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My 92 year old aunt went into the hospital a week ago after a fall. No broken bones, but pain from a bruised hip. The doctors have run a lot of tests and scans, got her electrolytes back in balance, and everything looks very good at this point.


She doesn't seem to have any interest in getting out of bed. She refuses physical therapy, refuses to get into a chair to eat meals. There's always an excuse, like the PT came at the wrong time or the nurses must be too busy to help her to the chair. She's soiled the bed a few times but seems to find it funny that someone else has to clean it up. Today she's said she won't leave the hospital for rehab unless the nurses comply with a long list of demands (not happening).


Has anyone else run into this? She's starting to drive me a little crazy because she's calling me every two hours to ask me to run an errand or complain about something but she is showing no interest in her own recovery.

I’m very surprised the hospital staff is tolerating this. When my dad is hospitalized we make very sure someone has him up and walking several times a day, it’s a use it or lose it situation, and it’s just not optional. The therapists are very good at coaxing and cajoling a hesitant elder to participate. This is their job. Time to tell the hospital staff member most in charge of her care that more has to be expected immediately of aunt and then you not be available.
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jacobsonbob Feb 4, 2019
Perhaps the hospital tolerates it because it generates revenue from what might otherwise be an empty bed.
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What conversations have you had with your aunt's doctors? How do they explain the change in her attitude and behaviour?

Don't underestimate how much bruising hurts, by the way. It is frustrating when people don't seem to be contributing to their own recovery, but put yourself in her shoes whenever you feel impatient with her.

What are her highly individual demands for rehab? Just wondering if they contain any clues about what's bothering her.
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NeedHelpWithMom Feb 2, 2019
Country mouse, so true! I fell in my kitchen not long ago and I was so sore that I could barely walk. I took a bad tumble and then I still had to care for my mom. It took about a week to feel better.
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When my mom falls and help comes, one of the first things they ask me is if my mom is acting like herself. Definitely something to consider if her personality or cognitive ability is different.
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qattah Feb 4, 2019
Good point!
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My question is why did the doctor put her in the hospital when there was no broken hip or brain bleed. If she has been in bed that long she's most likely bed bound and will have to go to a nursing home. Good luck. If the person refuses to get out of bed believe me physical therapy and nurses will not force her and will simply chart "refused" and be done with it.
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faranlee Feb 4, 2019
They put her in the hospital because she really wanted to be there but in hindsight, maybe that was the wrong choice.
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We had a different scenario - but still in regard to refusing hospital discharge. My mom had a massive stroke (Brian bleed) at age 87 that left her paralyzed on one side. She also had vascular dementia. She was comatose and the doctors asked us if we wished them to be aggressive or just keep her comfortable. We chose the latter, as that would have been her wish. After 4 days in the hospital, we were told the next step was at-home hospice or a local hospice facility with 24/7 skilled nursing care. My dad’s attitude became the issue. He adamantly declared my mom was comfortable, close to death, and he didn’t want her moved. Medicare was not going to continue to pay the hospital costs. We had a family meeting with the social worker and I later drove my dad for a tour of the hospice facility. The tour helped relieve his anxiety. He finally agreed to have my mom moved and in the end, he felt tremendous gratitude for the hospice workers (my mom lived another 4 days). It’s sometimes so hard for the very elderly to make decisions that seem so disruptive and unreasonable. I understand your aunt’s sentiments. Explain to her she’ll foot the bill of thousands of dollars if she stays in the hospital. If possible, have someone from the re-hab facility visit with pictures of the room she’ll have and amenities (re-hab facilities are often competetive for Medicare dollars and cater to patients by advertising special perks). Good luck!
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Time for a nursing home.
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They've ruled out a stroke, yes. She has had a stroke in the past and we were worried she'd had another when she first went in.

This is a significant change in her mental status. She's always been very independent, the kind of person who won't ask for help even if she could use it. She's gone from that to not wanting to do anything on her own. Maybe it's time for a geriatric psychiatrist since there doesn't seem to be that much wrong with her physically.
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shb1964 Feb 4, 2019
Maybe speak with her hospitalist about some sort of psych evaluation. If she has just given up and wants to be waited on hand and foot, Medicare won't pay for that forever. If she's deemed safe to be released, it is up to them to find a place where she WILL be safe if that isn't on her own, where she was before this hospitalization, or with family. By the way, they may try, but they cannot demand that she be released to your care. We were told by our elder advocate that it is up to the treating facility to wait until a safe place can be found for her to go. If family isn't willing/able, then it is up to them to find a place. Stick to your guns - she sounds like a handful.
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You say she lives alone and up to this point has been independent.

Could it be she is enjoying being able to make a call and you come running, pushes a button and her needs are met?

Maybe, just maybe she got very scared with the fall and instead of saying she doesn't feel comfortable or confident enough to try walking or to be independent, she is doing nothing so choices have to be made by others. Then if the facility isn't up to her desired standards she can blame others for her condition.

I can't imagine how it must feel to be a frail, weak (in comparison to her younger years) old lady living alone. If she watches the news she is fed fear by the minute. Now she feels safe, cared for and might be sleeping well in who knows how long. Just a couple of thoughts.

Can you request a chaplain visit and talk to them beforehand and ask if they would address her seeming desire to remain bedridden.

Unfortunately most people have a never gonna happen to me, it is always someone else attitude, until it's not and then we don't know what to do or how to move forward.

Help her understand her choices, she may be lonely and wanting a community around her.

Best of luck and please let us know how it goes. Take care of you with good boundaries during this transition and beyond, you don't want to train her that you will jump and run every time she calls.
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faranlee Feb 4, 2019
She watches the news non-stop, I don't know how she can stand it!

There is a part of me that's wondering if she enjoys the attention. She's lost most of the people she was close to and her only child lives quite a distance away. On the other hand, she has a community of people she lives with in IL. She could leave her apartment to go to the store, get her mail, go to lectures, eat with others during the day. She was far less isolated there than she is in the hospital and now rehab.

I wonder if there was another fall, if there are things going on that she isn't telling people because she's afraid of going to AL.
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My grandmother did a similar thing. She was in the hospital, and they wanted to send her to a rehab hospital. She was adamant she wouldn't go. The morning she was supposed to be transferred she died. She just couldn't take the thought of being jostled around and moved to yet another unfamiliar place.

The important thing, though, was that it also turned out she was riddled with cancer, and no one knew it. She'd had no particular symptoms because she wasn't in great health anyway. I thought that was really odd until this past autumn when my dad -- her son -- died of liver cancer after having no symptoms except fluid in his abdomen. (We did know he was sick, though, but he was diagnosed only six weeks before he died.)

Your aunt may have something else very wrong with her.
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faranlee Feb 4, 2019
So sorry about your father. I lost mine recently to a liver cancer as well and it was also very fast from the time he was diagnosed. I do wonder if there is something like that wrong with my aunt because she seems to be so weak and so exhausted but none of the tests, xrays, cat scans etc show anything wrong with her.
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Is this a change in her mental status?  What was she like before this fall?

Has a stroke been ruled out?
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