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Hmason Asked February 2018

Mom doesn't want to get out of bed, could this be a sign of the big decline going forward?

My mom with dementia fell last month at her AL and broke her hip. She had surgery and was sent to rehab so she could return to her AL. Once at rehab (which was renowned for getting patients up and out quickly) Mom had a different agenda! She was quite comfortable in her bed, thank you very much! She refused to go to/participate in physical therapy. Her medicare ran out after a week & they didn't take her medicaid (we live on the border of NH & VT) so we had to find a place for her STAT. Unfortunately, because she refused to get up-she couldn't go back to her AL (which breaks my heart-she had her own room w/ a bathroom and all the residents and staff ADORED her). We had to face the fact that she was beyond level 1 AL now and should get nursing home care. We grabbed the first bed we could get at a county nursing home 45 mins away w/ the caveat that we are on a waiting list with 2 local ones with reputable memory care units. Mom still wants to stay in bed all day (stubborn Vermonter) and is unable to tell the nurses when she needs to go to the bathroom (I think she got too used to the catheter in the hospital). My question is, is there hope that the nursing home would be able to get her back up and moving around? Could this be a sign of the big decline going forward?

Isthisrealyreal Feb 2018
My dad has wonky pain receptors, so asking does not always give you good info. He fell flat on his face, took 20 minutes to get up, huge black eye, nose punctured 3 places, knee swollen both forearms purple from bruising, nope didn't hurt at all. It hurt to look at it. Just know those things change as we age so she could have something going on that she can't articulate so just says no.

Prepare for the worse and expect the best, that's how I go from day to day with my dad.

Best of luck getting to the bottom of what's going on.

BarbBrooklyn Feb 2018
To answer your original question, my mom's NH got her up and walking several times after falls, pneumonia and other setbacks. But the main thing right now is to figure out what is going on; yes, I think a followup with either neurology or psychiatry could be a good plan.

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Hmason Feb 2018
BarbBrooklyn-thanks for your response! The director at her AL noticed a small decline when she fell and thought that she may have had a UTI. She started to get treated in the hospital for the UTI. She's been prone to UTI's in the past so it wasn't a surprise and I warned her current nurse at the nursing home to be on the lookout for those especially with her now wearing Depends.
She's been seeing a neurologist on a regular basis-wondering if she needs a follow up after this trauma?
I feel like she's scared to get up and fall and that she's getting depressed and confused with all the setting changes: hospital to rehab to the nursing home. We ask her if she's in any pain and she says no.

BarbBrooklyn Feb 2018
Hanson, sometimes our elders don't fall and break a hip.

Somethings happens. Their hip breaks and so they fall. Or they have a stroke and they fall.

It sounds as though their might be something other than stubbornness going on. Has she been examined by a neurologist or psychiatrist? Anyone done an extensive workup for dementia (I don't mean just a quick memory test. Needs to include an assessment of her reasoning abikities).

If she is unable to tell nurses she needs to pee, is it also possible she can't tell them she's in pain? Or other things?

Bring in a doctor who can determine was is going on brainwise and you'll be able to make a better plan.

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