My mom fell, now what?

Thank you Babalou, your responses have truly been so helpful to me. I've really needed this support with hubby gone in Europe and the six hour time difference makes it difficult to talk.

You don't. . You need to refresh your resources or you'll be a small puddle on the floor when your mom needs an advocate. At work right now, so no time, but wanted to encourage you to STAY HOME.

Babalou, thank you. Also, you are so right about the transport to doctor appts. She is still in no condition to get in a car, especially not mine as I drive a VW Golf (very small). While my mom has lost weight, she has always been a little on the big size and I'm only 5'1, 100 lbs, so I could never lift or move her. She has a follow up appt tomorrow with the ortho doctor. I'll meet her there.

One thing I've been struggling with. I constantly feel like I'm not doing enough. I still take care of everything for my dad in the morning then head to see my mom. I'm getting run down and need a day at home and feel guilty about it. I have Addison's disease so sometimes I'm just so tired I can't think. No one gets it because I "look" healthy. My husband is great, but is often traveling for work. In fact, has been gone through the last 10 days of all this mess. When I read the book that was given out at xmas mass (I'm Catholic), I just feel more guilty for wanting a day at home to myself. Do others experience this? How do you handle it? My mom is now is a safe good rehab, so why do I feel like I need to be there everyday?

Oh good! That's how it's supposed to be! This sounds like a much better situation. Make sure that your concerns about mom's pain are being heard by the folks who can write scripts, either the Nurse Practitioner or Doctor. Get the social worker involved. Don't be shy about asking for a consultation with a pain management specialist.

Another thing that i wished id known earlier in this journey...if mom is disabled in any way, send her to doctor appointments via medical transport, i.e. an ambulette. You meet her at the appointment. You use mom's funds to pay for this. Sometimes there is insurance coverage usually not. For the one or two out of the facility appointments mom has had each year, it's been a Godsend!

Babalou, thank you. She left the hospital yesterday afternoon and at the new rehab that took her in at 9pm before she went to the ER. It is not as "pretty", but the staff is excellent. Technically this is her first official day there the way things worked out. I've already had a meeting with social services, nursing, OT, and PT that lasted a little over an hour. My mom was at the other rehab for two weeks and never had one meeting with anyone except conversations when I sought out the nurses or case manager. I'm praying that she is in the way to recovery. She has lost 13 lbs. as she doesn't want to eat. I can understand not wanting to eat with so much pain, but she has to keep her strength and she is diabetic. I really liked the nurse who is caring for her, so my initial thought is this place is better. The staff has very little turn over and all the residents were out and about, not just in a bed.

She's still in the hospital or at rehab? Go to the director of nursing and social worker jointly and ask how you can get your mother effective pain relief.

UPDATE: it has been very tough since my mom fell. Long story short, they waited two weeks before doing an MRI, even though my mom was getting worse. If only I knew then what I now know!! They found five compression fractures. Three old and two new (L3 and L4), which were very bad. The original rehab moved my mom at 9:00 pm at night to another rehab because they said Medicare wouldn't pay after two weeks. My sweet mom has dementia (and many other issues). Thank god one of my siblings was with her. The next day we went to the ER from the new rehab from 10:00 am to 7:00 pm waiting for her to be operated on or admitted. She is diabetic and had no food! The next day they performed kyphoplasty to fix only the two new fractures. She was in the hospital for four days. She's still in terrible pain. When will all this pain go away? It's so awful watching your loved moan in pain and not to be able to do anything. She is tough as nails, way tougher than me, so I can't even imagine what she is going through. Will this get better for her? When?

Littlemisskitty, thank you. She is still in terrible, unbearable pain. She's going to the orthopedic doctor today and I'm asking about the cement. I'm glad to hear other seniors have had it work successfully. This is so awful, it just breaks my heart.

