My Mother is refusing additional PT Rehab. What do I do?

Be very, very, extremely clear with the discharge planner that your mother has No Family Support. She will be going home to no help. No help will be forthcoming from family. No, she cannot come home with you. No, you will not take care of her at her house. No. No. No.

This may make you seem cold hearted. Don't worry about it. Just say no as often as you must.

Your poor mother is mentally ill. She was not able to raise you to adulthood. This is terribly sad. But placing the burden on you will not change the past and could be very damaging to your future. I truly feel sorry for your mother. I hope you can continue to show her love. But do not accept day-to-day responsibility for her!

It is kind and responsible of you to visit her in hospital and to meet with the social worker in her best interests. Just be very careful of the old adage "No good deed goes unpunished."

And if the social worker tried to work on your guilt buttons, stay strong and come back here to tell us about it. We are on your side!

There's another issue here and it's the issue of ventilator weaning and maintenance of the trach collar, and probably suctioning to clear fluids. This is NOT a job for a nonmedical person; the vent weaning needs to be handled by a respiratory specialist.

I don't even know if Medicare would fund ventilator equipment for a home care environment, but I'm guessing no doctor would script for it under the existing conditions.

We did have a speech pathologist after my father was ventilator weaned, but that's much easier to deal with than vent weaning.

Under these circumstances, there's no way your mother could be treated in anyone's home. Perhaps one of the treating medical personnel at the facility should explain this to her.

She'll need to go to a rehab facility that does have the capability to provide vent weaning. In my experience, there aren't that many, only 13 in Michigan at the time. And one of them was somewhat dishonest about its capacity.

If you're going to take point on finding a rehab facility for her, you will have to check them out and verify that they have vent weaning capacity. The discharge planner and the current respiratory personnel can give you guidance on what questions to ask. The discharge planner should also have a list of facilities that do have the capability for vent weaning.

When I did my search for a facility with vent weaning, one of the admin people at the one which didn't misrepresented the situation by saying they could provide for vent weaning. When I pressed for more information, she finally admitted that their "vent weaning" consisted merely of oxygen at room air level. They had no respiratory therapist to provide the weaning.

In addition, I would be more than suspicious and reluctant to step in to care for a woman with complex medical problems who abandoned me when I was only 12. Don't let her use you, which is what she's trying to do. And don't let her guilt you into feeling obligations which she herself rejected decades ago.

This is a situation better left in the capable hands of medical personnel and government involvement to take care of her on a long term basis.

You can still keep in touch if you wish through sending cards, or calling (if she's able to speak, depending on the stage of her vent weaning).

You certainly need to make it clear to the discharge planning folks that, contrary to what you mom thinks, there will be no one at her home to provide care and that she cannot be discharged to your home. You would have to consent to that, unless she has legal residence there. If you cannot make her understand that you don't have the capacity to come live with her and provide hands on care, and if she is unpleasant about it, then staying away for a bit might make the point, although it would be sad. If she does not cooperate in rehab, she will be discharged to long term care, if it determined she can't live alone safely. Is she comprehending these facts? Have you spoken to the social worker or the psychiatrist who is treating her?

Can you continue to visit and be her cheerleader in rehab?

Thanks everyone, still awaiting a call from Discharge Planner at the hospital, I called and LVM for her to call me back. I am unsure what she will say, other than what my birth mother has already stated to me last week. (that she will not go to another facility for extensive rehab and wants to go home and rehab).

I want to be strong and show love to her through this ordeal, but caring for her and stopping my life for someone who abandoned me at age 12 is quite a far stretch for me to take upon all by myself.

I do understand that she is attempting to use me, and I am taking steps to reinforce good boundaries and take care of myself during this process.

I plan on stating to the discharge planner that I am unable to meet her needs at this time, as it will require me to move in with her and give or arrange for 24/7 health care. And, additionally, I am not equipped to deal with a VENT/TRACH and her other major issues. She is also verbally abusive and curses me and tells me to SHUT UP in front of her case worker and other care givers.

