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Sherry1anne your post reinforces something I learned many years ago when I worked in the student pharmacy at the University of Illinois. The pharmacists would get so frustrated with the doctors because they didn't understand medications and the interactions or side effects of medications. So I'm always recommending that seniors who take medications have the whole kit and caboodle reviewed by a good pharmacist - hopefully one educated in geriatric pharmacy. They're the ones who have been educated on medications and their side effects/interactions!
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Thanks, Sherry Anne. Mom does have HBP, but I don't know what she takes. I think that medication mix-ups have been ruled out a month or so ago when she was checked out by her Geriatric Specialist, some drugs were lowered in dose, some were tossed out of the mix completely. None of the falling really began until after her hip replacement surgery. She was in a rehab center and altho she had many "attempted" falls, there was always someone right there to help her. I know that since this surgery she has really gone downhill. I also know that anesthesia on the very old is a tricky situation. my DIL is an anesthesiologist and she stated she would NEVER accept someone in as bad shape as mother as a patient. She was out of it for sooooo long..then after her rehab and return home, and PT in home stopped, the falling began. AS soon as she wasn't getting in home PT she immediately regressed. I'd love to see her be able to have in home PT, but she doesn't qualify for it as she is too "mobile".
I'm out of the loop for the week unless she has a fall that is serious, I have some personal problems I need to work on, and I'm taking the week to deal with them. Still appreciate the comments and support.
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I'm not privy to Mother's drug list, so really other than what R tells me, I;m in the dark. She takes a handful at breakfast and one at bedtime. I don't really know what. Her pharmacists are excellent, tho, as I have filed scrips for her and know they are alert to her interractions.
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Sometimes we need to think about the fillers that the pill manufacturers used to fill, bind and coat the pills.... each manufacturer uses a different mix compared to other manufacturer. There are known side effects from these fillers, etc.

I ran into this during the past 5 years... I noticed if I order pills and they came from XYZ manufacturer I had no issues.... if the pills came from ABC manufacturer I ran into non-user friendly side effects.
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Midkid, is there no possibility of hiring a PT "off-piste", so to speak? It takes our poor elders *ages* to recover fully from breaks, and it sounds as if she really needs regular help to get out of this downward spiral.

I'm a bit surprised about the general anaesthesia, too. When my mother broke her wrist nastily there was pretty much a stand-up punch-up going on behind the cubicle curtain in the ER, then a terribly young anaesthetist appeared, pink and quivering with indignation, and blurted out without preamble "I have to tell you that IN my opinion to give your mother a general anaesthetic would be tantamount to negligence!" He was straight out Charles Dickens. I just gazed at him and said "well I'm not arguing." It transpired that the orthopaedic surgeons didn't fancy trying to set the wrist with mother wide awake - open fracture, delicate sweet little old lady, you could see what they were thinking - and had tried to bully this poor little lad into knocking her out for them. Anyway, bless him, he stuck to his guns, they did a Biers block on her arm, she was a total trouper about the whole ghastly thing, and the surgeon got the wrist debrided, set, pinned, sutured and plastered in one hour and made a beautiful job of it too. So for us a very happy ending - though it still took six more months to get back to nearly normal, mind you.

However. If it had been her hip… She couldn't have had an epidural. They couldn't do a spinal block because she's on Clopidogrel. The choice, I suppose, would be between a general or bed rest for a fortnight until her platelets had got back to normal, neither of them a good bet. I really don't know what they would have advised.

Do you think part of the problem might be that your mother is becoming afraid of falling? In the immediate term that's quite a good thing, because it'll make her cautious, but obviously it's no good at all in the longer term, not for her health nor her confidence and quality of life. Poor lady. It must be depressing and frightening for her, as well as terribly stressful for you.
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The medication thing is still my top suggestion. Two doctors, visiting nurses and the pharmacy and none of them suggested that it was the Toprol that was doing it. It is an unusual side effect they said when I figured it out and confronted her doctor with the information. Dig out the meds and go on line. It took me six months to find my answer. It was not on the black box warning.
