Elderly mom with dementia fell and fractured hip (money, Medicaid, Medicare)
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Ask the Dr. to write an order for social service/discharge planning. The Dr. runs the show in the hospital, no ancillary services w/o Dr. order, at least it was that way when I was working.
Also talk to the Dr. about discontinuing Zyprexa. It's a strong anti-psychotic. These kinds of drugs are used to "calm down" the elderly so they are more manageable to staff, but they have terrible side effects. My father was given Thorazine, he was a zombie for the rest of his life. Ativan is a long-lastng benzodiazapam that should help her anxiety, but not knock her out.
I agree with a urine test for UTI. Older people often get these & have no symptoms except behavior change.
Since you don't know my Mom and how long she has had dementia you can't be sure that what I said isn't true. Moving around has no effect on dementia but Mom's general well-being and outlook on life bloomed in the care center.
I wasn't arguing or denying what you said about your mom.
Thanks, ocnjgirl
Quote:
I don’t think it’s actually the broken hip or the surgery that causes a decline leading to death. Rather, I think in a lot of cases the fall and subsequent hip fracture is simply a symptom of a decline that is already occurring.
This was point I was trying to make. I tried to rep you again, but couldn't!
I think the fact that your mom does not speak any English at all it’s probably one of the biggest barriers to her getting adequate care. That is probably why they don’t see that she has dementia, and it is also probably the reason she is so agitated because she doesn’t understand what they are doing and why they are causing her pain in her mind. Hopefully she speaks a language that is rather common, because if she does not understand what the therapist is trying to do she may not cooperate when they come in to try to walk her. She’s going to be in tremendous pain putting weight on that leg. Are you able to talk to her on the phone to explain everything that is happening? Do you know if she is allowed full weight bearing yet?
Hello Ocnjgirl, and sorry for the late reply.
Mom was released from the hospital and I was very busy trying to have her adapt and be comfortable where I am staying right now, which is a small guest house.
It does help me to know that it is painful for her to put weight on that leg, because that was my original guess when she screamed when the therapist tried to have her stand up. The doctor said it should not hurt, but it looked like it really did, and they always put the reason for her being agitated in physical therapy on the dementia while in the hospital.
I was shown exercises for her to do in bed, so I am hoping that these will help. I am also looking for a physical therapist because we are only allowed three PT visits, and she needs them more regularly and more often.
Ask the Dr. to write an order for social service/discharge planning. The Dr. runs the show in the hospital, no ancillary services w/o Dr. order, at least it was that way when I was working.
Also talk to the Dr. about discontinuing Zyprexa. It's a strong anti-psychotic. These kinds of drugs are used to "calm down" the elderly so they are more manageable to staff, but they have terrible side effects. My father was given Thorazine, he was a zombie for the rest of his life. Ativan is a long-lastng benzodiazapam that should help her anxiety, but not knock her out.
I agree with a urine test for UTI. Older people often get these & have no symptoms except behavior change.
Thank you happygrrrl
I was off the forum for a while, as she was discharged from the hospital to my temporary place. Although it's tiny, it has helped her rebound a little but has added a lot of work for me. Of course, I am grateful to be there for her, and I wouldn't have it any other way.
I am very sorry to read about your Dad. My mom was prescribed other drugs that knocked her out , and then of course she couldn't eat, so it started a downward spiral I didn't like.
The problem with prescribing Zybrexa is that it is for schizophrenia, not for dementia, and can have negative effects for people who have dementia. Mom also has a heart condition they diagnosed on day one with an EKG, and that drug is specifically prohibited for heart conditions as it can provoke sudden death.
I only found this out days later as I asked to speak to a neurologist and he then advised the staff to avoid prescribing Zybrexa. The problem is that the staff is absolutely not trained to handled older patients. I asked for a geriatric doctor but didn't get one. The surgeon and the MD were NOT aware of the side effect of that drug for elderly patients with a heart condition. It's just a machine and drugs are prescribed to avoid taking appropriate care of the patient at their own risk. I mean what are you going to say if an elderly patient dies? Oh, she/he was old already, they could have gone anyway, it kind of doesn't matter for them. This is very sad and upsetting. Plus many anti-anxiety medicines have the opposite effect which can make them more agitated. When I asked the doctor why she prescribed it, her answer was: Just to try. And she had already prescribed 8 or 9 other drugs in 24 hours. Why didn't she contact me and explained the situation? Elderly patients are in tough luck at some hospitals.
Hello Ocnjgirl, and sorry for the late reply.
Mom was released from the hospital and I was very busy trying to have her adapt and be comfortable where I am staying right now, which is a small guest house.
It does help me to know that it is painful for her to put weight on that leg, because that was my original guess when she screamed when the therapist tried to have her stand up. The doctor said it should not hurt, but it looked like it really did, and they always put the reason for her being agitated in physical therapy on the dementia while in the hospital.
I was shown exercises for her to do in bed, so I am hoping that these will help. I am also looking for a physical therapist because we are only allowed three PT visits, and she needs them more regularly and more often.
Three visits???? That is insane, she should be getting PT 3 times a WEEK until she can walk again! Did you ever get a chance to talk to the hospital social worker? Did they even offer to send her to rehab?
Three visits???? That is insane, she should be getting PT 3 times a WEEK until she can walk again! Did you ever get a chance to talk to the hospital social worker? Did they even offer to send her to rehab?
I did and they worked hand in hand with the case management team who first wanted to send mom "anywhere in CA", even if it was hundreds of miles away and told me I would have to accept wherever she goes. So I am looking now for a physical therapist and will start a fundraising campaign to afford it.
I did and they worked hand in hand with the case management team who first wanted to send mom "anywhere in CA", even if it was hundreds of miles away and told me I would have to accept wherever she goes. So I am looking now for a physical therapist and will start a fundraising campaign to afford it.
I am so sorry you have been left with so little resources. Our health care system is shameful IMO.
So I am looking now for a physical therapist and will start a fundraising campaign to afford it.
If your area has an university with a PT program, contact its director or department head. S/he would probably know of PTs or recent graduates who are looking for jobs or freelance gigs. The Covid crisis unfortunately put many rehab professionals out of work so I think you will be able to find someone fairly easily.
If your area has an university with a PT program, contact its director or department head. S/he would probably know of PTs or recent graduates who are looking for jobs or freelance gigs. The Covid crisis unfortunately put many rehab professionals out of work so I think you will be able to find someone fairly easily.
Thank you for this advice.
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