So she's in her second week of rehab. Every time I visit she just wants to "lie down". Plus she has a completely unbelievable fear of falling, I mean she's comfortably in bed and gripping the railings like she's on a boat being tossed at sea. She says there's no vertigo or dizziness there either. Today I merely tried to raise the bed a little so she could eat properly and see me and she starts carrying on like it's the worst torture imaginable.
So I was talking to the therapist and she tells me that on Friday they had to change the mattress so there was no other option but to get her in the wheelchair for a while. This has been a goal since day one. She tells me that after a brief struggle she did get in the chair and remained there for a few hours with no issues. I was astonished as Mom never mentioned it.
So today I'm there and we figure let's go for it again. They sit her up and immediately the death grip begins. This little old lady who's always too weak to move was fighting off three people and resisting with everything she had. There was no risk whatsoever of falling. Eventually the therapist had to give up and i could see the annoyance there, as I felt it too.
I'm wondering if maybe it's me. When I'm there she never stops with the hapless routine and the fear of falling, then I hear that while I wasn't she's actually doing something. Perhaps i should skip a few days and see if it helps?
Regardless of "self destruct buttons", your mother may also be thinking of the phantom energy that's wasted when electrical appliances are left plugged in while not in use. For someone who went through the Depression, that's not unusual.
For me, it's an issue of minimizing my carbon footprint. Other than appliances and clocks, anything else gets unplugged when not in use. It's difficult to tell specifically how much has been saved, but it seems to be about $60 a year. For me, that's significant! I can buy a lot of seeds and a few plants with that savings.
If you've ever been the victim of identity theft, you can become hypersensitive to potential scams. We have gone through that, and I can tell you that you begin to think of everything you might have that could be compromised, sites you visit, etc. and how to protect yourself. Your mother may have that concern with verification of bills.
As to electronic gadgets, it's no longer easy to just turn them on; you have to have instructions even for phones. The KISS philosophy seems to have been vanquished in electronics manufacture in favor of one which is all inclusive - MIC - make it complicated.
After a while, an older person (even someone at my age) just gets tired of all the fooling around. I'd rather spend that 5 or 10 minutes in my garden than pushing electronic buttons.
An electronic gadget can't hold a candle to the pleasure of watching butterflies flit from one pollinator plant to another.
That's hilarious about your mother acting to stress out the recalcitrant granddaughter! Something I've noticed about the relationship though, is that the granddaughter seems to call you in panic for things that might seem unusual. How old is she? Does she have much real world experience?
And I think there's something to be considered about Babalou's suggestion of simultaneous orthopedic and brain issues
When she complains of being bored, what does she actually say about it?
babalou: The first time around her PT was a total disaster, as she was still not diagnosed properly. It was tough to really have a LT goal there as I was still deeply concerned about what was wrong with her, while PT's goals were based on treating her for an ailment that was merely a symptom of her actual problem. In short, it was a mess and I cringe when I think about it. My hope is that this time it can be more practical and well-thought out given that now we know exactly what her problem is. I know she'll never live independently again, that's a given, but I don't think it's entirely unrealistic to get her to a point where she can at least assist in some day-to-day routine things, like helping her get dressed, cleaned up, eating normally and etc. She's already not actively resisting her aides and nurses like she was before, so IMO there's a little hope there to expand upon (ideally).
And this time around I am absolutely insisting that no one is to badger her about "insurance cutting her off because of lack of progress" which I detailed elsewhere in this thread (and given her injuries it was even more awful when I look back on it) she has enough on her plate without having that crap thrown at her. In retrospect, IMO they were too quick to "give up" on her and label her as being "difficult", that needs to be atoned for even though realistically I know that I'm probably the only one who cares about that aspect of it. I only wish I could go back in time and insist on having those damned tests be done sooner, as we could have avoided a very sad and painful (esp. for her) situation.
As to creating an atmosphere that your mother can look forward to, what can you think of that she'd enjoy after PT? Listening to her favorite music? Favorite magazines to thumb through? I suppose you could consider bringing her a special treat she might like, or better yet, some flowers...perhaps "a daisy a day" or better yet some lovely roses?
I would also speak to the business office about a way to extend her Medicare eligibility, given the errors that occurred the first time around. I would appeal for another 0 days full coverage, based on her second hospital stay.
I spoke to her insurance carrier today and according to them they'd have no problem with covering her rehab based on a new assessment of her needs and goals but it has to come from the rehab staff. Apparently I have to go over the PTs head and speak to someone about this issue as she just refuses to listen. And she's already leaning on me again to attend Mom's PT, she's almost implying that it's up to me to demonstrate progress, which just annoys me further. I mean I want to participate but I certainly don't want the entire burden placed on me here.
And if I get one more somber head shake or if I'm dismissed as an idiot one more time I'm going to have to seriously consider moving her someplace else, if that's even possible right now. They're not seeing one thin dime until I see someone there prioritizing her care over Medicaid applications and insurance guidelines.
We had to do that for my mother, whose first therapist said there was nothing he could do because Mom wouldn't try. The bas**** even had her in tears. I was so angry with him for being so cruel to an 80 something woman recovering from a hip fracture, but with Dad and my sister, we turned the situation around with a good resolution.
Discussing it with her orthopedic surgeon, he said Mom should NOT be weight bearing on the fractured leg for 6 weeks. So Mom was instinctively not doing what shouldn't have been done.
We had a meeting with the Admins and addressed the issue, making it clear that the grouchy therapist's action was inappropriate and medically dangerous. Another therapist was assigned, and the recalcitrant one was moved to another facility, so they said. It wouldn't surprise me if he was given his walking papers.
