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I was alerted today by the SNF that my Mom is starting to show signs of declining. Previously, she was fairly independent, could transfer herself in and out of bed and to the bathroom. Would socialize daily. After a bout with the flu and her recovery, she returned from isolation and has been moody. Stays in bed constantly. No longer willing to move herself without staff help. She's still eating fine. She has refused bloodwork (says needles hurt so she won't accept it), is diabetic and now I was alerted that she does not cooperate with the Psychiatrist. So they can't figure out what's going on with her and they can't force her of course. SNF wants to try anti-depressants and are monitoring her. I've tried calling and coaxing her. Tried to lift her spirits with my support and love but while she likes to hear from me, is stubborn on all decisions and issues regarding her health care. At a loss on what to do next for her.

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essomd, are they trying the antidepressants? What has been happening since you first posted?
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Let her doctor step in because she is going to need the insulin.
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I have two elderly parents, one with dementia, the other with what I call "imaginary illnesses." I am the sole caregiver except for a PCA who comes in to help my mom shower 3x a week. Depression is a very real issue with the elderly. As long as your mom does not have a UTI or any other new illness blooming, I'd say there's not a whole lot you can do but love her, call her, be there when you can. I mean think of it--she is nearing the end of her life, and who knows what she's thinking. She could be afraid, she could just be frustrated with her limitations, she could just be tired of it all. I find that family seems to disappear when you get old. People forget about them. And they sure forget about YOU when you're caring for an elderly parent. Maybe you could arrange for some family to visit her? Maybe the nursing home could arrange for a therapy dog? I've seen the therapy dogs, they work wonders. And above all--I don't know how you feel about God, but he's the one who keeps me afloat. Remember to ask him for help. Minute by minute if you have to. I promise you He is there. God bless you.
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If you are able to get a urine sample for UTI testing, make sure they also do a culture! I know they will do the immediate test, but my grandmother has had them not show up there, we’re sent home to continue dealing with a lot of crazy for a couple days, but then turns out they find something in the culture later.
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I'd like to suggest probiotics. I know they give a little probiotic cocktail when they give antibiotics, but that's not enough to replenish the beneficial bacteria in the gut. Depression and anger can be a side effect after a round of antibiotics for this reason. A good grocery store (do you have a Kroger where you live?) has several types of live probiotic drinks, you need to get as many kinds of them down her as you can. Don't worry, you don't have to keep this up forever , just a couple of weeks. then a maintenance dose. Kombucha, Kefir, Yogurt (make sure it has LIVE cultures in it) non-pasteurized (live cultured) Kimchi and Saurkraut. The Kombucha is fizzy, so it can seem like a drink of pop or rootbeer. The capsules of megadophilus or other probiotics, can be opened and put into pudding or yogurt, if she can't swallow pills? Also, swirled into a little bit of tepid water. (not hot, as it will kill the beneficial bacteria). Another suggestion -- is she worse at 5pm? She could be sundowning. The homeopathy Alumina worked wonders for my mother. If I gave it at 4pm, she wouldn't sundown (get confused, anxious) at 5pm.
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Simple, go visit her!
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essomd, sounds like my mom. She was at my daughter's house while recovering from a broken hip. She was a b**** to my daughter and granddaughters. She later said she thought if she was mean enough they would let her go home. Never mind she couldn't be by herself. She eventually did go back home. I was so angry I could have throttled her.
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Perhaps she can't differentiate between feeling weak and confused after the flue and what she might see as a general irreversible decline due to age...it's a very fine line between psychological, physical and emotional... my experience is that sometimes they can "decide" it's not worth fighting anymore and to let go cause they think the end is approaching... then dementia and other symptoms become real.

In one word, maybe she's angry because she's scared of how she felt; perhaps you could try to reassure her that all the weakness and confusion comes from the flue, and that is normal, and that even young people feel the same after a bad flue, and that she'll be herself again soon...

Don't know, this seems to have worked with my mother who was "deciding" as well if life was worth fighting for.

