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Old 08-29-2015, 11:00 AM
 
Location: Wonderland
44,290 posts, read 35,841,586 times
Reputation: 62644

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Quote:
Call me judgmental, but... My mother fell once and never again because I personally made sure she didn't... AT HOME... Facilities simply don't have enough staff (it would cost them too much profit) to ensure that every old person is accompanied every step of the way, which is what it takes unless and until they're confined to wheelchairs or bed 24/7, which is a short step from total disability and death.

Incidentally, the ONE time my mother fell, she incurred a subdural hematoma from it... They tried to dismiss it as Alzheimer's, but it wasn't... This injury is very, very common in the elderly and treatable (or heals on its own), but Alzheimer's is the new wastebasket diagnosis for any mental status change.

If she's in a facility, she's going to fall again. A broken bone or brain injury is simply a matter of time.

Except that I did. Dementia, brain injury, bedbound, incontinent, feeding tube. And "rowdy," too! 18 months, 24/7. Including reversed sleep cycle (so I didn't sleep much). My brother gave me a four hour break every afternoon to run errands; otherwise, all me. And lesser care for years before that. And I count it all a blessing. I loved her. People can do more than they think they can, if they want to. Not everyone wants to (I wouldn't for "just anyone" or a MIL or even my father). But it's possible. Someone must be at her side 24/7 to avoid falls, or she's going to fall (if she's ambulatory). Is all I'm saying...

It wasn't "luck"; it was a choice. I took an unpaid leave of absence and was willing to give up my job, if necessary. I certainly gave up the rest of my personal life. Where there's a will... But there usually isn't. " Fortunately," there are always a lot of excuses in modern society to institutionalize and warehouse our elderly, however, and it's certainly widely condoned.
Yet you wouldn't take care of your own father or your mother in law in your own home 24/7. So why are you so quick to criticize others when you're clearly not holding yourself to the same standard?

Last edited by KathrynAragon; 08-29-2015 at 11:39 AM..
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Old 08-29-2015, 11:37 AM
 
Location: Wonderland
44,290 posts, read 35,841,586 times
Reputation: 62644
Quote:
Originally Posted by CraigCreek View Post
I'm not going to get into who has done what better, but have a few ideas - not sure if they've already been tried or not, but they can't hurt.



Best wishes to all of you...
What a kind post. THANK YOU SO MUCH for your well thought out and helpful ideas.

Quote:
First, is your MIL on any kind of medication to help control her mood? Perhaps a mild sedative or antidepressant might help her be calmer and less combative.
Yes, she is on Adivan (?) for anxiety and also one of her meds for Parkinson's has a sort of sedative affect. But her team is going to re evaluate her meds next week. We'll see what they come up with. The last time we tried to change up something, she actually had a series of mini strokes or something like that - she had several episodes of passing completely out and going completely limp and had to be transported to the hospital twice. Not sure if it was related directly to the different meds, because she's just so fragile anyway, but we really do hate to tinker with her meds at all because she REALLY has a strong reaction - either very much more agitated or she lapses into a nearly comatose state.

But we're going to take that plunge again next week because her hallucinations have really increased lately and her sleep is more disturbed. I think it's the natural progression of the disease so we probably need to adjust her meds.

Quote:
Secondly, she must be so confused and terrified most of the time, which of course makes her extremely difficult. Her reference to her mother makes me think she may think she is back in her childhood. Do her caregivers try to "be with her" and acknowledge her emotional/mental state compassionately, irrational though it is? As in, when she asks for her mother, telling her that her mother is busy with the baby, or is washing the dishes, or whatever reason sounds feasible as a reason she cannot come.

If her mother lived or is buried in another city or state, just say, "Your mother's in Tennessee (or wherever) with your daddy right now, but she's having a wonderful time and sends you her love". Do NOT remind her that her mother is deceased, or try to orient her - she's beyond that. Make sure everyone with her understands this. Try to acknowledge her emotions as much as possible, whenever possible.
Oh we do all this and so do her caregivers at the memory care center. She thinks her mother is alive and just out shopping or whatever. We have this conversation with her regularly. We stopped reminding her that her mother is deceased a long time ago! We just go with the flow.

The other day, we were struggling to get her from the toilet to the wheelchair and she was fighting it every step of the way and then suddenly she just stopped struggling and said, "Where is the baby?" I said, "Oh, I laid the baby down for a nap," and she said, "Oh good. Mother will be back soon." Then a few seconds later she was back to struggling to stand up again! Oh well. She must be remembering baby sitting her youngest brother while her mom was out.

