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My mom is 94, has lived alone in the house since my dad passed away 4 1/2 years ago. My brother and I went there every evening and called her every afternoon to make sure she was ok and to make dinner. Last Summer she fell two separate times requiring separate hospital stays of a few weeks each time. She broke a bone in her foot one time and the other time hit her head, along with other bruises. She insisted on going home and continuing the same routine. I wanted to place her in a nursing home, where she would be watched 24/7, but my brother was against it. She's gone downhill, forgetting pots on the stove, staying up all night watching TV, unable to deal with bills, only taking sponge baths, etc. A few weeks ago she fell again, on the carpet by her bed. My brother found her and phoned me to help lift her into bed. She's only about 90lbs but I have osteoporosis and arthritis so it was pretty awkward getting her off the floor. I think we should've phoned 911, but she said she wasn't in pain and my brother said he'd stay with her to make sure she was ok. She was shaken up but by the end of  the week she was alot better. About 10 days later she was just starting to use her walker again, when he left the room for a minute to get her something, and he heard a thud. She had fallen from standing by the foot of her bed to the floor. This time someone working in the backyard helped my brother lift her back to bed. Right now (this happened 8 days ago) she's got a badly bruised, swollen upper arm, shoulder, bruised knee. Last night she told me the back of her head also hurts. But maybe that's because she's been lying flat on her back for a week and refuses to get up even to use the commode, we have to use the bedpan. She mostly just goes in her Depends. She said she's afraid to even sit because she may fall again. It's worse everyday, even eating soup flat on her back, her head just on one pillow. I think she should be in hospital. This 2nd fall was 8 days ago and she absolutely refuses to try to get up, she sits up on the bed occasionally, with my brother right beside her. He's been staying there 24/7 since this happened and now I'm worried about him because of the stress and lack of sleep. She won't accept outside help, only wants us to be there. I'm only there every 2nd day now, because of my own health problems. Even though she's 94, she's very stubborn and will not get up. She's got some degree of dementia, takes donnepezil, which I suggested my brother ask the Dr for, about 3 years ago, also she has a pacemaker, takes diuretics, and thyroid meds. I wanted to put her in a nursing home when she came out of hospital last Summer, but my brother felt she'd be happier at home, and she was, until a few weeks ago. I'd really like any advice on what to do now, since we, mainly my brother, do everything for her, and she refuses to get up out of bed. Should we call an ambulance? What should we say is wrong with her, because last time the hospital discharged her last Summer, they said it was because she had recovered and no longer had an a acute condition. Is this refusal to get up and 2 falls in 17 days acute?? I think she should be in hospital.

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Your mother IS going to be lethargic for a number of reasons:
#1 Age
#2 Strong pain meds
#3 "The body in non motion"
#4 Loss of pharyngeal reflex
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UTIs can cause stomach pain and nausea

Add narcotic painkillers and it's no wonder your mom is lethargic

Her body is working hard to fight infection

As barb suggests - talk directly with doctor

Her shoulder will freeze if she doesn't do her physical therapy but have you been told her prognosis ?
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Not, are you talking to your mom's doctors about her condition and her prognosis? Do you say she can still swallow because they've done a swallow test?

We're not in the room with her, looking at her chart and we're not medical professionals. UTIS can cause a variety of symptoms, some of them psychiatric, in elders.

I know this is a sad and hard time for you; you love your mom and I'm happy that you were able to get her to agree to the hospital and that she's not in pain.

You and your brother need to have a conversation with mom's doctors about what is going on.
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If you needed quite potent pain relief after surgery, and you had a persistent UTI, and you were taking antibiotics, and you'd been much less mobile than usual for a few weeks, and you were 94 and very tired... how much of an appetite do you think you'd have?

