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My mom is here at my home in AZ for 6 month "visit" which I believe should be permanent due to her need of care. She's 91 and has been in MN living on her own until about a year ago when my nephew moved in with her to help out but due to working isn't there often. Some how some way she got a hold of an opiate pain medicine and started using it to help with her sleep (I'm pretty sure how she got it but I won't go there for now.) Insanely her friggin' doctor kept refilling it based on my mom's "promise" she wouldn't take it during the day. I suspected over the phone this summer she was indeed taking it during the day. Now she's in my home under my care and on her "last" bottle. I'm certain her doctor in MN won't refill it Long distance (I'll turn her into the law if she does) and there is no way my doctor here for her would. My mom when clean DOES want to get off of it, she realizes she has no choice. But she's hidden the bottle (I think I know where it is) and I can always tell when she breaks down and takes it. So I have two questions: first I believe she won't voluntarily give me the bottle, should I take it from her as I do have the opportunity when she's sleeping. There are only a few pills left if my estimates are correct. Second, and this may sound cold, but I can't STAND her when she's high. She's demanding in a rude and "be my slave" manner. If I don't bend to her exacting will she purposely pees on her bedroom floor. I'm so angry right now. I should be compassionate, I know, and I usually am but I just can't take this high ninny in my midsts. She hates going to the doctor, we've discussed her withdrawal symptoms and while clean she sincerely wants to battle it but I'm certain she's going to lie to me this next time. She actually seems to think I don't know when she's high but it's as clear as water. I'm at a loss of what to do just because of the simple fact she WILL run out soon and will have no choice but to get off them. I'm prepared for the compassion she'll need as she goes through withdrawal but dealing with this current druggie is driving me mad. Do I confront her, what do I do if (and she will, I know my mom) she lies about it? Say to her, you're not peeing on my floor anymore or stop acting like a victim when I KNOW you're more capable than that? Geeze I'm stuck. . . She's a wonderful lady that I adore when she's clean. I don't ever get stern with her and I don't really know how to approach this.

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GREAT answers! I will absolutely follow your advice:)
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I absolutely agree with blannie that you should tell the Dr everything you know and suspect before he/she meets Mom. Writing it before the appointment is helpful so you can leave your notes with him so he can refer to them later.
Do you have a reason or can you invent one to visit the dr alone in the near future? After the visit you can tell Mom that you mentioned that she was now staying permanently and he said he would like to meet her for meet and great or "Welcome to Medicare in Arizona " so he knows her history before she has any illnesses, get her vaccines up to date etc baseline B/P and all that good stuff. You could even push your luck and actually make an appointment while you are in the office if you think you can pull that off. I would not rush any of this, maybe take several weeks. While I would tell the Dr you wonder if she is having mini strokes I would not mention this to her. If she has another episode before Dr's visit put the frighteners on her and get her to the ER. Tell her how dangerous mini strokes can be because they can always go on to be full blown strokes leading to death, paralysis loss of speech, consciousness, inability to swallow. The actual definition of a TIA or mini stroke is one in which all symptoms resolve within 24 hours and leave no lasting effects. tell her there can't be any delay in getting medical help because there is only a short period of time in which the so called clot busting drugs can be given which can prevent serious damage to the brain. A few tears at this point may help your case. If Mom can be a tricky customer you are going have to be one step ahead of her and pull out all the stops. Just for the record if Mom does have severe pain requiring a narcotic at 91 I would not be concerned about addiction. The hydrocodone is probably not the right drug for her given her apparent reaction but there are plenty of other choices. Any drug given to the elderly can have unpleasant side effects so extreme caution is necessary is necessary in the choice and dosage. This is a very interesting thread so I hope you are successful.
Hugs
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It's interesting you say that, Captain, because I'm becoming very confused by my mom's actions.
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to this day science / medicine is not prepared to state whether an addiction came first or a mental discrepancy that is being self medicated. your mother may be as bipolar as a housecat and medicating with op;iates to blunt the highs and lows. give her the bennefit of the doubt.
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I would certainly tell the doctor your mother's concerning behaviors and the medication you know she's been taking. If you're thinking your mom might hear you, send him or fax him a letter explaining what's happening and ask that it be put in her file. He needs to have all of the information to make the best decisions about treatment/tests. And your mom may not share that with him.

