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I don’t know where to start really. Mom has had headaches for months now. But nearly 2 weeks ago they became really bad. Her back pain also increased. Lots of nausea She does not have a UTI! Because she can still speak & walk very little with a walker she doesn’t qualify for Hospice. She’s on their Pallative & Dementia Care. Mom maybe eats an ounce of food a day & drinks little. She’s a bag of bones. Her BMI is 15. Shes sleeping 98% now. Her eyes look different. Her communication and understanding is worse. She’s fallen a few times. She’s been put on Tramadol, a steroid, pain patch & nausea med. Nothing has alleviated her headaches. I've been going round and round with Pallative Care nurse and her dr (took her in last week). Her dr said well she had a brain scan a couple of years ago-seriously? I told him so did my SIL who passed away last year from Glioblastoma. Things change! So supposedly he’s ordered one, hasn’t been scheduled. Here are some of the many things the nurse has told me: dementia pts don’t have headaches, I’m not trying hard enough to get her to eat, steroids don’t cause headaches, she even accused me of demanding she prescribe Fioricet for my mom, so many other things. I asked her if mom could get something stronger like Fioricet. She declined. She said she didn’t have a diagnosis to support that!!! I sent her the chart notes where unspecified headache is listed, still no! I truly feel like I’m failing my mom. I’m fighting so hard but getting no where. Her labs came back with lots of abnormal results. I researched to see what the common factor was and it mostly comes back to kidney failure. Nurse dismissed this too. I’m going to get a specimen cup today and take her urine back to dr for further testing. I don’t want to take mom to the ER. I’d have to call 911 because she couldn’t sit and wait. What do I do?????? I sit and cry because I’m failing her, we truly think she’s dying but nurse doesn’t think so.

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Do the UTI test that you mentioned. What can it hurt? Also, I have no idea why a nurse would say a dementia patient doesn't have headaches....how does she know that. It's very possible a dementia patient is unable to explain to someone they have a headache, but if mom says her head hurts, then something might be hurting.

My aunt with alzheimers complained of terrible headache every single day for over a year. Hurting to the point of needing to get into a dark room and avoid lights. She had a history of migraines, so why would we not believe she still had them. She was constantly rubbing above her eyes/forehead. I asked her what the headache felt like and she said it just pounds all the time and if she could put her finger inside there, it might feel better if she could rub where the pain was.

As for kidney failure, just recently had that issue in my family. What I found out was that you can actually have lost up to 90% of kidney function before you realize you are really sick. The relative was in severe pain but no one really associated it to kidneys - by the time he went to hospital he in kidney failure and an inadequate hosptal held him nearly a week trying to treat infection instead of the kidneys. By the time he was sent to a 'real' hospital with specialist dr and dialysis equipment, it was really too late. He was put on 24 hr dialysis and a few days later he passed. If her labs came back with abnormalities, then you need to have a talk with doctor to ask what caused them and what will be done about it. If you decide to go the ER route, call an ambulance so she doesn't have to sit outside in a car waiting her turn or in a lobby. Ambulance riders get to go right back to the treatment room. And call her doctor when you're on your way so he knows she'll be there. Maybe that will get the ball rolling to pinpoint problem and get her meds she needs. -- Do what you have to to advocate on her behalf because no one else will do it.
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Is your Mom at home? Definitely, look for different palliative care.
Could new medications cause her headaches? Is there any food that your Mom really likes? My Mom always has room for ice cream.
Broth or Gatorade may also be helpful.
I know that you're frustrated, and well should be, but sounds like your trying as best you can to help your Mom.
Best wishes to you and take care of yourself.
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Momsonlychild: Your mother needs a more competent company for her medical care. I am sorry that I'm seeing this three days after your initial post, but it is quite clear that this company needs to be fired for their incompetency in so many areas of her health. I'm flummoxed as to why the doctor can still practice medicine! The doctor's medical license should be revoked.
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Reading before reading other responses. Gees am I pisssed at what you've been told especially since I am just home from 3 days in the hospital where I had to advocate for myself.... So my thoughts are, get a new MD for mom, dismiss that D--- nurse for laying a guilt trip on you. There are typically more than one hospice program in a town. Hopefully yours is one. Fire them. Take urine sample to NEW MD.

