My grandfather, who has dementia, fell 5 days ago. He didn't break his hip thank God, but does have a contusion, blood pooling in the muscle, as well as a pretty big nasty bruise and swelling. Since that fall 5 days ago, he's fallen (it's considered a fall in the medical field) or more or less "sat on the floor" 4 more times. He is unable to bare weight on his legs for more than a few seconds if at all before he starts to go down, and literally sits on the floor. We tried to get equipment approved through the doctor and they blew us off.
We got a semi electric bed via rental through a local DME. The bed was placed in their sunroom/sitting room which is off their bedroom. My grandparents have been married 62 yrs and never slept apart. Since the bed coming in (2 nights ago) my grandfather seems confused and keeps asking when will we go home, despite the bed being in the same room he is in day in and day out. The bed itself has seemed to throw him completely off. He is confused about where to use the restroom (he has a bedside commode next to him), where my grandmother is cooking their breakfast, etc.
My mother who's a hospice nurse and works literally 24/7 happens to be not on call, and has been around this weekend. The level of care for my grandfather since getting the in-home hospital bed has tripled. While he isn't able to walk he seems to be able to stand holding on to his walker better than before. That being said, plus his spike in confusion and level of care needs going up; I suggested we move the bed to their room and put his chair back. Allowing him to sit in his chair during the day, wheeling him to the table in his wheel chair for meals and then putting him in the bed for sleep only. I suggested this might put him back into his "normal world", thus causing him to improve not decline like it appears to be happening.
My mother flipped her lid at me when I suggested moving the bed and the reasons why. I know she's a nurse, she works in hospice, but I am afraid I am right on this one. I am the one here day in and out while she is out of the home. I am not going to be able to attend to him like this, it's too much and I feel it's limiting him. He has PT coming and and HH is about to start- I've requested and eval for that AS WELL AS I just set up an eval for in-home doctor visits. I have a feeling when his PT guy comes this coming week he will also agree. He is to be standing and being moved from wheelchair to chair/commode/bed, no walking right now. We need him to gain strength to try and have him walking again (PT just came earlier in the day, the night we got the bed and gave me instructions on the changes in care/mobility since the fall).
I am curious to know what y'all think and what has been your experience. Should the bed be moved to his room to help clear the confusion a simple bed has brought in? As well as to keep him mobile and moving without increasing his chances for decline? As well as to help lighten an unneeded level of care since the bed is ultimately making him bedridden when he isn't and DOES NOT need to be?!?
I would move the bed back to his bedroom and see if that improves things.
I think that there is a fundamental difference between your expectations and those of your mother, you are hoping for at least a partial recovery and she seems to be focused on easing him toward a peaceful end.... I think a lot of those involved in hospice care tend to go there by default.
Even if he doesn't improve that doesn't mean his death is imminent, I've learned that people can live a very long time in extremely compromised condition. I think what you need is a realistic prognosis and timeline, unless he has something specifically life threatening he could live this way for years (as my mother did). I couldn't handle that level of care in the home, you need to decide whether you can.
Let me add that the Physical Therapist (PT) who was coming prior to this recent fall, has already come to do a re-eval. The HH and PT just recently began in late Sept/first of Oct. due to my grandparents having covid and symptoms being so mild, no one knew they had it. Also to add, besides my grandfather falling due to the brain fog it caused, his symptoms were far less than my grandmother's, as was the rate in which he recovered. He was absolutely mobile prior to this and prior to this most recent fall- my grandmother was also with him in the bathroom when this happened. She thinks she can get him up and do for him and help him if there's an issue, WRONG! (SIDE NOTE: my grandmother is fine- she just trips over her own feet due to not following orders, wear slide on slippers, and dragging her feet. She is stubborn in all aspects but most importantly, doesn't manage her diabetes, eats/does what she wants and when she wants, as well as sleeps all the time- regardless of PT telling her to do the exercises and move/do more around the house; that she's unstable on her feet and has weak legs b/c she's in the bed all day, she does the minimum and sees my help as a "I don't have to do anything anymore". She's gotten so lazy she doesn't go out to eat anymore, go to church, or shop which she LOVES... she doesn't even want to drive or travel- they have a beach and mountain homes. Her blood sugar is in the upper 200s to 300 because she eats pastries, bread, jams/jelly, half bottle of syrup, and whatever else she can get her hands on. High BS#'s