Grandma finally got her knee replacement, how can we make people understand we can't take care of her?
On August 24th my grandmother finally had her knee replacement and has been in the skilled nursing/rehab place in the hospital since then. It's been pretty hairy these past few days. When I saw her on Wednsday, she didn't really understand why she was there and needed rehab twice a day. She thought that after her surgery she was going home and could do rehab there. My mom, dad and I visited her again on Friday and she was worse. Couldn't follow the simplest conversation, confusing a TV commercial for and actual TV show, confusing the sore from rehab to actual pain like she felt after surgery, wanting more pain pills. What really scared my mom was how long she was one Oxycodone and she kept thinking that she didn't have her knee surgery yet. When we were leaving, we talked to the nurses about the amount of pain medication and how long she was on them and how she is after taking them. I am sure that she has been cut off from the pain pills and now is given Motrin. My mother visited on Sunday and the physical therapist had mentioned that the doctor was thinking of releasing her on the 8th (today). My mother was horrified and told the therapist that before the surgery, she was living alone in her house and there were staires to get into the house and the basement and how was she going to manage? Mom, Dad, and I in a couple weeks are going to see my sister graduate nursing school in Virginia and then in mid October go to a wedding in Texas so there would be no family in Ohio to take care of her. Grandma living with us isn't an option. Both full baths are on our 2nd floor and there is no way she can handle 13 steps up and down. With how narsasistic she can be and the physical and mental abuse when she doesn't get her way, it's not happening. My coworker asked how Grandma was doing and I told her that the hospital was going to release her today and we let them know that there is no caretaker set up and our home is not elder friendly, we would not take her home. My coworker let me have it saying that my family was going to get into massive trouble with APS due to neglect. I know full well that we can't get into trouble if they want to release her and we don't take her home. Her daughter took care of her after her hip replacement and her brother took care of her 104 year old mother in England and that was their choice and that was the family dynamic, so that is what she is going on. At the time of the hip replacement a couple years ago she was mid to late 70's, my grandmother is 84 with kidney disease. What can we do to make people understand we can't take care of her at home?
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But never mind that: you do not need to provide rehab and the hospital with "acceptable" reasons for declining to take over your grandmother's care - you need only to make it unambiguously clear that neither you nor your mother is prepared to accept responsibility for her. So stop telling them about how your home is set up and make them concentrate: Mrs X on her return home will be living alone and without family support. The plainer you make it, the more likely they are to focus on meeting her needs properly. I'm concerned that you think they still think it's an option that the family will provide care - is your mother being too nice in conversation with them? She's going to have to tell it like it is and if that means she gets snotty remarks from people well poo to them. They can save their opinions for their own families.
Grandma wants to stay at home? Then Grandma, supported by her rehab team, can work out how that's going to happen - she doesn't have any right to make it your or your mother's responsibility.
How's your mother coping with all this by the way? Is she okay?
From your last post it appears that grandmother is still in rehab, right? While she's there, perhaps she can have an evaluation to see if she is mentally able to live alone. Her behavior suggest more is at work than her kidney and knee problem.
I'm glad the social worker is helping? Hope things go more smoothly and less alarmingly from here, and that your grandmother starts to recover well. Best of luck, please keep posting.
The social working called back from her meeting with Grandma's doctor and physical therapist and she is going to a rehab facility. She told them that if she was living alone, she would need more therapy to be able to manage on her own.
The risks that come with the general anesthesia needed for this type of surgery for a patient of this age are huge, one of which is acquired or worsening dementia.
When my dementia addled LO decided that he needed carpal tunnel surgery (because his brother had it) and he was only 73, I took him to hand doctor for evaluation, back to his neurologist (who was very aware of his dementia) for test and then to the hand surgeon who was hot to schedule him for the surgery -- none of them mentioned the specific risks involved for a dementia patient - just ready to do it and collect that $$. I told the hand doctor that I was concerned that since he could not walk - and that his hands were his only strength - why would he have surgery scheduled to do both hands at once and since he had dementia -- what were the dangers of the general anesthesia. I also told him I was his only caregiver and had to work fulltime, so the doctor needed to make sure he was released to a facility that would be able to care for him while he recovered and rehabed. Well that surgery was cancelled pretty quick - they were doing it for the $$ nothing else, three doctors, a patient who could barely say his own name and they "oops - didn't know he had dementia" which was bull because it was both evident and on his record.
With everyone else from co-workers to extended family to nosey Nellie neighbors, you thank them for their concern and tell them your family has it taken care of. And then change the subject or walk away. The lesson many of us have learned is that you can talk till you're hoarse only to have them say "yes, but..."
People have their opinions based on their own experiences with family or they project what should happen based on no experience with their own elders or they project if they were the elder in this case. You're best served by telling people very little and discussing it very little.
In any case, I've come to believe that people's opinions on elder care are right up there with religion, politics and other potentially inflammatory subjects. Take care - there's lots of support for you here.
The rehab facility will not send your grandmother home without a formal discharge plan. The exact planning procedure won't be identical to ours (I'm in the UK) but all the same there will *be* one, and it will involve some kind of assessment of your grandmother's ongoing care needs and of her home environment, looking at what needs to be put in place before she can safely go home.
If it is not possible to provide adequate support for her at home, she may need to be transferred instead to long term care, and that would be a whole 'nother discussion. What conversations have taken place since Sunday?
And caution your mother not to listen to gossip. If it ain't written down and signed by the manager, it ain't necessarily so.
And finally, don't waste your breath or your heartache justifying yourself to people who have no business telling you how to manage your family. Come here instead and let us know how you're getting on :)