If it's practical, you could try taking her some edible treats that you know she really loves. Ice cream, or a really good milkshake (use a cold bag or a Thermos flask), or just anything that she always ordered first at a restaurant, but in tiny amounts just to tempt her. It might be possible to stimulate her appetite and get her restarted on eating that way, and be good for her morale.
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Another update, the nurse told me that my mom refused to get up when physio came this morning and because she'd had trouble sleeping last night, she was very groggy so she wouldn't have been alert enough to do anything today. The nurses did get her into a wheelchair for a couple of hours at dinner, but she didn't eat anything. She's got another Urinary tract infection and is on antibiotics, (2nd UTI in about 2 1/2 weeks) Could that be why she's not eating? She can still swallow normally.
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As your mom is not drinking, I hope they have her on an IV drip? She can still swallow, right? Oh yes, I see that she's IV'ed.
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Just updating, my mom's still in the hospital. She's still very afraid to stand up. There's been some degree of progress though because they've gotten her into a wheelchair several times. She's not eating lately though, and hardly drinking, so the Dr has put her on intravenous to hydrate her. I hope she starts eating soon because I don't know why she'd just prefer to sleep when her meal comes. She is very tired though most of the time. The best thing is that her broken shoulder pain is well controlled.
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Which province are you in? - then I might be able to help as I have contacts in NB, SK, ON, QB, AB, BC who know the ropes to help you - some in medical field & some as front line helpers like you & me

So glad your mom is where she needs to be now - she will start to heal after her 'retreat into her shell' which that broken shoulder initiated which a normal response to a trauma like she had -

I know this was hard on you & bro but now you are in the system you will so much more help now - you were right that there was something untoward with your mom - our instinks are the subliminal alerting of a deeper awareness & you listened to yours .... GOOD ON YOU for going with your gut instink that something was wrong & out of kilter with her & got her the help she so badly needed - remember "d' nile" isn't just a river in Egypt

Just remember, they will bombard you with info - you & bro need to really look at this as it can be overwhelming - do either of you have a 'strength' in anything? ... like is either of you in financial or medical profession - divide this up between you going to where strengths are shown or just pick a part each so that you can wade through this

NEVER SIGN ANYTHING IN A HURRY - you have to look at everything well because you don't know where the loopholes are - if you are ONTARIO I have some experience as both mom & dad are in nursing homes here, so I will try to help where I can - if another province maybe my family contacts will know -

Keep letting us know how she is doing - you & bro are doing a good job taking care of her but at sometime you both may need to step up again keep her safe - hugs M
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Hi there, shoulder surgery is painful post op. Make sure they pre-medicate her one hour before therapy. It'll make a huge difference in her ability to participate.
Offer the pain meds if only Tylenol or Norco but something to relief the pain. It's got to hurt.
Watch for constipation too. Offer Stool softener, drink plenty of fluids. Push fluids on her to excrete the anesthesia. She will be extra sleepy for days due to the anesthesia.
She definitely needs to start walking and moving that arm, so don't baby her. Pace her activity providing rest when she looks or says she is tired.
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Not, thanks for the update.

Not to get ahead of ourselves here, but it seems clear that your mom should not go back to living alone. Are you and your brother working with the social work/discharge staff to identify a good rehab facility, one that might also turn into a long term care placement?
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Just a little update, because not much has changed. My Mom's still in the hospital, still hasn't moved much. They did lift her into a wheelchair yesterday, but today she refused to try it again. They said that she has to tomorrow though. She's looking pretty tired today. Wish this wasn't so hard for her, it's so sad to see her like this. At least she's being well cared for, and her pain appears to be pretty well controlled.
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Get a good night's rest, and thanks for updating.

Your mother must have been in a lot of pain and it will take a while for her to get over that. Give it a few days and then see where you are, try not to worry meanwhile. Hugs.
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We finally got my mom to ER and had her looked at. She's got a broken shoulder, and was finally admitted after waiting an unbelievably long time. So glad she's there and being cared for by professionals. She's still afraid to try to get up, the physiotherapist was in and tried to get her to stand, but she's very afraid of falling. I don't know how they're going to convince her to try, but I'm sure they know way more than my brother and I. Just wanted to update the situation, I'm so tired tonight. Thanks for the latest post from Raised on Elton, I was feeling bad because I sort of lost it a couple days ago and told her how selfish and unreasonable she was being, (it didn't phase her anyway, just made her tell me to get out of her bedroom) but I feel a little less guilty now, for losing it. But still a bit bad because I wouldn't have said quite the same things if I'd known her shoulder was broken. I really don't think she understands most things, but when she's asked questions in the hospital she can appear pretty normal, most of the time. I don't know how she can do that. I'll write more in a couple of days. Thanks for all the great help
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Oh boyee... do I relate to the "getting angry" at her stuff. My mother was much more reasonable and cooperative, however, I was angry at her for all the times that she chose to lay in bed, instead of doing her PT (when she was able). The more my mother layed in bed, the angrier I got.

