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dbcollins Asked January 2020

Mother admitted to hospital, what do I do?

With type A flu and uti and is showing signs of delirium , confusion, and agitation, and is combative and argumentative to the hospital staff. She has lost 5 lbs in 10 days, is frail and so weak could not get up from bed to the bed side toilet the night she finally let me call 911.
A little background on her...she has been difficult at times throughout my life, and as she ages (83) continues to alternate between irritable and depressed and then calm, sweet, and content. When she has been irritable and hurtful to me and her husband (who is only 68) she will turn within 15 minutes and say she's sorry and "I love you" repeatedly. She has shown some signs of dementia (asks the same question repeatedly in a short time, calls me numerous time in am hour to say the same thing, etc) but then remembers where I put her insurance cards when I couldn't. She is on oxygen (set at 3) 24/7 and has restrictive lung disease with asthmatic tendancies. She was in in the hospital for double pneumonia 8 months ago.
I am an only child and have taken care of her (in one way or another) all my life. We have a codepdent type of relationship.
All of this to ask for comments and outcomes from anyone who has been in a similar situation. The hospital seems to think her mental state and combativenes is UTI related, but has no idea if it will change back after treatment.
I am at a loss as to what to do. She will not talk about rehab and becomes mad at me when I suggest it. What do I do if she improves with the illness symptoms and is discharged. Neither I or her husband can take care of her 24/7 if they just release when UTI and flu are better.
I appreciate any information, advice or suggestions.

AlvaDeer Feb 2020
OK, clearly Mom needs evaluation, but with a UTI now is NOT the time to do mental evaluations. They need to be scheduled for when the UTI is gone. Yes, the UTI can cause this. Please get her on D-Mannose, supplement is once a day capsule. I use Source Natural and get on amazon 120 capsules for about 30.00. Keeps bacteria off the bladder wall. Write a personal message if you want to know more.
Now, contact social worker at hosptial. Tell her Mom really needs evaluation and if there is a serious dementia you will NOT be caring for her in the home and she will need placement. So that she is on notice. She, if they will keep her the 5 days, needs rehab. It isn't a matter of telling her or her telling you anything. It is doctors orders and they will swoop in with ambulance stretcher and take her there. It is time to know that Mom cannot in these circumstances be the boss. She is DEPENDENT on you and it needs to be clear that while she is dependent on you you will need to have a say. Or she will need to move into care.
The social worker needs now to help explain POA for health care and possibly financial, and most of all to get the health care in place so condition will be discussed with you.
Get all the help you can while she is in the hospital and start with the social worker. Tell her what you told us. GOOD LUCK!

JoAnn29 Feb 2020
Is the husbands age a misprint. If not, unless he has health problems 68 is not old and should be able to care for Mom with some help. I agree, if rehab is suggested, have her go. The effects of a UTI can last for a while so hold off on any eval. Pnemonia will have a Dementia type effect too.
dbcollins Feb 2020
Thanks for the reply. Yes he is 68. He does have some health issues, but has been working part time for a year. Mostly due to financial need. Think that contributed to my Mom's further decline. She stayed in the bed while he was working. They have only been married since 2013. Since I am an only child and have taken care of her in one way or another, I have continued to. He has not contributed financially since they married but has taken care of all the household needs since she has gotten really down.

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AnnReid Feb 2020
97yroldmom You are of course absolutely correct. I should have made myself more clear in indicating that the rehab setting AFTER the hospital discharge, would be the setting where a cognitive assessment could yield helpful info.

Thank you for addressing my omission!

AnnReid Feb 2020
For your help in planning for her future, request that she receive a cognitive evaluation given by a specialist in geriatric patients.

If she is found to be cognitively intact, you’ll have an objective reason for waiting out her treatments in the rehab facility to determine how well she recovers.

If she is diagnosed as having symptoms which may be dementia, you will know that her confusion and temperamental conduct will need to be addressed as her dementia progresses.

The evaluation done on our LO cost $300, and the brief statement of her situation was very helpful while planning for her best possible future.
97yroldmom Feb 2020
Gently suggesting that with hospital delirium and confusion from a UTI, now would NOT be the time for a cognitive exam. Perhaps on a follow up visit from rehab. So if her husband gets push back on doing that now, it’s probably best to save the test until she gets better.
Geaton777 Feb 2020
I'm sorry for all the stress you're experiencing. With the right antibiotic, your mom's UTI should clear up and so should her confusion and maybe other symptoms. Being in the hospital is the right place for being treated for flu, hopefully it doesn't turn into pneumonia.