When I take my mom for a doctor's visit, I have to fill the doctor in because my mom either won't remember or will downplay her problems, which is very common in seniors. When the doctor asks what is going on, my mom will say she's fine when she's not! So that's very common.
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Whoops, Veronica, I didn't mean anyone here bamboozled me:) You all here gave me really excellent advice, especially yourself. I meant my mom might be bamboozling me about not taking the drug anymore. It is very common for addicts to lie. She hasn't had an episode since our talk though it is too soon to say. I haven't been able to get her to let me set up an appointment for her yet. I'm not sure how to broach the subject that I worry she might be experiencing tiny strokes. I'm also finding mom can be a crafty little devil and your words of wisdom to not assume the worst about the doctors is sound advice and very welcomed. On that note: if I do get to set her up an appointment, is it alright for me to tell the doctor my concerns? I know the doctor can't reveal any information to me if my mom doesn't allow it and that's okay with me. I'm just worried she won't be completely honest with him. I'm beginning to suspect she wasn't honest with the physician who did prescribe her the drug. At the same time, I'm so novice with my assumptions I don't want to muddy the waters so to speak. What do you think the doctor would be most comfortable with for it's a certainty I'd be the one to set up the appointment.
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There is still a possibility she is physically addicted... the leg cramps are indicative of this... but you will be armed with much more info when seeing the Dr, and they will have a better picture of where to start and what to look for.... please let us know how things are going... sending you hugs.
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You are an extremely loving are caring daughter for your Mom. I am so glad you have been able to connect with her on this level and she is prepared to move forward medically.
I do not believe anyone here was trying to bamboozle you about the steps that needed to be taken if she was truly an opiate addict which now sounds unlikely.
When you first posted we read the panic in your words and responded accordingly. As time went on you added further information that made it clear that there was probably a different medical explanation.
I am so glad your mother has such a trusting and loving relationship with you and I see an excellent relationship going forward.
In support of doctors everywhere (and I frequently don't agree with their views) the start of this prescribing of hydrocodone sounds as though it was perfectly reasonable. She was having pain related to her PT and it was keeping her awake at night. The Dr determined that prescribing analgesia for a 91 year old was probably safer than sedation so that was what he did. Now of course he should not have continued to mindlessly sign refills for her every month but Drs are busy people and when presented with a stack of paper to sign just do their illegible scribble. I am also guessing she never actually went back for a check up or maybe your brother just called the office and asked for a refill. What I am saying is that these things unfortunately do happen. Of course your brother was wrong to give her the medication in the first place not to mention acting illegally but I am sure he did it with the best of intentions. People do that all the time.
I hope you do not see this post as critical of you and your reactions, it is meant to be supportive both of you and other members. Those on this site have a broad range of experience and in some cases training or have taken the time to educate themselves over many years as they go along. We do not all always agree and that is very healthy and sometimes someone reacts unkindly or indifferently. Others experience your level of anxiety every single day of their caregiving lives and the gut reaction on a bad day is 'suck it up, pull up your big gIrl panties"
I have been wondering where you can buy a pair of those! Do they come in different colors or do you have to sew your own?
Rarely we have a visitor who posts a fictitious question and everyone rushes to help only to discover a few days later that some of the information just does not fit.
You are a very wise daughter and clearly inherited it from a very wise Mama.
Please keep visiting. You may not think you have any caregiving experience but frequently experience in other areas can be very helpful and insightful. For example you could know about elder tax issues or many other subjects, also your mother could contribute ideas about elder living arrangements and what works for her. Hugs for you and your Mom
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I cannot thank all of you enough. Coming to this forum has turned out to be a huge catalyst to a hopeful final solution. It's amazing what has transpired since last I posted. I want to try and answer all of your inquiries within this post rather than reply to each of you so please know I'm talking to all who asked questions. If I miss something please ask again for I may have misunderstood your concerns.

It was as if magic happened and the strength I gained from approaching you all here and getting your advice transpired into reality. My mom and I talked. It was honest, thorough and life altering. It started off innocent enough and soon moved into discussing the future. I've wanted her to live with me for years and now it will be a reality. She's very happy here and I'm happy to have her here. With that discussion came a point where I could let her know I had serious concerns.