Sometimes there are also Visiting Physicians. Or Visiting nurse may have a hospice program...
You are not failing her you are doing the best you can. So stop crying and start researching...you'll find a better answer...
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Aneurysms come from falls and smoking. How old is she and did she already have a rather large stroke ? My friend's Mom died after kidney failure-- she was in a lot of pain. With dementia they cannot tell you how much pain they are in, but you can see it in their face and jaw clenching. You are not failing her. Doctors often do all they can and over-prescribe all the alzheimer/dementia drugs as well as thyroid drugs... maybe it is time for a second opinion. You do not have to tell the primary care doc.. or you can. If you take her to the ER-- the usual thing will be for the ER doc to put her in hospice and then they will give you the comfort care lecture and the local hospice folks who are stretched these days will be "busy" more than often and the level of "care" will decrease over a period of months and they will basically wash their hands of your mom. I saw how little they did. It was shameful and typical of a bunch of "administrators".
You may ask for them to give her Meniere's disease meds ( meclizine 12.5mg) to keep the nausea down and feed her mushy brown rice in homemade chicken soup with steamed cabbage and celery.... save the watery cabbage/celery "soup" and let her drink that-- brown rice soaks up poison and the body expels it. Ginger tea is good for kidneys. Rhubarb and honey with raisins will break up any collecting gunk in the colon. If you can find murdock ( wild rhubarb,,, burdock) add a small amount since it will operate like strong laxative and cause cramps if too much of the stem is used... good luck, God bless.
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Looks like you've received some excellent advice in this blog. Keep being an advocate for your mom! Suggest having a pharmacist review her meds. Important thing right now is pain control whether by her doctor or ER doctor since Palliative care has been nonexistent. You may need to get a new doctor for her if you keep getting the run around. You don't mention how long you've been involved with her health journey. Are you up to date on all her diagnoses? Has she kept secrets from you about her health & you're coming in after her condition as worsened? I pray for pain relief & comfort for your mom & peace & comfort to you. 🙏
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Unfortunately, this happens more than not....the lack of interest or down right neglect of seniors. It happens a lot with my mother as I have been witnessed to. I feel after you reach a certain age they just don't care about you anymore....your dispensable, you don't contribute to society anymore therefore there is no real interest in spending time or manpower on helping them. I've had to be persistent and even argue to get help. It's disgusting.
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PAH321 Aug 2020
Stephensglide - I couldn’t agree more. My 92 year old Mom fell and broke the tibia bone in her leg resulting in a hospital stay followed by 3 weeks of therapy. She got to the point that she could walk again up to 100 feet with a walker. Then the depression from isolation took over, and she refused 2 therapy sessions so the director at the facility stopped all therapy. It was 6 days before we could get her out of the facility. During those 6 days, every time my siblings or I called - regardless of the time of day - she was in bed. We believe staff just let her lay in bed most of those 6 days. When we picked her up upon discharge, she was so weak she couldn’t stand, let alone walk. All 3 weeks of therapy were lost. It is criminal what is happening to the elderly. And many of us will get there someday.
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I agree with Maryqesq1, she is on her last, and probably does have dementia and at the last stages. During the last 2 years or 3, from people I knew, like the Caregiver Support Coordinator for Alzheimers/dementia, she personally experienced her husband not eating and sleeping all the time during the last 3 of 19 years she took care of him with early onset Alzheimers ; my daughter-in-law's grandmother was forced fed with liquids, and not much went down, and slept all day and all night on Alzheimers during last 3 years. This type of sleep is usually in the fetal position. These are just 2 examples plus my husband, eating so slight as your Mom, and sleeping 98% of the time, He went from the bed to the recliner, slept all day, then to bed early and slept all night. Hard sleep, too. I had to force him to get up and go to the bathroom, eat a little, then back to the recliner and off he went to sleep.
And, the responses about Tramadol are true. When I took it the night of 5-toe surgery, I had a seizure. That was the early release of Tramadol and the pharmacist said there was no mention of it causing seizures in her files. I had headaches. I took it for 3 days, not all day, but just once a day and tylenol the rest. About 10 years later, it came out Tramadol causes seizures. Partner Tramadol with oxycodone, and you have drunken fall risk. During his last 2 months of life in a care facility, my husband fell 3 x and injured himself twice--once broken vertebrae for he was prescribed physical therapy but was not watched, so he didn't do PT as prescribed--therapist couldn't get him to perform, he was sleepy; 3rd time he fell he broke the bone just under the eye not the cheek bone, fell and hit the ceramic floor in front of the toilet. My husband's were both caused most likely strokes. No medical report says that, but HOSPICE stated that. He stood in place, couldn't move, and just killed over from the feet to the floor, over 6 ft, hitting hard the ceramic tile with his face.
I'm saying all this so you have an idea how falls can result in injuries, can be from strokes, even though my husband was able to crawl to the bed where he was found on the floor. Drowsy and incoherent. For 4 years before he had these accidents and in Alz care, he got up in the morning, went to the recliner, stayed there all day, sound asleep, went to bed around 8 pm, sound asleep. Get appointment with a neurologist to determine how much dementia is there, it's very important. Falls will continue.
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Your mom's issues with headache my not be from dementia. Ask her doctor to do a head scan. She may have an aneurism that can cause awful headaches and nausea. My Mom died of aneurism, which was at the base of her head. She had major headaches and the doctors told her she has migraines. Only when she passed they found the biggest aneurism at the base of her skull. You should demand your mom get a head scan. An aneurism can happen between now and two years ago. Go to a different doctor if you have to or pay for one if your financially able.
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I don't get it about hospice. Both my parents used a walker and were able to speak fairly well. We were told if there is ANY weight loss, falls more than usual, not eating as well or sleeping more, worse dementia. I don't think the hospice that you're dealing with knows their stuff.
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Your mom has dementia. Is she capable of reporting her symptoms? And Pallative care. To make her comfortable not treat and cure her. Therefore no diagnostic scans. She is Sleeping 98% of time and not eating. She sounds at end of life. Whatever her symptoms, they aren't disrupting her sleep.
You need to consider what is her future. Speak to home health. They can explain what her needs are and why she is on pallative care.
You need some peace of mind that discussing situation might afford you. Keep her comfortable during 2% of time she is awake.
(Walking has nothing to do with hospice. Dementia is a hospice diagnosis. At least with hospice a nurse can visit once a week and check her status. And discuss case with you. Hospice is also pallative care not diagnosing and treating. Evaluative tests , eg ER visits aren't covered when patient is on hospice. )
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You have the right to change hospice/palliative companies.
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You're not failing her. The healthcare system is. It seems to me that elderly are largely ignored, at least in the U.S. Dementia patients DO have headaches. My mom does. Steroids DO cause headaches. I get injections and always have headaches. I don't have much advice, except by some miracle find a caring doctor, someone who cares about the elderly. But you are not failing your mother. You obviously care about her a lot.
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How old is mom? Her headaches, and kidney disfunction are likely caused from severe dehydration. Medications won't work if her circulatory system is like sludge...get her to really amp up the fluids, or else she's going to fail very quickly.
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different meds work differently on different people and headaches could well be caused by tramadol.