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Oddly this could be as simple as having a UTI. Hard to believe but a elderly person that is having episodes in your moms case it could just be that that is the problem. She probably is not having any symptoms of a UTI, which is fairly normal for older people but that makes it more serious. It will mess their heads up, not to mention their medications and they can fall, etc...I experienced this with my mom and after she was in the hospital for 5 days on 2 antibiotics she was the mom I remembered. Not the monster she was acting like. I do not mean that in a bad way at all. That was my mom in a nutshell. Have her checked. Good luck to you and God Bless Big Time.
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To all of you--
Love ( well, as much as you can "love" something like that--the story of the anes. dr who wouldn't do a general.) My DIL has and will refuse patients on whatever concerns she has. She is a terrific doc and has not lost a single patient in 8 years.
I honestly do NOT think it's the meds. I get what everyone is saying. My gut feeling is that she is in the slow process of dying, following the exact same pattern of behaviors that her mother took as she went. Gigi was pretty independent, had a bad fall and broke both wrists. 6 weeks later, she's gone. She was 95 and a vibrant, active woman until that fall. Mother has not had good health, ever that I can remember. She falls and has no memory of how she got from, say the chair to the floor. She weaseled out of one dr's visit, she'll do it again if given half a chance. R did have her checked for a UTI--none found. The dr will check her more thoroughly for med interactions and maybe get a CT scan. As bad as I feel that she is continually falling, I know that sometimes people just go when it's time. I'm not going to strap her into a wheelchair, I can't be there 24/7 she refuses the idea of assisted living, she's got that "panic button"--and she gets checked on constantly at R's house. What else can we do? I have no idea if mom is afraid of falling, sometimes I think she makes it up so the absent sibs will come running with flowers and candy. Don't know. And this week, I don't have to care. I'm in time out (unless she winds up in the hospital, I don't need to even call her or go see her).
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Hang in there Mid. If you stay there 24/7 you'll be in the hospital before her. There is nothing else you can do. Don't beat yourself up over it. If this is the way that your moms mom passed away then maybe this is the middle of the end of her life and that's OKAY. You did everything that you could to try and make her comfortable and safe. You can't fight her unless you just bite the bullet and have her put in a home. Unless your siblings are still against that. If they are then they need to grow up and take some responsibility for their mother as well. I have a couple of siblings that are the same. Mom lives with me but my sis that lives in the same town won't give her the time of day. But, she gets mad at me if I don't let her know that mom is in the hospital. I told my others siblings, and my son, that if you don't care enough about her while she is here don't even think about coming around and crying after she passes away. Live with it. All you can do at this point is prepare for her passing. Very hard to think about. Making sure things are in order if that is your responsibility. You've done all you can and don't question yourself anymore. You have given 110% of yourself. That's more then some people give in a life time. God Bless You...Hugs from me to you.
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Paulaa--
YOU get it! I appreciate the many comments about possible UTI's, drug interractions, etc. but a child knows her mother. She is in the slow process of doing just that. I accept that. I'm ok with it. I feel for the "off board" sibs who don't call or visit and just assume as long as she 's not in the hospital, she must be fine. I have zero power and cannot force her into a facility. I can barely talk to her now...she is mad at me all the time, thinking I am colluding against her. My oldest sister, just today said "I don't want you to call me if all you want to do is talk about mother. I can't deal with it. I don't care". Well, at least she's honest.
I appreciate your comments about my giving my all and then some. I will not let her suffer and once she has passed into Hospice care, I will support my brother. I have no bad feelings about my relationship with Mother, other than I wish she had liked me more. I know my youngest sister is going to fall to pieces, but we'll deal with that when it happens. I'm slowly growing a thicker skin. Hugs right back atya!
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Well, that puts a different spin on it. I suppose there is a line between neglect and acceptance of the inevitable and letting things be...and the latter is what everyone really wants and maybe that's the side everyone is on now. Nevertheless, if you find you want to change something reasonably smallish in the situation, there are buttons that will call automatically when you fall and help will be sent unless you tell them you are OK and you could switch to that from what she's got

I did not understand why some of my mom's medical care was so rudimentary and laid back, but now I get it, believe me...there is sort of a don't rock the boat approach that really does not fight so hard against deterioration. I didn't really agree with that, and once I was more in charge, I knew I wanted my mom to have the best care to maximize her well being and hopefully length of life, but well-being first, and willing to limit care that was going to be very burdensome for her...I fussed until I got more of it and mostly it was good, but there were risks and side effects at times too. When you are making these decisions there are always the non-medical side of things to think through too - what if having some treatment takes you away from family or disrupts relationships to the point it is more stress and less joy. Not easy. Almost any decision you make can leave you wondering if the other would have been better, but you can know that you thought it through and did the right thing in your own heart based on what you knew at the time. I think I am still making peace with mine...