Let me try to keep this as simple as I can. First, I do not believe she is taking the "hydrocodone" on the sly as I had suspected. I'm very confident of this. I do believe the withdrawal symptoms should still be addressed by a doctor even if she isn't in current danger. I am now EXTREMELY concerned that something else has been happening and it started this last summer (I even suspect a fall caused it or "it" was the cause of the fall). She had no clue anything was happening and I followed the instincts presented here and didn't scare her by describing what I'm seeing; however, I did explain as part of her staying here I no longer wanted the antedotal remedies from my well meaning brother. I asked her to allow me to set her up with a relationship with my wonderful doctor here (if it takes getting a POA as what was suggested here, I'm all for that if she is, thanks for suggesting it.) I did express at the very LEAST if another episode occurs I want to address it immediately with her and deal with it right then and there. She is in agreement and while I was careful not to frighten her I think I got my point across that "something" is happening beyond her becoming weak.

She wears the full regiment of the padded underwear and pads on top of that, which is why the sudden urinations had me thinking they were purposeful. Now, I'm changing my mind because descriptions here fit what might be happening. I did not want to embarrass her so I didn't press the point, but as we move to me being more involved in her medical history I will gently address it with her. I believe her past physicians unknowingly (or uncaringly) have tossed her into a medicine induced nightmare and I want all her meds checked. Here's why: my mother ended up on hydrocodone because my brother gave it to her to ease her itchy leg syndrome that disrupted her sleep. He had it because of a car accident he was in and I remember her specifically telling me that when she first started taking it. I told her to check with her doctor, which she did, and I assumed it was okay until I could tell she was fearful she was getting addicted. When she got here and I realized it was more serious and I expressed my concern to her and my outrage her doctor would let her have it in the first place her story changed. Then she said she was given it for a slight back injury she got when she was doing physical therapy after a serious fall she had two years ago. I don't know which story is true but my money is on my idiot but well meaning brother.

Lastly, I do realize I may be getting bamboozled about her getting off the medication and I'm keeping my mind open to the great advice offered here. I am absolutely blown away at how instrumental the advice given here has helped us. I'll be a frequent visitor as I am clueless about elderly care and I can use all the help I can get. I love my siblings, I love their support and advice but I like the idea of being able to freely express my fears without breaking my mom's confidence. She's a private lady and they aren't doctors, experts nor any more experienced than I. I find common sense here with a good healthy dose of "get her to a professional" and have garnished almost instantaneous results because of you fantastic caring people. Thank you SO much for the time you have given me!!
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Your mom acknowledges that there is a drug problem. Your husband doesn't think that she has been taking many in the last couple of weeks. How long has she been taking them? Could she have another supply that you don't know about? More than one bottle from different doctors, different pharmacies would not be uncommon. Does the bottle she has show up on an insurance statement, or does another one? Could she be paying cash for some, insurance claim for others?

maybe it is mini strokes. I would get her examined at the hospital next time something like this happens. If she refuses to go and not medically necessary she does not have to agree.

Who has her medical POA? That person should be able to get information. If nobody has it do that NOW!

Also consider a geriatric psychiatrist that could help identify what is going on with her.
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I would also be concerned about small strokes. You can approach her with that idea and if she's taking pills when those kinds of episodes occur, maybe she'll admit it. If not, when one of those episodes occurs, if it was me, I'd call 911 and have the paramedics assess her. Strokes are nothing to mess with. TIAs (transient ischemic attacks) may be what she's having.

