Mom had a TIA on Tuesday. Sugars, BP and cholesterol were very high because she had not been taking all meds consistently. Symptoms of stroke disappeared after entry to ER and administration of meds.

Attending physician wrote discharge order yesterday without making an appearance. Neuro, nurse, discharge mgr and diabetic mgr questioned Moms readiness to get her sugar #s and maintain diabetic diet at home. Neuro cancelled discharge and ordered Neuro//psych/cognitive eval, keeping her another day or so. Neuro sternly recommended Mom take help from me and my Husb,, and explained reasons why she should not be driving. Awaiting that eval and findings.

Things in process for discharge: a walker for each floor of home (2), nurse/therapist 2x/week to monitor her #s and assist with steadiness & mobility w/walker, diabetic nutrition class (Mom agreed) and received Home Health Care local listing from hospital.

Suggestions on tasks I’ll need to work on, please?

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Therapeutic nurse started, coming twice weekly. Diabetic management will call back to schedule classes.

Willing to help, but not give my life to it. These issues won’t be resolved in a few days. Hoping her PCP, now our family doc, will act and have a different eval of her cognitive state.

Attending in hospital did not process DMV paperwork. She must pass a driving test. We have all car keys.
Helpful Answer (1)

In the last 5 years, Mom needed care after 2 falls, a mastectomy, and then a minor TIA. She is a retired nurse, 94. She didn't think she needed support at home after the 2 falls, but agreed to have the therapists/support at home, just to prove she didn't really need them. She discovered she DID need the help after the falls and mastectomy. But she DID work hard to come back and to be able to celebrate when we all felt she didn't need them anymore.

The day came when she needed to give up the car, and move in with me. Luckily we made the move in December and she didn't have the stroke until March.

This has been a learning experience for me, learning the FAST symptoms for a stroke so that I quit worrying. And I made sure the doctor taught those to me in front of her. That has been helpful so that she understands why I might ask her to speak, lift her arms, or squeeze my hand, etc.

We now live close to my sister. She drives us to lunch daily. She also takes care of Mom's business as needed. Right now, Mom still opens her mail and writes checks. She forgot how to endorse a check this week. So right now, my sister is making sure her insurances and credit card bills are paid on time, and that her checking account balances.

There have been lots of changes since the TIA--getting her 2 walkers. She went kicking and screaming until she zipped around the store with that triangle affair. WHAT A DIFFERENCE in her walking and in her positive attitude. I can't keep up with her now. She's back to painting, dusting her own furniture, making her bed. One day she said she thought she could mow the yard. I let her try. One half of one trip across the back yard was all it took. She returned to the porch with a glow for having tried.

The best change has been to take a good hard look at all the meds she was taking since the mastectomy, the move to a new town and new doctors, and then the stroke. Blood pressure and diabetes meds were switched, dosages changed, and others done away with altogether. Taking away Metformin was the best decision. She had been unable to eat hardly anything, always saying she felt full, and nauseous. The day after taking that med out of the mix, she was a completely different person. Eats like a horse now at each meal. AND she now gets the meds packaged in booklets that take a week to work through. She's only missed meds twice since April. Pretty good!! And it's so easy for me to see if the meds are gone out of the package, instead of checking 15 bottles.

I'm not sure why Metformin became a problem since she had taken it for years. The doctor believes it was interacting with one of the new meds after the stroke.

I guess I'm saying to take each day as it comes. Figure out what your parent can do and what needs help. Involve them up to their new abilities. Let them "show" or "prove" what they CAN do and then involve them in figuring out what can be done to make them as independent as possible. And who will give them the support they need and WHERE that support will happen--home? family member? assisted living?

Someone in the family might rise to the occasion to help your loved one accept whatever decisions for change need to be made. My younger sister is really good at this. I text her about whatever challenge has hit us. Then the next day, when she takes us to lunch, she moves the discussion around to that problem, listens, jokes around about this new set back, and then we come up with a new solution.

Mom gets cold even when it's 95 degrees outside. We've had a minor cold snap. She started wearing her long, warm pajamas which made her legs be less achy. But the cold snap added to incontinence which resulted in mom's only pair of long pajamas getting wet. So hurray!! We just went shopping and bought some more long pajamas so the wet ones could have time to get laundered. Sister's antics made us giggle until we p++++++++. At least I did.