I'm so sorry for you and your brother. Can you impart to her how selfish she's being towards her children? How sick she's making the both of you? I'm sure she doesn't want that for you.

Maybe her doctor can write that she's a danger to herself and get her admitted, whether she wants to or not.

Be strong. Do whatever you have to do! Keep us posted. Sending you strength...
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Time for an update, Notenough?
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Where in Canada? - here in Ontario there is what used to be called the C.C.A.C. but now is L.H.I.N. - the doctor can get home help coming in - they can give her sponge baths & more - these are trained people who can help you & her - they will also be another source of independent observers who will have experience with similar problems

If in another province they have similar organizations - they or dr should have emergency numbers that will get help A.S.A.P. - if you don't know where to go call your pharmacy as they may be able to steer you to right people - I got help within 18 hours with mom for her diabetes etc - then they were able to indicate where her other problems had got much worst than we knew - good luck
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I didn't even need to read your entire story, before posting my VERY STRONG recommendation: Your mother needs to be in the hospital for a complete examination of all potential injuries. From there, she needs to be moved directly into a rehab facility or nursing facility. Call 911. Request an ambulance. Admit her via the Emergency Room. Be there with her and be her strong health advocate. Describe EVERYTHING.

My friend, I say this with all due compassion and respect to you: This situation is officially above your head. It's more than you can handle, anymore. Have mercy on your mother, and get her professional care. Hopefully, a comprehensive hospital stay will render her healthy enough to be transferred to rehab. I'm sure she has a UTI, due to poor hygiene, which will be treated in the hospital. She may have broken or sprained something. She may have head trauma.

Do this for her health and for yours and your brother's! Don't delay. Call that number now. Also, it is completely within your jurisdiction to have her admitted to the hospital.

Best of luck to you. Be stalwart.
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Notenough;

I wish you all well and hope that you come up with a solution to this problem!

Saying to my mother "I can't do this anymore, Mom" was THE hardest thing I've ever had to do. But I had to harden my heart, because I KNEW that moving her out of her house was the best, safest thing for her. She no longer had the capacity to make safe decisions. Yes, she was legally "competent"; but she had the reasoning skills of a 5 year old and it was no longer safe for her to live alone.
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Competent, huh?

You and your brother don't live with her, right?

I'd see if I could get in touch with a hospice organization. They will make her comfortable. The thing is, this is all so treatable. It doesn't HAVE to end in her dying. So...

I might play hard ball here. "Well Mom, brother and I must be getting back home now. Not sure how you're going to manage,, but we can't stay longer". I'd leave and call 911 again. I'd also call the local Aging Authority and report her as a vulnerable adult.

I don't know Canadian law, but there is probably some sort of emergency guardianship you could pursue.

Chances are, when you start to leave, mom will relent and allow you to send her to the hospital.
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Thanks to everyone for the helpful advice. Implementing it though has become a nightmare because of my Mom's stubborn nature. My brother did call 911, when the ambulance got there they spoke to him in a separate room while they examined my mom in her bedroom. She absolutely refuses to go to hospital even though they told her she may have a "green" fracture in her upper arm, plus the blood in the huge bruise behind her shoulder may be "bad blood" and if it is then her heart won't be able to pump it, if it's infected, she'll get very hot and probably die,and they think she may also have a hip misplacement. They were even nice enough to phone an emergency Dr who spoke on the phone with her for awhile trying to convince her to go to hospital. She refused, and they said they'd​ be charged with kidnapping, because she was able to correctly answer some competency questions. I really don't get this, she'd starve to death if we weren't there, she can't or won't even move, so how can she be considered normal??? She takes donnepezil for dementia of some degree, but legally she can make these decisions, it's insane. Her head isn't hurting anymore, so one good thing. My brother is going to try to get her Dr to recommend hospitalization, but we don't even know if that will work. This is a nightmare, having to be there every second, while she just lies there not even trying to sit up. I'm beginning to be more mad than worried about her at this point. I asked her how does she think my brother and I feel having to do everything for her 24 hours a day and she just said "not very good", then I said "please let us get you to a hospital where they can help you" and she told me to get out of her bedroom. As it is, my brother is going to speak with her Dr (Dr is only in on Friday and Sunday, and is new, only has seen her once). I want to get some help in, very difficult here in Canada because with most stuff you have to go through the health department and it takes more time. I don't know why my mom is being so stubborn when she could go and see exactly what's wrong with her. She's content just to lie flat on her back and have my brother and I do everything all the time anytime she calls for us. I'm very worried about him, he's doing most of it,
because I have chronic health problems and can't.
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She needs to go to the ER stat!
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I agree that an evaluation should be done immediately. My father-in-law fell frequently and my MIL did not seek help for him. He eventually died of a subdural hematoma due to a fall. Prior to his death he started telling my MIL that he didn't want to get up. He ended up in a hospital and then a NH within a month but by then it was too late. Although he also developed pneumonia an autopsy determined the primary cause of death as the subdural hematoma.