My neighbor keeps ODing himself on Xanax and gets to the drooling out-of-it state. He thinks his mom is still alive (she died a year ago). He can barely stand when he's in that state. We called the paramedics on him last time and they admitted him to the hospital. If you can get her to the ER, they can take some blood tests and determine if her problem is pharmacological or physical. Once you know what you've got going on, you can get it treated.
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Thanks AF, has been many times in all these years that it has been tough... have had many 'excuses' but no 'reasons' to give up my new life.... So please don't feel I am lecturing you... I just know how hard it is to stop denying the truth, and how hard to get help.... you will have to use your own judgment about when to intervene....you are determined to get her some help... and deep down inside she really wants that help... but she doesn't know how to do it. And the drug will always speak louder than your love for her.... it's a tough situation you are in... but you are certainly a loving and caring daughter and will do the right thing for the right reasons.... please keep us updated on how things are progressing... and they will, it will take time... she didn't get addicted overnight, and she may have all sorts of problems afterward..... educate yourself as you have been doing... and be prepared that Dr's do not readily know a lot about addiction.... the detox can do her more harm than good if not done properly..... You are in my prayers, as is she... I have been in her shoes and I know the fear she is feeling right now.... give her a hug for me... she doesn't have to know it's from me.....
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Thank you for the description of the symptoms. can you tell us the name of the medication. Is something like Vicoden, Tylenol# 3 or similar. These are not very strong narcotics although very addictive to the right person.
As you have described the episodes my first thought is that she may be having small strokes rather than or as well as taking pills. The next time this happens can you tell her you think she is having a stroke and must go to the ER at once. would she go under those circumstances? as you have left the room when she is mad and urinates is it possible that she is actually incontinent at that time? Is her underwear wet? does she hide it and later rinse it out herself? this is quite a puzzle and I am just having random thoughts but the weakness following an episode and at other times certainly points to something medical.
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Here's where we're at: we found the stashed away pill bottle and counted them. Unfortunately my husband admits he didn't actually count them the first time he checked it a few weeks ago. He's certain there's not a dramatic decrease in number but he's not certain if there are some missing. There's 16 left and counting the "episodes" she's had and accounting for her "cutting them in half", which she has stated she started doing when she realized she wouldn't be able to get them refilled, there is a definite possibility she could have taken them. However, there's just as much a possibility that she has stayed away from them for I do know her desire to get off of them is sincere. When we looked up the symptoms in the past when she would have these radical personality changes the descriptions matched perfectly with how she was acting. However, we now realize our suspicions are pure speculation at this point. So I'm back to square one. Understanding my mom is not one to deal with issues whether they be medical or mental I need to approach this so she doesn't shut down my concerns. She is absolutely capable of and likely to lie to me to get me to not discuss it with her.

We were thinking when the next episode occurs (which terrifies me to wait because our research says this drug can be very dangerous if she tries to get off of it and has a relapse) to confront her at that point and compassionately yet directly ask her if she has taken anything and if she hasn't explain to her what we're seeing, why we're so worried and can we please take her immediately to the doctor. Absolutely if I video tape her I will ask her permission first for I agree 100% humiliation will not get me any where. Now if I may: here are the symptoms.

Her eyes become "beady" partially closed and one eye squints shut. She drools. Her speech is slurred and while cognitive the topics are strange like a drunk person. She becomes very weak and can't do things she has no problem doing otherwise. She becomes narcistic, rude and will suddenly give me the "evil eye" over simplistic matters. She doesn't ask for help and seems to want me to read her mind. When I don't guess properly what it is she needs she urinates on the floor as soon as I leave the room. This is NOT my mom. Sure, my mom has bad days when she needs heavy care because of weakness, down in the dumps and even times when she has a desire for sympathy, but this is really different. It's as if a completely different personality over comes her and wavers from demanding to guilt ridden. She's always been smarter and more alert than any of us even at 91. Can mental capacity diminish so quickly, radically and infrequently like this?

I keep my care for her at a high level always, knowing she hasn't had good care in the past as my brother and nephew believe she's way more capable than she is (they are SUPER good people, she just refuses to be honest with them at how hard things are for her.) Bottomline: I do too much, they don't do enough.

Sorry for the long explanations but I'm brand new at this. We don't even have kids so caring for someone in need is a foreign realm for me. Is waiting for another episode foolish? I'm just certain she'll deny everything if I approach her without evidence.

BTW, ladee - as much as I detest addiction, I believe those that beat it and work every day to keep on track are some of the most courageous, successful people in my opinion. I respect your success SO much!
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Fantastic... be pro mom and getting healthy..... I don't know that I would tape her without her knowledge.... you can let her know you will do it in the future so she can see for herself what you see....humiliating her will not get her clean... she may be for awhile... but shame never got an addict clean.... I am speaking from personal experience as I am an addict with 29 years clean this month....prayers for you and her....
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Well done you have taken a giant step forward.
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Thank you all so much! It won't be difficult for me to show emotion to her for I'm all twisted up inside about it. It's evident to me I've had my own bout of self denial going on. It's amazing how clearly a person begins to think when they write something down or ask outsiders for opinion. It is a certainty to me now I need to involve my doctor. I believe I'm allowing my sympathy for my mom's desire to stay out of the doctor's office or handle this on her own to influence my judgement. I'm the one who's clean, I'm the one who's not being subjected to the mind altering state of this drug, it's up to me to step in, be brave, be by her side and get her the help she needs. If my suspicions are correct, she may already be aware of the serious situation she's in and just like me reaching out to you guys has cleared my vision perhaps my bringing this out in a compassionate way will clear her vision to the path we must take now. In a few hours I'll have my hands on those pills and know for certain what is going on. I'll report back, just because speaking here is keeping me alert as to what must be done and is keeping the denial of it all at bay.
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get those pills counted as soon as possible so you can gauge how much time you have before an emergency intervention is needed. As soon as she runs out of those pills withdrawal will be immediate and possibly life threatening for someone of her age and a 911 call may be necessary, it is that serious. She needs alternative medication often Methadone to get through the withdrawal period and this is best accomplished in an inpatient setting. Talk to your Dr about this and take his/her advice on how to handle this. it will be tough and she will be mad at first but in the end will love you for taking action. Any 91 year old has some fragile health issues.
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I'd try to have the loving conversation and count the pills (without her knowledge). If she balks, then I'd wait to videotape her and show her the difference. Hopefully if you come at it in a loving, caring way and not in an accusatory way, she'll agree to get help. This has to worry and embarrass her. So don't compound those feelings up front, when you're trying to get her agreement to treatment.