make you have yeast infections -which she has, makes you eat even more- which she chooses more sugar, and feel like absolute garbage- which is why she's in bed. She's stuck in a vicious cycle. Yesterday (Sunday) her BS# was 495 and she took it again on the opposite hand, it was 521. She could've had a stroke. Alllllllll this is by her choice and disregard of my, mom's, the doctor's, and HH's instruction. She does NOT have dementia, she is fine. She's hardheaded and can be quite mean due to the irritability from the high BS. She takes 3mg injections of Trulicity 1x week and Metformin 3x/day and still....these numbers B/C SHE WILL NOT LISTEN AND DO WHAT SHES INSTRUCTIONED! Part of the doctors not 'hearing me" is because my grandmother has lied and downplayed hers AND my grandfather's health/condition for awhile. That's recently changed since I stepped up). The same 2 PTs/HHN's who sees my grandfather, sees my grandmother, so they're able to check in with either or, several times a week. The PT sees me every visit and relays everything to me, as do doctors, nurses, etc. I am the "face" that handles/deals with everything; obviously because I'm the one here and that takes them now. The PT is who instructed ME (as stated above, in my original post) not to encourage or allow him to walk. I however, was instructed on how to and when to transfer him, according to his care needs at the current time. I was instructed to have him standing, pulling himself up (with assistance- I use the belt in case) while using his walker....then using the walker to pivot himself to wherever he's going next. I WAS NOT INSTRUCTIONED TO KEEP HIM BED BOUND! The PT wants him standing and getting his legs/back stronger again THEN we will gradually work on getting him up and walking again. Again, THE ONLY LIMITATION IS TO NOT ALLOW HIM TO WALK, IN EXCEPTION OF THE FEW STEPS TO STAND THEN TURN TO SIT/LAY DURING TRANSFER TO AND FROM, WITH ASSISTANCE!!!!
My problem is my mother who is a nurse got mad at me when I stated I wanted to move the bed into their room, bring the chair back in it's original place. In fact this past weekend he transferred himself to the bedside commode and got back in bed upon waking up from a nap. This isn't necessary. I'm going to call the PT and relay the changes from this weekend and ask what he thinks about it. If he agrees, it's being moved back.
"...my grandfather seems confused and keeps asking when will we go home..."
This is a common dementia behavior called Sundowning. He is most likely referring to the home of his youth (which is in his long-term memory), not his current or most recent residence. It often starts to occur in the late afternoon and science is not sure why, although the darkening of the day and the resultant shadows may throw off those with cognitive issues and triggers confusion and fear in their minds. One way to combat it is to turn more and brighter lights on earlier in the afternoon; distraction (not arguing or insisting he is already home); or engaging him in an activity he is capable of doing (like sorting things on a table like nuts and bolts, screwing nuts onto bolts, sorting and pairing socks, folding kitchen towels etc).
I agree with Cashew to not change anything until his eval from an objective and professionally qualified person. May you gain wisdom and peace in your heart as you work to help him along this journey.
PT gave me instructions to have him pull himself up with his walker (with assistance) and pivot himself to where ever he's being transferred. With the exception of the few steps it takes to turn (pivot), he isn't to be encouraged or allowed to walk. I was NOT instructed to keep him bed bound.
That and the above about the bed placement, him being bed bound, etc. causing his decline is what my issue is.
My husband was completely bedridden the last 22 months of his life in our living room, and even though when my grandson lived with us to help me out, and would lift him from his bed to his lift chair, he still was considered bedridden, as he couldn't walk or stand on his own.
Are you able to lift him from the hospital bed to the chair if it were in the same room? It's a lot to have to lift someone who is basically a dead weight, this I know, so before you go making all these plans to make your life a little easier, please consider what makes his life a little easier and get all your ducks in a row, as what you're wanting isn't that easy.
So I guess wait and see what the physical therapist says and take it from there, and then just make the best of whatever the outcome is. I wish you the best.
PT gave me instructions to have him pull himself up with his walker (with assistance) and pivot himself to where ever he's being transferred. With the exception of the few steps it takes to turn (pivot), he isn't to be encouraged or allowed to walk. I was NOT instructed to keep him bed bound.
That and the above about the bed placement, him being bed bound, etc. causing his decline is what my issue is.
PT gave me instructions to have him pull himself up with his walker (with assistance) and pivot himself to where ever he's being transferred. With the exception of the few steps it takes to turn (pivot), he isn't to be encouraged or allowed to walk. I was NOT instructed to keep him bed bound.
That and the above about the bed placement, him being bed bound, etc. causing his decline is what my issue is.