How can we prevent my Mother, who has dementia, from pulling out her IV? - AgingCare.com

How can we prevent my Mother, who has dementia, from pulling out her IV?

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My mother is in a nursing home and suffering from severe dehydration. Apparently the staff has not been monitoring her fluid intake. She was diagnosed with a UTI a month ago. Her doctor put her on an IV but she keeps pulling the IV line out. Now the staff is asking us to come and stay with her to make sure she does not continue to do that. My sister and I are the only ones who live in the same state and we both work full-time. We cannot just leave our jobs whenever we want. We both go to the nursing home after work and stay until 9 p.m. but we cannot do that during the day. The nursing home is insisting we hire a visiting nurse to monitor her and this is at the family's expense. Has anyone dealt with this before? I suggested putting a mitt on her hand or a glove of some sort. Surely the nursing home can come up with a solution. And we are very angry that they let her get so dehydrated in the first place. How much time does it take to make sure she drinks a cup of water every hour or so? My sister and I are beyond frustrated. For the weekend it is going to cost almost $5000 and how are we going to ensure that this doesn't happen again in the future?

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In the last two weeks of his life my dad was in the hospital and kept pulling at everything he could. They tried a sort of cuff but he would pull them off too. A young doctor was kind enough to explain to me that it was time to switch to palliative care. I wish I knew that sooner. My dad passed away several days later in a hospice facility. I wish I had gotten hospice involved sooner too. You may want to look at those options.
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We did end calling The Visiting Nurse Association for 24/7 nursing care over the weekend. It will end up costing less than I thought but the family is responsible for payment. Insurance does not cover this care.
My mother stopped trying to pull out the IV, but still does not want to eat or drink. Once the IV is removed, I'm afraid she'll just get dehydrate again. She just hates being at the nursing home and it's getting worse. I think in her own way she is intentionally winding down. It's very sad.
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Does your mother's insurance cover required 24-hour supervision for a limited time?

How long is the IV supposed to be used? Might it be cheaper for you and/or your sister to take a day off work to be with Mom?

What would the nursing home do if Mom had not relatives in the state?
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geewiz, CMS considers mittens a restraint and requires documentation down to the minute of when they are applied and when they are removed. Hospitals that use them routinely can lose their accreditation or worse, the state could pull their license and/or cite them for abuse.
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I see dementia patients in the hospital where I volunteer all the time with gauze mitts. Are we sure they aren't allowed???
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I think it suggest a splint on the elbow of the arm she uses to pull out the IV. But, it also questions the effectiveness of IV's for those with advanced dementia.
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Sometimes, dehydration is a part of the progress of the disease. The dehydration may not be the nursing home's fault. I found this about it. See page 18 on hydration and IV fluids.

avoidablecare/wp-content/uploads/2012/04/Sharpe-Handbook-A-Caregivers-Guide-to-Advance-Dementia.pdf

You might also ask if her doctor can write an order that explains why restrains are necessary.

See page 10 that addresses your situation.

http://www.aging.ca.gov/programs/ltcop/improving_dementia_care/docs/restraints_the_exception_not_the_rule.pdf
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This was ten years ago and in a hospital setting but - to keep my son, who has sever autism, from pulling out a g-tube the doctors finally relented and ordered "burn mittens" - they also came with straps and we were allowed to loosely tie his hands down. This only came after several days and no-sleep nights of his father and I sitting on either side of him holding his hands down - more than once he got a hand free and zippppp, out it came. Also, with the mittens one of us had to be with him at all times - which we were anyhow so that was fine. I did get the impression that it was a huge, hairy, big deal that they were allowing this.
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My mother kept pulling her catheter out in the nursing home. The solution to that was to make sure he always had pajama bottoms on, so the tube was not visible and accessible. (It was easier for staff to keep her in a short nightgown, but when they realized what a difference it made they cooperated fully.)

Might clothing that covered the IV tube work for your mom?

It would seem to me that keeping a resident hydrated would be a basic responsibility of a nursing home, so I don't blame your anger.

Will Mom's insurance cover the extra expense during her convalescence? How long is she expected to be on the IV? Can mother afford this?
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Restraints, even "mitts" are considered illegal in all 50 states. Did the MD mention Hospice? IV's are not a permanent fix, they buy you a week or two at the most. Sorry to say this, but maybe Mom wants to go to Heaven.
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