When I've really had issues with my mom, I've cried. When I cry (because I'm usually so in control) it really tips her in favor of doing what I need her to do because it makes her understand I'm serious and at the end of my rope. I'm not doing it on purpose, I just get so frustrated that I break down in tears. I'm not suggesting that you fake it, but you gotta do what you gotta do to get her to get help. Good luck and keep us posted.
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She doesn't admit she takes it during the day but does admit she shouldn't be taking them at all. I've never confronted her about taking them during the day due to only realizing the situation since she's gotten here. In hindsight I realize now this seemed to develop over the summer because of how her speech changes when she's high. Over the phone I had just assumed her age must be catching up to her. She has absolutely no legitimate reason to take them. I'm FURIOUS that the doctor allowed her to take them just to help her sleep. My mom may have fed her crap about having itchy leg syndrome but there are a LOT of different ways to handle that and that doctor HAD to know that. I think whats occurring now is she IS trying to get off of them but after about 3 days she gets sever cramping in her leg (the research I've done explains that's exactly what happens during withdrawal) and she's using that as an excuse to herself but she's pretending to me she isn't taking them. IF she isn't taking them then she's suffered something very serious because she is not my mom during these episodes. After writing this I realized I can go and check the bottle to see if they are disappearing for I had my husband check the bottle some time ago to see how many were left. You're advice to not diminish her trust in me by stealing them is EXCELLENT advice and not something I had considered.

Video taping her is BRILLIANT! I know she'd be mortified by her behavior and cannot be aware of it, I'm certain of that. I agree, I do believe I need to get her into the doctor. My husband and I have come up with this plan of action and I hope you don't mind me running it by you: I'll get her positioned out of her room to sleep in her favorite chair in the living room. Then we'll find and check the pill bottle to see if indeed she is taking them or is this more a case of mental deteriation. If she is taking them, then beg her to go to my doctor to work out a plan for getting off of them (I'm certain she'll fight this idea). If its something medical then I can insist she go to the doctor because something serious is going on (as if this isn't serious enough, I'm terrified for her.) Now I ask, do I wait first for another episode (having a video of her would go a long way to convince her how serious an issue this is) or do I confront this head on?
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First and foremost.... make absolutely sure that you know what to do during withdrawal......she can not just abruptly stop taking this med... you didn't say what it is..... I would have to tell her , like it or not, she would be admitted to a hospital for a medical detox...... it's not like an addict has any 'reasoning' about them.... it will be dangerous for her.... please take this very seriously... it can be life threating depending on the drug....... prayers that this lady lets you help her.... I would let her know she would not be allowed to detox at home... too dangerous....she isn't going to like it... so what....you do what you have to do to feel you are doing what is in her best interest..... hugs to you!!!!
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Why does she take it during the day? Have you discussed that with her? Is she experiencing pain that needs to be managed in another way? That's the first thing I'd try to find out.

I'd also get some video of her while she's high and share it with her when she's clean. She'll probably be appalled based on her normal behavior.

I'd be concerned about the physical withdrawal she might experience. She needs medical help to get her through that. If she's going to be with you for a while, offer your loving support to get her off the pills. I would also look to see if there are Narcanon groups in your area to get some education from them.

I wouldn't take her pills while she's sleeping. She needs to trust you in order to work with you to get her through her addiction.
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