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Yup. Truth is, she really does want to go. We can rail against the fates, but she is not enjoying life the way she did, say even a year ago. It's hard to watch her slowly crumple into a small, sad person, but that is what she is doing. As for the falls, we've done as much "fussing" over it as we can. R takes care of her as best he can. I'm taking a hiatus from her care, but I did call R last night to see how she was--they had bought an electric recliner for her so she can lay comfortably in it & still watch TV and read, if she chooses. It was delivered yesterday and R said she dozed in it all day long. Part of me thinks she is just exhausted....and she refused to lay down on her bed, during the day, ever. She also refused a new dr's apt, saying she'd wait until April. I am glad I suggested the recliner....maybe I'm not so awful, eh? I am at peace with my care of her, despite her anger and outburst towards me. So many dynamics are in play within a family.....personally, as awful as this may sound, if she is unhappy and ready to die. OK, that's OK. (She actually woke up from hip surgery, mad that she'd lived through it...I did tell her that anesthesiologists really hate to lose a patient on their "watch")
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Good, it is important that you are at peace with how you have helped your Mom. Long after she has passed, you will still be living with YOU.........
Her assessment of you is not nearly as important as your own. You know in your heart when you have done right or wrong. God gave us that ability and you have used yours wisely. Now....Enjoy your time in respite!!
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Thanks, Vicky. I am at peace and I will resume my caregiving of Mother for my brother's sake. It will be OK. I was so at peace when daddy passed and I know I want that with mother and likely will not have it. Lost a brother 18 months ago--and tho he was not a factor in my life for many years...I am still working on forgiving him and letting peace in where there has been years of anger. It's much better when someone passes and you are at peace with them at that time. I AM enjoying the respite!!!!
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Have the doctor check her hemoglobin levels. That is a common culprit in the type of problems you are discribing.
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I would do that if I had any say in her care. I don't. She will see her dr in April. I will mention this to my brother with whom she lives. I've been "relieved" of being concerned about her care. I can go and clean and grocery shop but I have been asked to step away from anything to do with her medical issues. Thanks, Tho, I can pass that along.
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MidKid, first I want to say you have my sincerest sympathy for having to deal with this situation with your mother. She probably is mean to you because you want to do things that are in her best interest, but she wants no part of them because they require change, and your comment about the nightstand shows me she does NOT want change. I'd say that is also why she is so reluctant to go to the doc about the falling episodes.

I am concerned because she indicated that she "blacks out" sometimes when she falls, sometimes for hours apparently. I hate to ask this, but does she drink? Also, how old is she? What meds is she on? Does she have more than one doctor prescribing? The falling can be TIAs, low blood pressure, an inner-ear thing, a drug interaction - any number of things.

Do you have her permission to talk to her doctors? If so, I would definitely call her doc and let them know about the falling. Another thought - although she will hate this mightily - is the next time she tells you she blacked out and fell, you call 911 and have her taken to the emergency room to be tested for a stroke, or a series of strokes. I know my dad had a few TIAs that he didn't tell us about, but when he mentioned to his doc that he had these "weird spells" he was immediately tested for a stroke, and told that if it EVER happened again, he needed to call 911 immediately.

One last thought, and this comes from a long spell of caregiving with my parents, it may be that your mother resists the idea of the doc or going in to figure out what's causing the problem, because she's really ready to die, and would resist any efforts to treat whatever is wrong. She doesn't like falling, but maybe she doesn't really like living either. Although if she is young enough to have had a hip replaced in the past year, she isn't all that old. Which brings to mind another thought. Could this be caused by blood clots from back when she had the hip replaced? I know after joint replacement surgery you have to have injections of blood thinners to prevent clots, but after the three weeks of injections, nothing.
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Wow- a lot of thoughts.