Quote:
Is there a closed-circuit television camera in your MIL's room that relays to the nurses' station? If not, could you arrange for one?
There's not a nurse's station at this facility. It's not like a typical rehab or assisted living place. The staff are rarely in their offices, and they "operate" from a mobile cart that can be pushed around - it's got a laptop on it, various supplies, etc. Everyone sort of pitches in and does a little of everything - for instance, the activity director may be helping to serve lunch, or the bookkeeper may be manning the front desk or helping make up someone's bed, that sort of thing. That's one of the things I really like about the place, actually - they really try to make it seem like a home and not a facility. So there's no central "hub" like I've seen in so many other, usually larger (and louder and more confusing to my MIL) places.

Also, she's fast about this standing up - and just as fast about falling down. Honestly, the other day she was sitting in the TV room with other people all around. One of the aides was sitting with her and got up to go get a drink of water - just across the room. No lie - my MIL suddenly just pitched herself out of the chair and onto the floor. I wouldn't have believed it if I hadn't seen her NEARLY do it just the other day, with me sitting right there beside her!

Quote:
As for combativeness while being bathed, perhaps the two bathing her could try the good cop--bad cop routine - one could say, "It's okay - I won't let her hurt you. Now let's wash that pretty face - doesn't the soap smell good? Can you wash your own hands? Good, look how nice and clean you got them!" If she thinks she is a child, then work with her on that level. Distraction can be a great tool with small children - it can work well with her, too.
This is exactly what they do. I sat and watched this entire thing yesterday. She never responded to their kind words or their tactics. All she would say was "Oh stop it stop it stop it stop it. I don't like you. I don't like you," and stiffen up making it very difficult to get her clean. She stiffens up her arms, for instance - or worse, her legs - and then when they try to move them, she cries out, "OH YOU'RE HURTING ME YOU'RE HURTING ME," and when they say "Miss_____ just relax your arm and it will be OK, I promise," she just simply will not do it.

I take that back - one of the aides told me that she got her to calm down the other day by telling her that I was on my way up there and didn't she want to look pretty for me? For some reason that calmed her down, even though I swear she didn't know who I was when I actually did get there! What a strange disease.


Quote:
Last, try giving her a life-sized, realistic baby doll or a realistic stuffed toy cat or dog (whichever she may have had in the past) to care for. If she's holding the baby or her pet, she may not be as likely to get up and fall quite so readily. If this works, add doll baby bottles and simple changes of clothes and a receiving blanket. When you give her "the baby", don't refer to it as a doll, but as a baby - ask her what she's going to name it, talk about how pretty and sweet it is, etc., just as you would with a real child. Encourage her to sing to the baby, burp it, wash its face, and so on. Baby dolls have been very helpful in many Alzheimer's care facilities.
This may be a good idea. I will ask the staff about it.

She does like animals and had a favorite dog as well as a favorite cat that she sometimes talks about.

I wonder if she would like one of those stuffed cats that actually "breathes?" They look super real. Not sure if she'd like it or if it would freak her out!

Quote:
It is so hard to witness a loved one in this condition, and so frustrating to see them undercut their own best interests - but that is a symptom of this terrible disease. Setting the environment to avoid some of the pitfalls can help to some degree, but it may become necessary to more your MIL to a facility which uses restraints or to arrange 24/7 care for her, to ensure her total safety.
I am appalled by the idea of restraints as well - and have heard some horror stories about injuries from them. Twenty years ago, my grandfather was struggling with dementia caused by a brain injury from a wreck (that he caused even though we had all been begging him to quit driving - a wreck that killed a 22 year old man). He had a broken femur that simply would not heal. Part if the reason it wouldn't heal is because he kept forgetting that it was broken and he kept getting up, trying to walk, and falling. So eventually the facility did use restraints on him. He was PATHETIC - he knew he was basically tied to the bed. He struggled against those restraints constantly, and would beg me to help him escape every single time I visited him. It was so heartbreaking.

Of course this situation with my MIL is heartbreaking as well.

We've hired someone recently to stay the night with her because I'd been up there for hours already and she was very agitated and we were literally having to hold her down, and we'd already given her the max amount of meds she was allowed to have.