now that ive said that remember that some pain meds may NOT work AT ALL. It can be trial and error.

But also remember that there are things your mom may not be able to tell you and it may take awhile to find something that helps.

tramadol and hydrocodone have not helped me. After knee surgery I took oxycodone some nights just to help me get some sleep. If i took pain meds during the day it was aleve. i didnt take too much oxycodone since i was afraid of addiction.

if you think your mom has kidney problems see a nephrologist.

as others have told you change docs and look into other hospices unless youre in a really small town and theres nobody else. Then consider how far youd have to go to find someone that you thinks helps.

theres the old saying that a person at the bottom of the medical class is still called a doctor when they graduate but even people on other levels may not have common sense or any clue. So no matter their level keep YOUR MOMs needs in mind and that one of the best things a doctor ever told me was that if he didnt know the answer to something i asked hed find out.
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You are certainly doing everything you can and it is frustrating. My experience with my husband is that he can't describe what is wrong. he says I need my walker and gets upset and confused , takes a long time questioning before he can decide he needs to go to the bathroom. another time he will keep saying I'm locked in here and repeats and repeats...I finally figured out he wants to go to bed. Will she be able to tolerate a brain scan? Prayers for you and your mother.
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We beat ourselves up and second guessing ourselves on did we do enough until it makes us sick. I did with my mom until I realized it wasn't me that didn't do enough...it was our healthcare system that fails us.
Keep doing what you are doing for your mom. Make sure to take a couple seconds for yourself each day.
If your mom is in that much pain then I would demand better drugs or different nurse / Dr. or both.
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I am in same boat. Mom who is falling and terribly agitated) was taken to hospital twice this week. Because she has no fractures and blood and urine were "ok," she will not be admitted. I think it is because of COVID. I am told she needs to be in the hospital 72 hours and have a "workup" before she can go to nursing home by the home health agency. The hospital does not want to get involved.

She is completely "out of it." She fights me constantly and took swings at the last EMT crew. She hits me, won't let me change her and is just awful.