Mother is 85. She had a blackout fall the night before her hip replacement, which she didn't confess to until weeks after her surgery, when she wasn't doing well. The ortho doc said he NEVER would have done the surgery if he had known. That's all water under the bridge.
I am not allowed to go to her dr's appts. I am not 100% sure of all of her meds. Some she keeps out in the kitchen, some in the bathroom and some in the bedroom. I think only my brother knows all the meds she takes--and even then he barely found out she was sneaking pain pills at night, a huge no-no b/c of the falling.
If it WERE up to me she would have been in the ER and tested for all the things that have been mentioned. It is NOT up to me. I have come to realize that I do not have a voice in her care, beyond cleaning her place and random errands. I went once last week to get her a prescription and it was a controlled substance, tho I did not recognize the name of the drug-she had about 7-8 scrips waiting to be picked up and she specifically told me not to get anything for her but the pain meds.
I know this sounds like I don't care, but I have to preserve my sense of well bring too. I can't barge into her life and demand that she tell me everything. I am done trying to figure out why she does what she does. I think she wants to die, honestly, and I also think if she saw her dr she'd just lie to him.
I don't have permission to talk to her drs and I don't try. She has my brother do it. I don't see the meds she takes, but I know she has about 15-18 she takes daily. She doesn't WANT me in her life and I will respect that. Hard as it is to take the rejection, she is happiest when she can all the shots. I don't think she has fallen this week, wouldn't know unless she winds up in the hospital. I do appreciate all the thoughts and concerns for her. You all have been wonderful.
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Mid, all good thoughts to you..you are an exemplar of detaching with love. You have a good sense of self preservation. Her docs and pharmacists? Not so much.
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Midkid, if it's any consolation at all I don't think you're an uncaring child, and I don't think it's a question of rejection either. Your mother needs to be in charge, and hard though it is you are doing a very good job of respecting that while at the same time trying to look out for her. It's one thing to talk the talk about autonomy and another to walk the walk: grim, frustrating work that I think you are doing with aplomb.
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Sounds like you or your brother need to have a conservatorship over your mom. She is a danger to herself. If she's taking pain meds when nobody is watching, she could be falling because she is high. Does she have any history of addictions? Even if not, she could have become addicted. Many pain meds are highly addictive and she should be monitored with these since her history of falls.
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Thanks--I am not an uncaring person at all--some people will take all you have and ask for more--mother has always asked a lot of me, and I have always given. My kids don't ask a lot--and it is joyful to give to them and the grands. I think the difference is that mother is not really grateful, she is selfish and spoiled. She has always been that way--why should aging make that better?
Oh, how I have enjoyed this week off from her! My stress levels are low and even tho hubby is kind of sick right now, I can deal with him. He'll be out of town for the next 2 weeks and I plan to do whatever I want ( I am looking down the barrel of some really nasty back surgery come mid-Jan and so I plan to play all during Dec with the grands and some friends.) Mother seems stable. I don't think she's fallen, don't really "care" (you know I really do) but not getting those stupid alert calls has made it much more peaceful. I will spell my brother next week and clean for mother, but I do feel refreshed from not having constant worry.
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just from the headline -- she may be weak from all those strokes .
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Would there be any chance the doctor would make a house call?
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I cannot imagine her dr would make house calls--nice thought, tho. And we have never determined whether she is having strokes or not because we can't get her to go to a dr or get a CT scan. I have 2 kids who are drs. their input (neither live in state) is that she is having TIA's and very likely medicine issues, but they don't see her and geriatrics is not either of their specialties.
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Didn't see the other comment: yes, she has a history of pain med abuse, but the stuff she was taking is very mild..so not likely to be a factor. She's also diabetic, has HBP, high cholesterol, osteoporosis and she's 85. People wear out. I think she's wearing out. I know her dr said if she wanted to die as much as she sometimes says she does, ahe can stop taking all her meds and she'd go within a month. She still takes all her meds, so her talk of wanting to die is likely more an attention getting thing. Don't mean to sound abrupt or uncaring, just being honest.