That one night of additional care cost $175. My gosh, that would be an additional $5300 a month! On top of the current $5300 a month. $11,600 a month and she'd still be miserable. And like I said, she's very determined - and uncannily sneaky about it.

I honestly wonder if it's not intentional - if she's not subconsciously or even consciously trying to kill herself. I really do wonder that. It would be like the last sense of power and control over her own destiny. I could see that being the case.
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Old 08-29-2015, 01:18 PM
 
10,366 posts, read 8,359,306 times
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Just had another idea: look up "weighted blanket". These are typically used with children who have behavior issues due to ADD or other related problems - the blanket doesn't hold them down, but it gives a sense of safety and security and is calming. I don't know if they come in adult sizes, but even a weighted lap robe might help keep your MIL put.
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Old 08-29-2015, 01:36 PM
 
Location: Wonderland
44,290 posts, read 35,841,586 times
Reputation: 62644
Hey, thanks, that's a good idea too!

She does better when we put pillows all around her too. That seems to make her feel secure.
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Old 08-29-2015, 01:39 PM
 
Location: Wisconsin
16,874 posts, read 17,190,006 times
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Quote:
Originally Posted by CraigCreek View Post
Just had another idea: look up "weighted blanket". These are typically used with children who have behavior issues due to ADD or other related problems - the blanket doesn't hold them down, but it gives a sense of safety and security and is calming. I don't know if they come in adult sizes, but even a weighted lap robe might help keep your MIL put.
Weighted blankets come in all shapes and sizes, including bed size and lap robe size and weighted stuffed animals that act as lap robes. They can be very helpful.
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Old 08-29-2015, 02:25 PM
 
Location: Whereever we have our RV parked
8,666 posts, read 7,632,897 times
Reputation: 14825
OP: Our all wise, all benevolent govt. decided that it was inhuman to restrain somone, even for their own good. So when she gets up, she falls. Don't blame the facility. They're following the law. If you want to blame someone, blame your govt., which you love so much.
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Old 08-29-2015, 05:00 PM
 
Location: Canada
3,872 posts, read 2,704,778 times
Reputation: 5054
Quote:
Originally Posted by augiedogie View Post
OP: Our all wise, all benevolent govt. decided that it was inhuman to restrain somone, even for their own good. So when she gets up, she falls. Don't blame the facility. They're following the law. If you want to blame someone, blame your govt., which you love so much.
The OP didn't blame the facility. Perhaps you should READ her posts- particularly post #10.
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Old 08-29-2015, 05:31 PM
 
6,319 posts, read 5,684,066 times
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OK let me tell you, all very nice for folk who can nurse at home...

but I wouldn't in a million years.

Why? because I AM NOT AN AGED CARE NURSE.

I have friends who work in those places and they are UTTERLY devoted to quality care for everyone.

They don't get paid very well so most do it because they care.

It is so incredibly easy for an old persons skin to tear, for a start, which can lead to infection, thence to death.

I am not experienced in caring for someone with skin and bones like tissue paper. I would literally do more harm than good.

I am not experienced in caring for someone with advanced dementia. Its not just a matter of rolling up your sleeves, these people need constant care, constant monitoring, constant patience. NO human alive can be expected to provide this, which is why Homes have 8 hour shifts for staff!!!

Its a horrible situation, but Alzheimers is horrible, some would say the WORST, because the brain and personality die first while the body perambulates on mindlessly.

Only specialized care facilities can be expected to cope with Alzheimers, it literally IS the Worst Case Scenario for old folk.

I applaud Kathryn for caring so much!! if only other peoples families cared as much! Most Alzheimers patients are literally, forgotten - so painful it is to watch.
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Old 08-29-2015, 05:55 PM
 
Location: Las Vegas
13,837 posts, read 25,215,602 times
Reputation: 26173
We had the same problems with my father towards the end. They put him in a net bed. No actual restraints but he could not get out of bed unassisted. Sort of looked like a bed in a cage.
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Old 08-29-2015, 07:57 PM
 
Location: Wonderland
44,290 posts, read 35,841,586 times
Reputation: 62644
Quote:
Originally Posted by augiedogie View Post
OP: Our all wise, all benevolent govt. decided that it was inhuman to restrain somone, even for their own good. So when she gets up, she falls. Don't blame the facility. They're following the law. If you want to blame someone, blame your govt., which you love so much.
I haven't blamed anyone.

Have you actually got anything edifying or helpful to say about this topic?
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