I've spoken with her about this, and she said she is sorry but I am acting as if I know what's best for her. I told her that I expect a level of respectful communication from her, and will not tolerate the verbal abuse and manipulative behavior that she's exhibiting. I think it went in one ear and out the other, but atleast I put it out there and laid down some boundaries.

I have also limited my visitations to once a week now because of the verbal abuse.

Sigh... Anyways, I thank you all for your thoughts and prayers, Its so good to be able to just tell someone what's going on.

Hugs,
Shiloh

I just got off the phone with case worker at the Long Term Care Facility and I was able to tell her what my Mother wants is to go home and rehab, but that would require someone to live with her 24/7. She agreed that that is the case. I informed her that she has no family support and this would require her to have to hire sitters and care givers around the clock.

I also said, we both know that since she needs extensive rehab, that sending her home and hiring sitters will be to her detriment and she will not recover by being cared for by sitters. She agreed.

She is looking into another rehabilitative facility in our city, and does not think it would be ethical to send her home with little to no family support.

I can't believe how emotional I felt during this conversation. (I didn't break down and cry) I guess it's because, I really do want what's best for her and can see that just being sent home without extensive rehab will ultimately be her demise.

Anyhow, she is qualified for another 12 days in the hospital and hopefully they will send her to rehab for further care.

Thanks Everyone - Ya'll are great!

Shiloh

She's bipolar and stubborn, right? In addition to all of her medical issues that are better handled in skilled nursing. You should read some of the posts on this board from folks with Bipolar, narcissistic moms. They are emotional vampires.

You would be very, very wise not to attempt to care for her in her home.

Thanks again - I know from my visit with her yesterday, she was extremely complimentary and in a good mood. She requested that I go to the store and bring her Oil Of Olay Beauty products for her face and a nail file. She also wanted a vegetable plate from a local restaurant.

She was in a fantastic mood and kept telling the nurses that I was her beautiful daughter. She's never spoken to me like that before, so it was kind of shocking to hear words like that come out of her mouth.

I know that she is an emotional vampire - because on most occasions I am so drained with the negativity and judgmental comments on every person and thing she encounters that i feel like I need a shower after a visit.

I also understand she is "buttering" me up, in an attempt to make me feel differently about taking care of her at her home.

I also took your advice and looked up Bipolar w Narcissistic Mothers and you're right - it would be an absolute nightmare!! ugg

Not only that, But I do agree with GardenArtist with her assessment of responsibility, After age of 12 - there has been very little to no contact with me, in my teens, 20's, 30's, and early 40's... not even a phone call, and she has never been to my home for a visit. But, still she thinks that her children owe her a level of care and concern that she never showed us.

So, yeah, I get it, and I understand that it would be a complete and utter nightmare, but it's still a head trip at times because she's so whack a doodle doo crazy at times (pardon the expression) lol

And, just so you all know, I can't and won't be taking care of her at home. Its just an impossibility and I refuse to shoulder that responsibility.

I did take care of my grandparents who raised me. Both have passed on now, and even then, care giving, even for people you adore and love is time consuming, energy zapping and financially a burden, but, caring for people who cared for you and raised you, that's is a completely different situation. It's a labor of love, and you are putting back into them what they put into you, the time, the caring, the TLC.

And, it all works out because there is a "mutual" love and relationship that you both share.

Ok, I am going to stop waxing poetic now.. LOL I love this message board, its helping me verbalize and get others opinions about this situation.

Love to you all xoxo :)

Uh oh, I just discovered a big error.

First sentence of the 7th paragraph should read:

"When I did my search for a facility with vent weaning, one of the admin people misrepresented the situation by saying they could provide for vent weaning."

My sincere apologies; the words just seemed to get tangled up after I typed them!

And Shiloh, congratulations to you for standing your ground.

I don't think your mother realizes that what she wants is not necessary what she can have, particularly in her physical condition.

When my father was trached and on a vent, he would LOVE to have had some nice juicy ribs. But he couldn't have them until he was completely vent weaned.

Hang in there!

Shiloh, you are so on target on all counts. Stay strong and let us know how it goes.

Update: She has agreed to further Rehab Therapy at a sub acute rehab facility, just awaiting Insurance approval so she can be transferred. Very pleased that she made a good decision for herself. :)