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Midkid, I so wish you had a say in what is going on. You see through the cr@p for what it is...a big pile of wishful thinking with a steaming heap of denial on the side. She does not want to die, she does want to feel better, but she is scared of losing control or being made to do something differently that she thinks would be too hard for her, and like too many of us human beings, thinks that avoiding the things we fear is a reasonable way to deal with life. And she is probably completely wrong, it probably would not kill her to get a checkup before April and maybe start using a cane or a walker, taking some iron or vitamin D pills, get new glasses or God forbid consider changing some of her meds up a little. (OMG, my patients would storm the place if the next available appointment for a serious medical concern was in APRIL!) She is probably accelerating her own deterioration and demise. And brother is probably right there in the same boat with her. And you - you get nothing out of the deal but knowing you tried to take a higher road and were blocked from it, and the bitterness of the "I told you so" that you are probably going to bite your tongue to hold in. This just sucks all around.
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VStefs--
Oh, Mother had an appt with her dr last week and she "forgot" to remind my brother of it. I was actually AT her place, she was dressed to go out, and I commented that she looked nice & asked if she was going somewhere. No answer. I could most assuredly have taken her to the appt, but she waited until I was gone and the possibility of getting to the dr's was gone and she went and found my brother and "told him" they'd missed the appt. She doesn't have another "scheduled" one until April and that is her YEARLY physical. She is very controlling, with all us kids, pits us against each other--this is a dynamic that's 63 years old, so it's not going to change.
I so try to talk to my other sibs, tried to get an "all hands on board" mtg and no one would come. Not one. Well--the brother with the POA said 'maybe' and then changed that to 'not interested'.
Mother DOES use a walker--all day. She is so frail after her hip surgery, she really cannot even move w/o it. She wanted to use a cane and the one day she did, she had the only fall that landed her in the hospital with 28 stitches in her forehead. She has since used the walker. Altho I am pretty sure than the times she's fallen at home she has not been using it.
I have come to terms with the lack of concern on my sibs' parts. I will do what I can to help my brother and his family. I feel sorriest for my sis-in-law who has to deal with mother. Now Mother is incontinent and in diapers all day, she just takes the soiled/wet ones off and puts them in a bag outside the door of her apt. They are very powerful smelling--as you can imagine, and since no one is home much of the day, well--the whole house smells like urine. I will always clean out mother's trash and will always make sure there are no soiled diapers..but still..it's gross. Mother either cannot smell them or loves the attention she gets from it all. Another problem that will require some solving. There are teenagers living in the house and while they are amazing with mother, having friends over to their home has become a challenge. I'm done with my week of respite..tomorrow I see my back surgeon for a "chit chat" and then to mother's to clean. Ah well! Thanks for your comments--it is what it is,right?
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"SAFETY FIRST and above all, per Doctor" -- I know this is two years later - and maybe not applicable any longer, but "for what it's worth" - I am the daughter that has looked after my mom who is 95, severe dementia, feeble, and now blind. I retired a bit early and bought a condo unit right next door to her to help her at age 85 (she had mental problems, but physically healthy). After helping for 7 years, she had to go to (very nice) IL, then Assisted Living (same place) and then move to Memorycare when the IL/AL said she was wandering and they could not keep her there. SO - I spoke to her (also mine) Primary Care Provider. He made it very clear: SAFETY trumps ALL other concerns including health and happiness. IT REALLY MADE SENSE to me when he put it like that because without SAFETY (and subsequent possible death accidents), the other things are irrelevant. So she is safe now - and it is pricey, thankfully she had equity from her home sale but it won't last forever. Her Memorycare is wonderful - loving caremanagers - and then I fill in the gaps by taking care of everything in her life, overseeing every aspect of her existence in Memorycare, and visiting her and taking her out to doctors' appts, and giving her love and fun. Safety has to be #1, and obviously she is not safe as is. My siblings don't help, it's just on me, for decades now. It's the right thing to do, but it is exhausting (and sometimes without appreciation).
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Good move on getting rid of the bed rails. My sister-in -scooted to the bottom of the bed, fell and broke her arm. She had Alzheimer's, and has since passed. Someone in this family needs a durable power-of-attorney so that they can take needed action. This is in addition to a living will, and they are pretty much generic. After we paid $800 for POA's for each of us, I found one on the internet, and it was verbatim what the lawyer had done. Boilerplate. Hang in there.
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