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Mom is 87. Broke a hip bout year ago & quit walking, using wheel chair. Recently she has switched to her walker part time but she is having severe bouts of Diahria(?) during sleep, during day, in recliner, everywhere & yesterday this happened & the ONLY person o duty at her ALF was on break so she had to wait in it for over 20 min. I asked the adm a while back how to know when to switch & she said she would tell me when. But I worry they are just tryin to stretch it out to keep occupancy rate up. Mom is very high strung & extremely nervous & has frequent panic attacks. She lives 28 miles from me so I can't always just run over there, besides I have a major problem at home with sick hubby. So how do u no when?

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She does have a doctor doesn't she? What does he/she say about the diarrhea? Because that needs to be stopped and it seems to me the doctor ought to be looking into that. Asst. living isn't really set up for the kind of nursing care your mom needs NOW at least. So you're right, you do need to start thinking outside that box. Have you ever looked into Adult Foster Care? We had such good luck with my father-in-law going that route when he got ill and died about 6 mos later. It was a house with a young Romanian family who had only 1 other man staying with them. He got so much better hands on care there, and it was cheaper. For those who can still go that way, I always suggest it. Too bad that your mom didn't follow thru with her rehab after her broken hip so she could keep on walking instead of being in a wheel chair. My mother-in-law has fallen and broken both her hips now, and each time during rehab at the nursing home they made her get up and walk. When she broke this last hip, and combined with her dementia, they did have to call me and I'd talk to her and encourage her to keep walking. Or I'd just go over and go thru her exercises with her so she'd walk, since she didn't remember what the heck had happened to her. It hurt, but she loves to walk with her walker so it was worth it to keep going over and walk down the halls with her. But for you, call the doctor and find out which medication or whatever is causing the diarrhea now, that's the first order or business in my opinion. Also, you might look around for a different asst. living closer to you. Or in any case, a nursing home in your immediate area you might visit too. Just saying.
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I agree there is a reason for the diarrhea and it is very important to get that under control. If her diarrhea is frequent and uncontrollable, ask that a stool sample be tested for signs of an intestinal imbalance like c-diff. This is something that can spread unknowingly. My father had frequent diarrhea which we were told was because of the food he ate, it caused dehydration quickly and kidney failure, we learned that he had this intestinal bug. (It was quickly diagnosed with a stoole sample). Then treated with an antibiotic and probiotic supplement.
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I moved both my parents from nursing/skilled care to assisted living. They had been living in independent facility and transitioned to skilled...which was overkill! In the skilled facility, they put my mom on a Foley catheter which I found out later is not a good long-term solution for her incontinence. My dad, as I found out later, was in the first stages of Alzheimer's and became very troubled with bowel and incontinence issues. The move to ALF has been great. I moved them over a thousand miles so I could keep an eye on their care and be with them during this time of their lives. When the administration says they'll 'let you ' don't be alarmed. It's better to have your loved one close in a familiar setting. The caregivers become extended family and there are extra services, such as home healthcare and hospice that will provide medical expertise. My sweet daddy passed peacefully in my arms this past November. Mom is still there and I have no doubt they'll be there for her (and me). If you are not trying to find a 'cure' or trying to extend life using medical techniques, ALF is perfect. If your goal is to do whatever it takes to keep your aging loved one alive with the assistance of medical intervention, skilled/nursing is the answer. At least this is where I've landed in my situation.
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Dear Jazzy -- You are wise to raise these questions and more. Every case is different. I see a number of issues here:

(1) Has your mother's doctor evaluated her for medication to help with the nervousness and panic attacks? This might be a good place to start.

(2) Is your mother sociable at all? If so, she probably will enjoy an assisted living facility more than a nursing home.

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(3) Regarding the diarrhea, I am fast becoming a reluctant expert on that condition in the elderly. Recently I learned of a problem that apparently is quite common and I want to share about it, despite the yucky nature of this subject.

My 95-year-old mother has had the runs off and on since September, and then without let-up last week. Friday at the request of her doctor, we went to have her examined at his office. We then were sent directly to the local hospital's ER. This involved long waits and to make the long story short, they took X-Rays and then gave her an enema to try and remove "fecal impaction in rectum." What I thought was diarrhea actually was liquid seeping around the impaction and the real problem is CONSTIPATION.

Based on the ER physician's advice and further research, I have drastically changed her diet. She's back on MiraLAX, gets more fiber in foods, no peanut butter or dairy, and as much liquid as I can get in her (not an easy task at best as you may know).

Please don’t be too hard on the staff because of your mother having to wait 20 minutes for help. Circumstances are such that my mother had to wait considerably longer than that when the flow was constant. I put adult diapers on her. However because of her dementia (or whatever reason) she can’t/won’t change them herself and I do have to sleep. She hasn't suffered any ill effects because of this. Thankfully, she now has improved and does not have to be changed as often.
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Back to your original question, your worries can be eased if you make use of resources such as doctors and the staff at the ALF. Getting an accurate diagnosis is a big step toward peace of mind because then it will be clear what to DO. Taking action is an excellent antidote for stress. God bless.
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First, there is a reason for her diarrhea. Nurses are supposed to chart that, but inform her doctor anyway and he can prescribe Immodium. Diarrhea can be serious as it makes one dehydrated and throws off the electrolytes in the body. One can actually die from that. So, get this diarrhea under control, find out what they are feeding her and get her to walking more. The longer she sits in that chair, the more damage to her kidneys and bones. This is not a good prognosis. If you feel the assisted living facility is not doing their job, find another. It sounds like they need more staff to care for their patients in need.
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If they give her anti-anxiety medication it can cause diareahea at night, it happened to my mom.
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