Mom was taken to ER yesterday with DVT the length of her thigh due to her non-activity. What do I do now?

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My mom is 6 mos post hip replacement, and her recovery has been slow at best. She has been told by surgeon, physical therapist, nurses, etc. that she NEEDS to stand up every hour, NEEDS to make more of an effort to walk with her walker, etc. yet she sits in her recliner all day long. The closest she gets to walking on her own (even if I offer to follow her..she always refuses or makes an excuse why she "can't" right now) is transferring from chair to wheelchair. When the therapist is here, she complains about not being able to do what they're asking her to do, but the PT says she can and she makes her walk the hallway and back and she does it (LOVING this PT!)! There is no good reason my mom CAN'T walk again, nor should she still be wheelchair bound, due to anything other than her lack of compliance and motivation to do the prescribed exercises in between PT visits ("I'm not an exercise person"). If I suggest she do them/walk/etc. I get snapped at, so I basically told her it's all up to her & left it in her lap.
Enter karma. The past few days we noticed her right leg was a lot more swollen than the left, so the home nurse told us to go to her primary dr. & be evaluated. He sent us for an ultrasound of the leg, which revealed a DVT that runs the length of her thigh. From there, we were sent to the ER and she was admitted last night. My Mom, upon hearing what she had, couldn't understand why this has happened! We've all told her the past few months that if she didn't get busy and MOVE that this could happen, along with her muscles atrophying further, etc. It's as if she doesn't "get" that her behaviors are a direct cause to a majority of the issues she is facing - she just complains that now she's got "one more thing" to deal with... "if it's not one thing, it's another..." as if these events are being cast upon her instead of caused by her actions (or non-actions). The "oh poor me" attitude is wearing reeeeally thin.
So at this point, the hospital is starting her on anticoagulant therapy, and may be inserting a filter into one of the veins in case the clot breaks off & becomes an embolism. Not sure how long she will be in the hospital, but to be honest I am grateful for the breather. Part of me hopes they will send her to a SNF afterwards for in-house physical therapy, and depending on her progress there we can decide whether she should even come home again or not. I just can't continue to care for someone who won't help themself get better, and then drags the entire household down with her attitude.
Of course the "good daughter" in me feels guilty for thinking this way, and I know NONE of this is my fault and I can't fix someone that doesn't want to be fixed, etc. - I KNOW all of this in my head...I know I have NOTHING to feel guilty for, so why do I feel this way??? The neverending question....

