us. I provide updates on whats going on or problems with my mom to the doctor. It's way too hard to get my mom dressed, put in the car, getting her out of car, and then walking is another major issue. I only deal with 2 doctors Neurologist and Primary Care Physician. Try to keep it simple. Tell the doctors you need 90 day prescriptions with at least 1 refill or more. Tell them your moms health has declined no longer able to come into doctors office. The doctors should not have a problem with doing a TeleMedicine appointment for you. Please check into it.
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Update: We had the Senior Housecalls nurse practitioner come by the house yesterday and it was an amazing experience! He had all the equipment to check both my parents out thoroughly and set up an appt next month to do their bloodwork so as not to stress them too much on the 1st visit. If they were to have a fall, or just get sick, all we have to do is call and the nurse will come out to their house! Even bring a portable x-ray machine if needed. It was so nice to have someone take their time and I felt like their checkup was more thorough than either has had in a long time. Also, the NP can prescribe all their medications so another load off my mind. I have a call out to their cardiologist as to how he wants to handle their appts - I do want to keep him in case of an emergency situation - the nurse is supposed to get back with me and I'll let you know how that'll work. VERY impressive program and wonderful people. I'm seeing rainbows for a change :)
Blessed Be
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Llamalover47 Mar 2022
MamaChar: Thank you for your update.
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I had that experience with my mother, who had advanced dementia. She didn't understand what was going on, found the trips very burdensome, and was not verbal. Her primary care physician agreed to hospice care with a "no hospitalization" directive. Her doctor worked a couple of days a week at her assisted living facility and was able to make "house calls" the few times it was needed. He stopped most of her medications, including the dementia medication. I felt that she should continue to take eye drops for her glaucoma, and her eye doctor agreed that he'd continue to order refills, even though she was not capable of coming to the office.
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