My grandma broke her back and they did a shot of cement into her back which immediately took the pain away. She suffered for two weeks before they could schedule her for the shot and that was the longest two weeks in my life up to that point (the neck was worse as they didn't do anything just let her heal naturally but the rehab had her so high on drugs I'm guessing it was worse on me than it was on her). See if she's eligible for the shot. If she isn't nerve blockers as mentioned above do wonders. My grandma receives them for her neck since she broke it years ago and it never quite stopped hurting her. Also a tens unit if she can. Not sure how healed you have to be to use one of those. My grandma uses that after her healing since her neck still continues to hurt her. She loved it and wanted to have it on a few times a day which they said was ok (that was before the nerve blocker). Now she doesn't need it as much.

pam stegman ,
head nurse ?
just say what you mean - the one with the dirty knees ..
people are so damm pretentious .
its annoying at times ..

It's crap about the level of pain meds. They can give more and do more - I went through this ten years ago with my son in the hospital. You may have to get aggressive and throw a fit. Be sure you are talking directly to the doctor though - nurses are following his orders.

Sophe509, thanks for the reply. Your advise is very helpful and I'm writing these, and the others, down in my book to ask tomorrow when I'm there. Thank you all!

Agecare, you might also check when the doctor comes on rounds again, if she has been evaluated for other diagnoses, more than just compression fracture going on. Maybe a thyroid or who knows, but a thorough medical workup? I can imagine for sure she's in a *lot* of pain, but sometimes also a second medical issue complicates things, like: cancer, or terrible fear, or excessive anxiety, or disorientation from dementia on top of the pain. If the doctor is not adequately addressing the pain issue, ask (insist) on a consult with a pain specialist or anesthesiologist or second board certified orthopedist...if that doesn't help, go to the patient advocate or ombudsman at the facility and tell them about this problem. Just telling you "too bad so sad" is not reasonable. They need to *work* to get her more comfortable and you need to push them to do so if they don't do it on their own. Or find another place for her. I've been down the same road with my dear Aunt; she had a complex procedure and was in terrible pain. I raised H3ll w hospital administration (after begging the doctor and unit staff) until they worked several different methods to get it under control.

Plus, talk to your own doctor about how worried you are to see if s/he has any help for you, too. If you become incapacitated, you can't be of any help to your Mom, so take care of yourself first. Take care...

Babalou, that is a good idea. When I was rubbing her legs I could feel a real big bruise on her upper leg. I assumed that was the side she must have fallen on, but maybe there is something else going on.

AngieJoy, I will ask about that. They seem to be real strict. She can only have Tylenol 3x daily and that is not a narcotic.

Thank you all for your feedback. I really appreciate it.

Are you there when the doctor does rounds?. You want to make sure that mom is not minimizing the pain for the doctor. Lot's of patients do this.

I don't know whether or not this would be a good option for your mom, but there are IV pain meds that are not narcotics. I needed to drive myself home after an ER visit last year, so I couldn't have a narcotic, and they gave me a non-narcotic pain med via IV. Also, would you be able to discuss the dosage of the narcotic pain med with her doctor (not just with the staff at the nursing home)? When my dad fractured his tailbone, he was in excruciating pain, and he was supposed to take only half of a 5-milligram pain pill. That didn't do anything much to alleviate the pain. We talked to his doctor, and they ended up prescribing a 10-milligram pill, which helped a great deal.

You may want to have them check again for other fractures. My mom had a broken hip that wasn't picked up for several days....

Pamstegma, I've asked about giving her something else or more, they said she is on the maximum amount allowed due to them being narcotics. I'll ask about the injection though. She hasn't had that. Thank you. They also don't want her laying flat all day because she will never be able to walk again. They have her doing PT and OT. I wonder if this is hurting more than helping at this point.

Babalou, yes she has two of them on. Nothing is helping her. It's so awful, she is physically shaking from the pain and she is super tough.

See the head nurse and lobby for better pain meds. The bigger problem is preventing a repeat. They will probably have to lower the bed all the way down to keep her from repeating the fall. Ask for injections of nerve blocking agents to ease the pain.

Can they use local pain patches? They've worked amazingly well on my mom's compression fractures.