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I so feel what you are going through. We have had my Mom almost 14 years now.She hasn't wanted to be involved in any way for years. Now she is in skilled nursing. I have had so many at the hospital and SN tell me I need it as much as she does. My husband hasn't stated as clearly as yours, but he feels the same. It is so hard. Hugs to you and your husband. I am learning to lean on God more.I don't want to bring Mom home. I love her, but this person is overwhelming and wants me to do everything. I cant and I understand the guilt.
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Purplesushi, I'm so glad for you that it looks like your mother will be able to stay at the SNF. My mother too refuses to take responsibility for her well-being in many important ways and it is quite tormenting to watch while being able to do nothing and "wait" for something awful to happen. In your mother's case the something awful has happened, but now it has now you can be free and you mother can get care from professionals who will find it easier to deal with her. I too hope that the doctors tell her she has to stay so you don't have to be the bad guy.
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My Mom has been at the SNF for a week now. I was there the other day, and the social worker saw me. I told her that I was wondering if they had any long-term beds available, and how that process works. She said "I've actually been meaning to talk to you - come into my office." She shut the door, and told me that she had just been looking over my Mom's records earlier in the day - she noted that she has been in their facility 6 times in the past 2 years, and was also concerned about the fact that she doesn't seem to be getting any better over the long-term. I explained a lot of the concerns I have, and felt that she wasn't listening to me where her best interests are concerned. She told me their long-term beds are full at the moment, but also told me not to worry about that right now. She said there comes a time when our parents have to face reality - that they require more care than they can be safely given at home. She said that they don't have a "waiting list" - they would work with us. We talked for quite awhile, & I told her that I have to get back to work - I can't afford to stay at home with her all day any longer, and it is not safe to leave her by herself for more than a couple of hours. She agreed, and said "We'll see how things go with her for the next couple of weeks, and we'll definitely talk about this again." Soooo the ice has been broken with the SNF on the matter... I just don't know what to say to my Mom, or when to say it...or do I say anything at all, and let the SNF or the doctor be "the bad guy" by saying they don't think it's safe for her to go home, etc.? I guess I'll just play it by ear & see how things go for now.
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Let her go somewhere else. They will push her and hopefully she will do something. My mother's husband let her come home. She laid in bed for over two years. She wouldn't do the home PT. Finally, her heart gave out. It could have been so much better...
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Your Mother's lack of interest in her own health, her thwarting of your best efforts to keep her healthy is a complete mirror of my mother's behavior right down to spending all day in a recliner, incontinence and all, and thereby suffering unnecessary life-threatening conditions. When she landed in the hospital, and then rehabilitation, there was no way that I was going to allow things to go back to where they were before, and believe me, all that rehabilitation would have been wasted if I didn't get her into assisted living with additional services and then communicate to the medical folk that she needed to stop pushing her in a wheel chair and push her to walk with the walker. Now she has maintained the health and capabilities that the rehab facility gave because of the large number of staff that can care for her, and is happier because the gerontologist knows what drugs to use to combat depression. She is seen every week by the visiting doc. Best place for her.
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She may listen to others better than she listens to you. She also has to comply absolutely with her anticoagulation - if she is on Coumadin (warfarin) there are some dietary concerns and higher risk of bleeding, plus just taking the meds correctly and getting regular lab work to monitor it. It would seem that you are making a good call - and even she knows it wouldn't work out to do otherwise!!
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See - that's what is scary - the doctor said it could take months for the DVT to resorb, so a portion can break off at any point between now and then and become an embolism. I don't think it's doing her any favors coming back here for the very reasons you have stated - she is not respecting anyone's orders or concerns and does what she wants anyways, so it's a complete waste of my time & the doctor's breath to even try & get her to listen anymore if she doesn't plan to take responsibility for her own health. To be blunt, I think I finally decided that I don't want her dying in my home, under my watch, due to her stubbornness & my inability to get her to MOVE. I told everyone that I am not washing my hands of her - obviously I will still be involved in her care, and will be her watchdog where her care at the facility is concerned - but I just have to take a step back & reclaim my life, and my home, for my sanity's sake.
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You have gotten good advice here. If Mom knows she can just go home with you and sit in her recliner and be waited on, it won't be very motivating for rehab. If she knows she does not get out of a care home until/unless she phyiscally makes herself able to, she may have a chance. If she is too lacking in insight or judgement to do the hard work of regaining strength or mobility, she may not, but that does not mean you have to be the caregiver. This is hard, and sad, but physically caring for a large, immobile adult requires more than many of us can do in our homes, even with the best techniques and equipment.

The DVT from being so sedentary is not the worst that could have happened. I know of a mom of a patient in my practice who basically decided to be lazy, indulged in overeating and substance abuse, and more or less took to the couch -she got a DVT that went right into a pulmonary embolus and killed her, leaving grandmom to deliver all the care. Not a nice situation. Move it or lose it may refer to a person's LIFE.
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The last time she was there, she voiced that she "wasn't ready" to go home & the social worker told her she could stay if she had Medi-Cal. Well, at the time she hadn't been approved yet so she had to be released. I am pretty sure they have long-term beds there - can't imagine they would've asked her if she wanted to stay if they didn't. I do like that place - we haven't had any issues with them at all in the several times Mom has been there. I am crossing my fingers that they have room for her there & that I don't have to hunt for another.
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Is the SNF where she is for rehab where you would also want her to stay, if she needs SNF? (Between my mother and my husband I had experience with 3 TCUs. Only one of them would I have considered for permanent placement. Mom doesn't have to stay where she happened to wind up for rehab.)
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