My husband and I had not had knowledge about this as an injury to rule out so we learned the hard way when we did not press my MIL to have my FIL evaluated. Since then whenever my MIL fell (she is now in a NH and can no longer walk) we called 911.
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Calling 911 is a good thing, but if she refuses to be transported, they cannot legally take her to ER. I am supposing that she is still considered competent.
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Yep. Call 911 and at least get her to a hospital for an evaluation. Lying in bed that long? Something is definitely wrong.
Don't let the hospital check her over and send her home. Explain fully what you've written here and they can begin getting the ball rolling. Sounds like she most assuredly needs 24/7 care. Whether you can somehow provide that for her at home, or she needs to be in a NH, she can't continue to lie in bed---unless she's actively dying, she should be able to get up and walk around some of each day.

Good luck with this. It's so easy to dish out advice, and I know, so hard to implement it!!
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I would urge 911 and also tell them her head hurts, they will do a cat scan to check for brain.
That happened to my mom, she fell but signs didn't show up right away, had have her admitted and checked out. They bleed stopped but she was in rehab for two months.
She needs to be checked over !!!asap!!! My mom is 92 and lives with us and has for over 10 years!! Good Luck with your mom!!
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Notenoughtime
How is your mother doing? Is she still in bed? Four days is a long time. Was thinking of you and your brother and, of course, your mom. I hope things are better.
Let us hear from you when you have a chance.
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As usual Countrymouse gave excellent advice. Your mom's condition needs to be assessed. Call her doctor and fill him in on anything that he is unaware of at this time. Since she will not stand or walk you will likely be in need of an ambulance and a hospital visit.

After she is assessed and any medical issues have been dealt with, if she wants to go back home, fine. But she must be willing and able to pay for caregivers. It is the price of staying home. I get that she does not want outside caregivers. We do not get everything we want in life and if staying home is her priority, this is how she can make it happen. Come when you can, split the weeks staying at night if you wish, but what ever you come up with it must work for you and your brother.

Should you bring her home and her movements are compromised there are tools that can make her care easier for caregivers. I was 24/7 caregiver for my mother and these tools were very helpful to me. There are alarm pads made for both beds and chairs that will beep when the person tries to get up. Some alarm at the location of the pad. If being in a room away would mean not hearing the alarm, there are others with a remote that you can keep with you so it beeps where you are. I used a security camera in mom's room that sent the image to my iPad so I could check her without having to go in her room. Additionally, I used baby monitors so I could hear her if she wanted me or was making noises of discomfort.

Your path will not be easy, but you have what it takes to find the best solution. I wish you well.
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How is your mom doing now as I see you had posted this 4 days ago. Please call 911 and let her be evaluated. She may have a concussion or having broken something and you don't know it. My scenario was very similar to your. My mother fell 3 times in one week, and we didn't know it, but she had broken her back with one of the falls. 911 was called where She was taken to the hospital and then rehab.I will be taking her from rehab to a facility because she can no longer be alone. She is 87 (almost 88) was very resistant, and she has dementia. Most difficult because she wants and thinks she can be independent, but after all of this realize she can't be anymore. It is a horrible devastating situation that so many people are going through. And most if not all of these nursing adult care facilities are only looking to make money. It is a disgrace! Whatever you decide or have decided to do, I hope and pray you have peace of mind and that your mom will be ok. Please let me know how she is doing.
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A person who is in bed all the time looses 10% of strength for every week in bed - doesn't sound like she can afford to loose any more - rent a wheelchair for her & get her out of bed after the ER & DR do assessments
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It sounds like it is time for her to move to a nursing home where she would be watched and assisted. I recommend getting her doctor involved and let the doctor be the one to tell her what she must do. Make sure the doctor knows how many times she had fallen.
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