I know she needs more help than I can give her (I can't lift her and it is just me in the house) but how do I get help?
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GO SOMEWHERE ELSE. Get a different agency... get a different doctor... I have seen some great people in the medical field but sadly, much of the time, I have seen way too many that are horrible. Surely, these are NOT the only nurses and doctors available to you. I have worked as a nurse and home health aide. I have had to also work with some of the "yahoos". Again... change physicians... nurses... whatever you have to do.... hugs..
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There are many different hospice communities. I think you need to find another. Mom's palliative care team is not serving her well at all. Can you reach out to her former primary care doctor for help? Ask for a social worker. As for nutrition many times my dad could not eat and we made nutritionally dense smoothies that he enjoyed. We incorporated greek yogurt, spinach and all kinds of veggies. I am concerned about your mom's headaches and pain. Something is going on. She at least needs a Cat Scan but I don't know her age or health issues.
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Get another PCM. She probably is having some neurological issue. She probably needs a neurologist consult and a cat scan. Then, you can discuss options with the neurologist. Just because somebody is on hospice does not mean we do not address their issues.
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Check her d hydroxy level. This is very important. It may be critically low. Optimum levels are 50-60. I have seen seniors below 20. Also, the high quality Vitamin D3- i.e. Vitamin D3 with VeSSIsorb that are highly assimilable are the best quality to take.
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And you are still going to this medical center why? The nurse is failing you!! Seriously take your mom to another doctor. You should not be this stressed over getting answers from her medical team. Stay strong. Go somewhere else.
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First, please know you are NOT failing your mom. Based on the description of your mother's condition, you are both being failed by your local resources. Based on Medicare standards, (loss of weight, decreased nourishment intake, BMI, continual sleeping) your mom qualifies for in-home hospice care. The caveat is if you continue to provide curative care. Hospice care will help you make her comfortable and provide a better end of life quality care for your mom and for you. If one hospice agency denies her, keep trying. Another one may accept her. I have seen this more times than I can count.

You are not on an easy road. I have traveled it both with my mom and with clients of the in-home elder care agency I founded. But you must find the energy to advocate for both your mom and you.

Sincere best regards.
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Hi. It seems odd that she won’t qualify for hospice. I think you should call a hospice service and have them come see her. My dad has dementia and he passed on Friday. We all went through so many ups and downs since he was diagnosed in 2009. Walking around affects nursing home acceptance from what I experienced but my father was on hospice for over a year and he was bolting around in the beginning. We are paralyzed by the medical industry unless we take charge. You need to get a hospice person over there... don’t just listen to one opinion. Take charge. Tell them what you want and what you think because you will regret it if you dont... and fight like you would wish to be fought for. You are an advocate for someone that cannot take care of themselves.... be strong and get them what you think they need. You are not failing... but when you watch someone sick you feel like you’re failing if you cannot take the pain or process away and that would be impossible. You care, you are there, and I know you will be taking charge and getting her the care she needs. I fought many doctors and nurses opinions... and I won. Yes my dad passed but I did the most to make sure the care was there and the comfort and that’s where hospice comes in.
you are doing fine and you will get her what she needs.
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I am so sorry to hear this. I can only imagine the turmoil inside of you. They need to be upfront with what is going on. It seems like she is shutting down which is part of the dementia process. I know it can be painful to watch as I have seen it myself with my MIL. I pray for strength and courage. It looks like you have done everything you have been able to. Her illness is out of your control and our job is to be there to provide the best quality of life possible.
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Y’all will not believe this! As I was leaving for a specialist dr apt(my hubby was watching mom) there was a lady in the hall looking for unit 102. I thought she was delivering our groceries. So I said that’s my mom’s address. She said oh, what were our names. I told her. She said she was looking for us. I said you must have our groceries to which replied, no I’m from Adult Protective Services!!!! “Someone filed a complaint against me! The complaint stated I was neglectful, my mom had lost weight(of course she has) and get this- I only feed her strawberries! Can you believe this! Well after all was said and done the investigation revealed of course no neglect. After my hubby and I explained what we’d been thru with the Pallative Care nurse & her dr she was appalled! She was impressed at how meticulous my record keeping was and asked for copies of all 107 text messages that I purposely saved between the nurse and I. She is going to contact Hospice herself and see what she can get done! She remarked what an amazing job I was obviously doing with my mom and apologized for what we’ve been through. We see mom’s dr tomorrow and you can be darn sure this will be addressed. Thanks again for all the love and support. I’ll let you know what the dr says.
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MammaDrama Aug 2020
I wonder if the person who filed the complaint was really trying to help YOU and it was the only way they could do it. Maybe another nurse witnessing the whole thing? Glad you are getting some help.
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Momsonlychild,
How is your mother? Has her pain subsided?
Please keep up updated on your mother's status.
Sending hugs and a special prayer to your dear mom.
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I would fire the company that is not listening to you and find one that doesn't have a know it all witch nurse. One that will treat your mom based on her needs not what a nurse knows.

I would also file a complaint against her license. It sounds like she is burned out and should not be practicing her knowledge on patients.
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BarbBrooklyn Aug 2020
Well said!
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MOC; How are you all doing today?
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