May you all find your sense of humor
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Oh if only all moms were like yours. She sounds delightful!
I don’t think I would let her call the shots. Find viable options, primarily living arrangements and tell her these are her options that are perfectly suitable for all concerned.

She shouldn’t feel like she is a queen and you are her lowly servant. Believe me, I have been there. You will burn out like I did.

So let her know that she has to step down from her throne! I’m not trying to be nasty. Really, I am not. I only want to show you that catering to them consistently will not work. Give an inch, they will negotiate for a mile.

Hopefully she will cooperate when she sees that you are not allowing her to make choices on important issues. It becomes too much for adult children to care for uncooperative parents. I don’t understand how they don’t consider that adult children are doing all that they can to help. Some parents are not just stubborn but down right selfish too.

When my children were young I didn’t present important things in a question form. For instance, I would have never said, “You have a fever of 102 degrees. Do you want to go to the doctor so she can help you get better?” I would simply tell them, “You have fever, we are going to the doctor today.”

For unimportant things, I gave them choices such as, “Do you want a vanilla or chocolate ice cream?”

Older adults become like children. They don’t know what is best. They know what they want. They become like spoiled children if they get their way all the time and that is not fair to you.

Stop giving her choices for the big things. She can make choices for things that don’t matter.
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Task #1: Tour local Assisted Living communities to find one that best suits your mother's needs.
Task #2: Sign her up to live there and have her meds taken care of by the staff and the ALs pharmacy as well.

She's already giving you a hard time about doing what she said she WOULD do and what she now will NOT do. She can no longer drive. Being "just short of incompetent" is being incompetent. She has way too many medical issues for you to handle or for her to handle by herself. It's time for Assisted Living.

Best of luck!
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Katsmihur Dec 2019
Cannot afford AL and trying to get her expenses for Medicaid app. She yessed me in the hospital but, as we all know, tigers don’t change their stripes. Back to arguing with me about stupid chit, e.g. I didn’t take out her trash the ‘right’ way. Today she argued Medicaid doesn’t want her expenses by month . . . I let it go and returned the paper she wrote all her bills down on (instead of letting me see them) and told her I can’t apply for her Medicaid.
She didn’t understand home health care and now doesn’t want it. I’d be driving her to the class-close by. Neuro cog done this morning.

Neuro read psychiatrist and psychologist report and said it is just short of saying she is incompetent. But they are concerned about her ability to manage meds and test blood sugar consistently. Social worker asked if someone could take her in or help her out. All this after she was told she had been discharged. I appealed.

Will look into options for her as the social worker suggested.
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Driving issue: you can go online to DMV site and anonymously send info detailing reasons why she shouldn't be driving. The state will probs call her in for eye or street test. If she fails, you're not the bad guy. If her driving is scary right now, please remove her car on pretense of maintenance or mechanical problems and just keep it and keys. "Taking keys from her" will be very contentious so finesse it if you can.

Do you have all her info in one place/recorded? All her important paperwork: legal, financial, medical, personal? A fire-proof safe in her own home can work to consolidate it all together (but best to scan or photocopy critical ones as your mom's cognitive condition changes and causes her to "rearrange" or lose stuff. I'm an only also and have done this with my mom. Good luck!
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Katsmihur Nov 2019
PCP Monday and will process revocation of license paperwork. We have all car keys - there’s NO WAY she’ll get them back from my husband or me.

No info, only what she told me a few days ago after telling her my hands were tied and couldn’t help with post-discharge arrangements. She opened up real fast and am almost certain she’ll get Medicaid.

She has a safe Dad installed. Problem is that her bills and paperwork are in piles. There’s virtually no filing system to gather important papers from. My camera has been working overtime photographing whatever we can find ...
What about Assisted Living? This is all a bit much, don't you think?
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Katsmihur Nov 2019
Yes, I do think it is too much. Problem is - hospital discharged her home. I appealed and Medicare agreed with hospital - Mom would have to pay out of pocket for AL or NH care.

Hopefully PCP in Monday will recommend something other than her living alone.
Getting home health agency set up.
Arranging transport to the class.
Arranging for neurocognitive evaluation.

Your mother agreed to this plan? Do you think she will stick to it?

What are the parameters of how much you and your husband are willing to help?

Did the doc contact DMV or is s/he leaving it to you to take away her car and or keys?

Did anyone discuss Assisted Living?
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