I also don't understand why the therapist is pushing for your presence at PT unless she's using you to document something, like her concern for what she might interpret as a lack of progress. In my experience, therapists often suggest family don't participate because patients "perform" differently when family is present. She may have a hidden agenda.
Something's amiss; once again you'll have to be assertive and straighten things out.
This has really been quite an experience, hasn't it?
When I see the PT tomorrow I'm going to just ask her point blank, is she going to help Mom rehab from her spine injuries and is this facility equipped to handle my mother's case? Because if not, I have to find another rehab that will.
When my mom, then 90, was in the hospital, post broken hip, they had her up out of bed VERY SOON after surgery. It's how they prevent blood clots, which are the real enemy. But DO make sure that you speak with the Director of Rehab.
Look, if they have orders from the doctor to start pt, no, they don't have to call you. Your mom's not incompetent, right? They tell HER they are starting pt and if she calls you, that's how it gets communicated. Since my mom has aphasia, I gave her a card that says "call my daughter" with my phone number. It took me a year to come up with that.
They want you there for several reasons. One, to be a friendly face and to aid communication with your mother. Two, so you can observe the techniques and provide some additional continuity in future. Three, for arse covering so you can witness exactly what they're up to - and don't forget they will have lots of patients' relatives calling them up and demanding to know what they're doing for their fees and why isn't mother/father/spouse making more progress.
Is anyone explaining to mom what's going on? Is she understanding the instructions? The fact that PT hurts, but it's ultimately going to help? Again, i think the cognitive/mental state thing is the wild card here.
With regard to the SW, in my experience, they are ALWAYS at the care meetings.
It must be so disconcerting to folks of our mothers' generation to be told to get up so soon after surgery, when in their youth "resting" was the cure for everything. I remember my mom being horrified that I walked out of the delivery room after having my first child.
Mom was definitely a real pill today, super grouchy and difficult and I have no idea why. I asked for more psych evaluation, but I've been pressing that for a while now. I don't know why she's so afraid of getting up and out of bed but it's still an issue.
Of course, for someone with some cognitive issues, being afraid that it's going to hurt is as bad as actual pain. Sometimes you have to think about how to coax her in the way you would a young child.
And today I'm working on the Medicaid application and I find out that they don't need six months of bank statements, they want 54 months worth. It's going to cost me $250 to get those from the bank and it'll take at least a month which means I have to request a later deadline. Sigh. $250 for a box of paper.
I think it's important to remember that the PT her/himself doesn't have a lot of leeway in "flagging lack of progress". Medicare has very specific guidelines for progress and there's not a lot of wiggle room. Are mom's cognitive skills intact enough that she comprehends that the therapy is important, and that she can't say later?
Two things that I had to change helped my mom make better progress. One was to get a specific order for her pain medication to be given about 1/2 hour before therapy. The other was to schedule an aide to come in and get mom to the bathroom immediately before therapy. It made all the difference in the world.
I used to consider myself a tough old bird, ready to tackle challenges, physical or otherwise. Then, as happens at my age, I started getting older, less physically flexible, and a little more vulnerable.
A few years ago I suffered some kind of injury that made it very difficult to walk; it was unlike anything I'd ever experienced. The toughness I usually had was hard to maintain, and there were times when I really just did not want to move because of the anticipation of the excruciating pain. I had to force myself to get up. I couldn't force myself to drive and take care of my father though so I adjourned his appointments.
When I reflect on that, I'm still surprised and unsettled that just a minor injury could cause such apprehension.
Maybe your mother is going through something like that - the perception is worse than the actual reality?
Dman, are you required to provide just bank statements or data such as payee, amount, & purpose for each of all of the checks written? I've wondered that as I've read of the Medicaid back data requirements.
GA: If they want documentation for every single transaction, well, that's just not possible. I mean she gets the exact same amount every month and has for years, with a few cost of living increases, tax refunds and property tax rebates thrown in once a year. Mom got a paper shredder a few years back and she faithfully shredded all old paperwork after it built up for a while, so most of the old paperwork is already long gone. It's funny, every month the local senior center has a shredding day where they encourage the seniors to dispose of old "useless" documents and such for the sake of ID protection. Then, later, social services asks for that very stuff. Medicaid wants copies of everything imaginable and some of the stuff they need requires some time to get. I'm wading through it and looking for some reasonably-priced help with it, as paying a lawyer thousands of dollars to do it is just out of reach right now. Bear in mind we're talking about NJ here too, the state that makes a mess out of everything.
Today I learned that her nighttime yelling has run off FOUR roommates so far and three of them didn't last more than a night. Her doctor has been advised and he's supposed to look into it. I don't know whether she's dreaming, waking up and panicking, having muscle spasms or cramps or what. Another weird mystery to crack...Mom's a lot of things but "dull" ain't one of them!
Next time you visit, forget about the medical issues, the rehab and everything else. Just pretend you're visiting you mother as you would have several years ago, just for the pleasure of being together. Just talk, don't do anything special, don't discuss rehab or getting out of bed. In fact don't discuss anything that's not pleasant or cheerful.
I say this from experience; sometimes it's helpful to just set aside all the caregiving issues and just bond with your parent before all the caregiving started. It can be refreshing and rejuvenating for you as well as your mother.
She's probably completely worn down by medical issues and may even be sick of talking or hearing about them.
Bring her some flowers as well; that always delights a woman. It will also make her feel special when staff compliment her on the lovely flowers. It wouldn't hurt to include a nice little card that she can look at repeatedly and remember that before all this started, she was your loving mother and you her loving son. Try to recreate those days as respite days for both of you.