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Her mental state is deteriorating, she is not responding well to PT (this is her 5th recovery) and she seems to have stopped caring. She’s depressed and I haven’t found a way to help her rehab. In the last 3 weeks she went from walking w pain to now being completely bedridden and her mind seems to have shut down or given up on trying to recover.
Tonight I changed my mother for the first time unexpectedly 4 times and because of her fracture it was quite complicated. I feel like my brain shut down.
we’re trying to keep her safe, but what the balance?
she has an aide during the day, and I’m trying to find the balance. Each person she has contact with adds to her exposure risk.
Do I go all out and get more pt, do I add an additional nighttime aide? Or is the risk too great because of her diabetes that I need to just shut down my brain and do it myself? The dementia also complicates it...
I am at a loss and my family is looking to me to decide. Everyone has their own opinions but a decision must be made and time is of the essence that I act and decide her care plan.
TIA

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If you continue with the plan get those caregivers legally. They will become employees of your mom. That means payment must be in compliance with labor laws, taxes and workers comp paid, etc. Each worker must be on contract so as to not get mom in trouble with the IRS and Medicaid. Do not think about paying under the table, that would lead to many issues should mom ever need residential care on Medicaid.

You will need an elder law attorney to set this all up correctly.
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Is mom in a facility now? I would not consider taking her home now, if that is the case. She needs more care than you can provide. And that is ok.
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ZenPanda May 2020
She’s not in a facility, she briefly moved in with her sister so they could quarantine together. But she’s rapidly deterioratied both mentally and physically and had no improvement. So I’m leaning to moving her back home tomorrow. She has an aide during the daytime and I just found someone who does nights and family will have to fill the gaps. Hopefully... maybe... being home again will improve her mental state and give her more will, and also additional pt at home will hopefully... get better rehab results. I believe that the 2 are feeding into each other in a bad cycle now, and I’d like to reverse that.
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It’s a hard decision but what is her quality of life at this point? It may be time for a hospice consult. Hospice will provide support & medication to keep your mother comfortable. Hospice will not be at your home 24/7, just a few hours a week, thus family will need to provide most of her hands on care. She may get a hygiene/bathing assistance from a hospice aide 1-2x week & a weekly RN visit, but hospice can provide a hospital bed to make it simpler to take care of hygiene needs when she has an accident.

Also remember the importance of turning and repositioning your mother while in bed for long periods of time to prevent skin breakdown and bedsores. Inspect her skin daily at the pressure points (sacrum and heels) for redness pain and blanching- when you press into a reddened area and notice it is white-ish in color for a time after the skin is depressed then released.

Is she in pain? I imagine with a fractured spine changing her in bed just be very uncomfortable for her.

Good luck with your difficult decision.
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ZenPanda May 2020
id Ideally like to get her the help at home. Her mental state fluctuates day to day. Sometimes she’s completely lucid, yesterday she couldn’t even get a sentence out. But that was late at night after a long day w pt.
She was in tremendous pain from the fracture itself until about 10 days ago and now the pain is almost all from muscles atrophying and lack of movement. This is her 5th fracture in 11 years- hip, tailbone, collarbone, shoulder, and now t12 compression. She has osteoporosis as well..

Its incredibly difficult to change because of all the muscle and nerve pain she experiences, but I’m learning and adjusting. However she really requires full time care at home along w alot of pt to hope to recover. She’s at her sister now and her health is only getting worse. It’s time to try something else and just use every tool we have - hiring extra pt, extra care- an overnight aide in addition to her daytime, my brother and our wives.., - for her to have a full chance at recovery.

I likely will make that decision tonight and make arrangements for tomorrow.
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