I hope your mom will feel better soon.
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An illness can effect them. I would check her for a UTI and pneumonia. Both can cause a change.
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It’s super frustrating to deal with a parent who acts out in a facility. Even though you know they’ve seen it all, it’s still embarrassing to hear the staff tell you what’s she’s doing. Staff will probably put her in diapers and she won’t like that either. When my husband was in rehab, he wasn’t that cooperative either. Although he wasn’t resistant to the point your mother is, he could be less than willing to cooperate with the therapists, and therapy was the reason he was there. However, there was one LPN who refused to put up with his “act”. When he’d claim “I can’t do” this or that, she never let up, and he’d do it. My husband eventually came to call her “Sarge” and asked if this Christmas, we could go visit her at the rehab. Perhaps there’s an aide at your mom’s facility like “Sarge”? Sarge wasn’t disrespectful to my husband, but she brooked no resistance when she knew he could do something and just didn’t want to or happened to be feeling sorry for himself. She was a real gem!
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Has she been diagnosed with dementia? I suspect if dementia has already set in, but is in the very early stages, any trauma or illness will exacerbate it. It does sound like she needs to be checked for an infection, and needs a geri psych eval. and treatment. Hope that she settles down enough to cooperate with the SNF staff. ((((((hugs)))))
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I don't have any helpful words, I'm hoping that you soon find an answer! This post has been helpful to me because my mother has likewise been recuperating from pneumonia (not flu or strep according to the ER doctor). She was in decline previously, but it's now on overdrive it seems! She won't feed herself. She will eat if she's fed, though. At first she wouldn't eat any meal on her own, now she will feed herself dinner. (?) Also, prior to this she was able to go to the bathroom and take care of herself. Now she's in diapers 24/7. She is cooperative when they prompt her every 3 hours or so. But she doesn't remember to take herself to the bathroom. She wasn't able to walk at all at first, (but now she's able to use her walker again, she just needs assistance getting up. That was the way it was previously. She has severe arthritis in her knees, so getting up on her own has been difficult for years.

I appreciate this site, because I'm reminded once again what can happen with a UTI. So I will request that the NP that visits the care home will arrange for that.

Thank you so much!

And essomd, I'm really hoping that you find an answer soon! I understand your frustration and the feeling of being at your wit's end! Take care!
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Your mom is exercising her "independence" , and telling those folks where they can go.
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I would not be surprised either to find she had a UTI. But I will also tell you that my mother, who has Alzheimer’s Disease is generally much worse during and for quite some time after any illness. The fatigue the illness brings on her system just saps any ability to fight the ravages of the disease and the confusion it causes. Your mother my also be lacking the energy to fight any unusual impulses brought on by whatever other circumstances she may be dealing with. This is often why the elderly appear to “go downhill” so suddenly after having been ill. You’ll remain in my thoughts. Remember to take care of yourself!
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When did she have the 'flu? This year's vintage seems to be particularly vicious. Just wondering how long she's had to get back to normal.
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Esso, I'm betting it's UTI as well. Keep us updated!

I'm a bit confused about her non-cooperation.  Are you heathcare poa?  If the decisions she's making are not in her best interest, do you have the authority to authorize a blood test? Have her taken to the ER in an emergency?  Authorize the use if antidepressants or other meds?
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Have you asked her what she wants? Just a simple, non judgemental question. Sit quietly, listen very carefully and ask her the question. Once asked stay quiet and give her all the time to say whatever she wants to say. Acknowledge her answer, whatever it might be. Ask her what she wants ou to do and what she wants others to do. The clues are in her answers. I don't sense depression. I sense anger. Acting out and expressing her anger the only way she knows how.
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essomd, I fully understand your worry and dismay at this sudden change. With my Mom when she suddenly would not walk and had personality changes it always turned out to be a UTI. This always caused people to be confused as to what was going on. You would think people in SNFs would be aware that UTIs cause personality changes in the elderly! Is your Mom on any different medications? Sometimes meds as well as a UTI can cause major changes in personality. I would be looking for the test results for the UTI first.
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Thanks freqflyer.

I do have an update on this. I posted this prematurely as more drama ensued as the day wore on!

A few hours after I posted this, I was alerted that my Mom suddenly left her room, wheeled herself to a staff person's office and berated them LOUDLY. I know this staff person well and they're constantly sending me updates on Mom's condition and I haven't witnessed nor heard of any foul play at this SNF. Mom just doesn't like this person. Plain and simple.

Now, as I mentioned, Mom has stopped going to the bathroom on her own. She has been, without using her call-button, urinating in her bed. Staff will find her when they make their rounds and have to clean her up. I can't believe it.

I have asked for her to be checked for UTI but I have another concern....

I wonder if she's deliberately acting out in hopes to be "kicked out" of SNF? I know she legally can't be forced out but I'm at my wits end!

Everyone is trying to just see to her care but dementia appears to setting in and she's becoming more vocal and irritated. I asked if the Psychiatrist has seen her and the psych said that Mom won't cooperate.

Anyway, I'm not sure what other solutions there could be. I'm going to wait for further updates.
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essomd, I am moving your questions closer to the front page. Hopefully a caregiver who has gone through this will be able to help you.
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