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My mom has stage 4 Kidney failure she’s on Dialysis 3x a week. Rehab released her but the family and counsel on aging thought it best if she do respite care but Mom wanted to go home. Now she’s home can’t get around without use of big wheel chair in her small apartment. I’m Miles away medic calls my sis, who lives in town to say mom press her emergency button they came but said she refuse to go to hospital. She also missed her Dialysis appointment. She tells me to run my home and she’ll run hers. She’s getting meaner change in character. She calls to tell me she’s cold and need someone to turn up her heat and bring her Tylenol so I send my sister she couldn’t get into apartment because after hours they lock the inner door. Sis finally gets in and I told mom she needs let her make a copy of her key so when she needs something they can get in. Mom goes off on them and me and the grand kids. It hurts, she’s always been my sweet mother. Seems like she doesn’t like us anymore, which makes it hard to help. I’m trying to be strong and not take it personal but it really hurts. She says she knows what could happen if she doesn’t get Dialysis. I would like some advise please.

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This needs to be reported to the dialysis team, it can be a side effect of chronic kidney disease and hemodialysis.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2504691/
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Do you have HIPAA authority to talk to the nurses at the dialysis unit? You might find a solution if you can work together and present the same options and they are very experienced in working with people like your mom, they are also experienced in bringing up and discussing the possibility of Hospice.
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Luvmom1 Dec 2019
She will not give anyone HIPAA rights. She’s afraid of losing control, her independence, she's afraid of losing her apartment. The coordinator in her building called me today, my mother fell so I had to leave work go down there and she said she did not fall, she slid down she’s in denial of so much no one can help her I have talk til I’m blue in the face she won’t listen.
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She's likely irritable being sick and tired, not feeling like doing anything, not having real control, and taking it out on you and whoever's around.  I hear you, and feel your pain trying to help and getting those kinds of responses.  Often, when I get these kinds of responses, I get off the phone or away from them as quickly as possible, and return the call or visit some other time.  Otherwise, I'd lose all my sanity. 

You didn't say, but sounds like she lives in some type care home.  Those workers are experienced in handling patients who get like that.  As long as she's not dangerous, they'll take care and help her.  Remember that in order to give yourself and your sis the break/s you both need. 

Don't the workers there get her to Dialysis?  Or is she refusing to go?  Call them asap about getting her there, and what's needed to make her go. 

Take care.
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I am sorry your mom is going through this difficult time of transition and of course she does realize at some level what will happen.
The anxiety must be overwhelming for all of you. I know you want to do what you can do to make her more comfortable and she appears to be making it harder on herself right now and by default harder on all of you.

There is a book that I found helpful in dealing with end of life. It’s called “Being Mortal, Medicine and What Matters in the End” by Atul Gawande. It’s written by a surgeon who gives examples of how different people managed their final days and the protocol he advocates for doctors to use to help patients live as they choose as long as possible.
His own father, also a doctor, was one of those people whose final days he describes.
He has five questions that he says we need to be asked as we are nearing the end.
Dr Gawande is a big proponent for the individual to live out their life as they wish. He helped raise my awareness on how to better manage our lives so that we are continuing to have a level of control and to realize what is truly important.
You can find interviews of Dr Gawande online. Here is a link to one where he discusses his five questions and more.

https://www.google.com/amp/s/www.nextavenue.org/atul-gawandes-5-questions-ask-lifes-end/amp/

Once you find a level of peace within yourself, perhaps you will be better able to calm her when she panics or is frightened. It won’t do her any good to be abusuve to those who love her, don’t get caught up in that. Easier said than done I realize. This is new for all of you. I’m sorry for the pain. Hugs
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Thank you all for you’re encouragement and information. You’ve all been help. Mother decided she wanted to go home to her independent apartment. She missed two Daylisis appointments. I don’t know or if I can force her to go to the hospital. I feel powerless trying to respect her wishes but she can’t do Anything for herself. She only was an aid 3 times a week and nurse coming in once a week. Nurse called me said mother is really bad, that she should be in the hospital because she needs 24 hour care. How do i make her do what she don’t want to do? I try to stay calm around her to keep her from going off.
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KIdney failure, dialysis, blood.... infection in the blood can make people crazy... like UTI's urninary tract infections...It affects the brain... And I am sure the dialysis is supposed to cleanse the blood, but it may not get every thing.. so it may have reached the brain.. I am not an expert on dialysis, but I know some stuff about UTI's and the effects on the brain, just from personal experiences WITH LO's...

infections like that can make people crazy.... so check the blood for infection of such.. if you can...
ASK DOC TO EVALUATE MOM FOR PALLIATVIE CARE OR HOSPICE.. They should grant you an evaluation...

get palliative care/hospice care on board..

Personality change... infection... got something into the brain... antibiotics need to be questioned. or on BOARD. .. It can go bad fast.. Ask for UTI evaluation too....NOW DON'T THINK ABOUT IT... TELL THEM..

I WANT MOM TESTED FOR UTI...It's all part of the kidneys, and if it goes past that, it can make the brain crazy. SERIOULSY
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I am sorry for your situation...STAGE 4... The end is near... And for some reason people don't talk about this often....

If social worker gives you a 30 day pass to nursing home... take it. Do not ask questions... take it... This will give you time to , a little time to figure out the next plan... But take this for you and your family rest...To get up, and get the next step figured out...
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Tylenol... codeine. Look it up... Kidneys, liver connected... Is this good or bad for the liver and kidneys with cancer? I don't think so.....

So, look up the better med for someone with Stage 4 kidney failure...

Do not give her codeine....

I think Tylenol may be in the same category...look it up.
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Where we are, there is only a couple of dialysis places left, and it's a wait....

Maybe she is just tired... It''s not just a short jot around the park...It takes a few hours once you are there, cleaned, prepped, and hooked in...

It is not fun, and then, SHE DOES THIS 3 TIMES A WEEK?

Cant' she do respite at home? Ask for PALLIATVIE CARE...HOSPICE
I agree with MOM, 3 times a week with stage 4 cancer... It is too much... Better quality than quantity... think about it... the poor thing...

A couple hours a day.. the getting up and driving to a place to drain your blood and filter it...I do not blame your mom....She doesn't want to... Get her to sign a POLST ...DNR.... Acknowledge, she is tired... LOVE HER... PLAY MUSIC..FEED HER THE FUN STUFF SHE LIKES..LOVE, LAUGH.. Talk about growing up, HER PAST and what she did when she was little how she met your dad...THANK HER SHE IS SUPERWOMAN!!!

IT IS OK... LET HER DO WHAT SHE WANTS.... Give and send her happy thoughts. LOVE
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Your mother doesn't love you any less; what's changed is that she feels just *dreadful* - ill, exhausted, possibly frightened - and that's what is affecting her mood, her behaviour, and her ability to cope.

If your mother is snapping at your sister and at you, is there anyone she does listen to? Doctor, nurse, social worker, anyone running the apartment block?
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