The main issue is her husband (not you) being overwhelmed by the thought of her continued care. Her husband is responsible for her care, if he has full cognitive abilities. Does he? It makes no sense to have 2 (or more) people orbiting around your mom. Does she have the financial means to have some in-home care? If not he can contact social services to see if they quality for any in-home services to provide some relief. As for your admitted co-dependent relationship, I'm not sure what to say to someone who probably will struggle to enact any of these suggestions because of that dysfunction. Your profile says you're married...your husband has priority over your mother. He needs you to be whole and healthy (and you need that for yourself). What are you willing to do to help find permanent care for your mom that doesn't come from you?
dbcollins Feb 2020
First...thank you for taking the time to reply. Then...wow...I could really use someone like you in my life!
I guess there are others with similar stories to mine, but for so many years I thought I was the only one with a mom like mine. The codependent part from above is more of her dependency on me and me allowing it to continue instead of a true codependent relationship. Growing up as an only child with a dad that spent a lot of his free time in pool halls, it allowed my mom to start being dependant on me for companionship. It wasn't until I was in my 30's and in therapy that I realized it was a form of emotional abuse. I loved my dad and he was always supportive of me, but wasn't invested in their marriage. I was too involved in trying to help them stay together and trying to make my mom happy than I ever should have been.
Then I made a huge mistake in trying to "take care" of them again. When I got married we built a duplex and lived in one side with them in the other. By this time my dad had a lot of health issues and once again I was trying to take care of things and make my mom happy. My husband agreed with it, even though he put down the down payment and then we split the payments. His only real comment was that we would be there for a few years then put our side up for rent as an investment. Well, time has a way of moving really fast and many things happened along the way, and here we are still there 35 years later. He was a truck driver and was gone for a week or so often. This unfortunately allowed me to continue spending too much time with my mom.
She has always been very easily agitated, depressed and for some reason I continued to believe I was the only is that could make things better. My therapist called her symptoms, (as I explained them because of course my mom would never consent to anything wrong with her), Borderline Personality.
My dad's health continued to declined until it became necessary (to keep any peace) for him to go to an assisted living facility. He died a few years later and after dating several men met Joe. For what ever reason, (probably being too much in debt and needing a home being at least 50%) he married her...him being 15 years younger. I know you will find that they continued to live beside me unbelievable, but true.
That was in 2013. Since then... the short version is...My husband is now on disability, Joe went on disability shortly after they married, and my mom's health started to deteriorate. Joe has taken care of most everything...fixing food, helping her to get around the house,etc, but has never contributed financially. Last year he admitted to a gambling problem and took a part time job to try to get out of debt. The 20 hour job has turned into 30 to 35 and My mom spent most to all of her time in the bed when he was gone. She is very afraid of falling and thought she would be safer there. Since I am a kindergarten teacher and gone during the day, she had no other outlet. She never developed long lasting friendships due to her "issues" and the longer she stayed in bed the less mobile she became.
Last spring she had double pneumonia, recovered mostly, but started showing some signs of dementia. Nothing dramatic, mostly calling me and Joe multiple times staying the same things, asking the same question over and not remembering it...etc.
Now this new issue has developed. She went kicking and screaming (literally) to the hospital. Yesterday she seemed better and the case manager is discussing discharge.
I know this has been waaay long. The honesty in your response once again gave me a jolt I needed. I know that I have put my mom first my entire life...even before my own happiness and well being. I have resentment over things I allowed her to ruin or choices I made trying to make her happy. I know this is totally on me. I should have changed long ago. Now at 62 and her 83 it is even more difficult. My head tells me one thing then my heart...
97yroldmom Feb 2020
You have to wait to see if she recovers mentally from the UTI. As for Rehab, don’t give her a choice. Dr said for you to go. Call it step down care or something else besides rehab. She has to be able to walk, transfer or whatever stage you can get her to before coming home. Is her husband in charge of her care? He may have to make the decisions. Let him know you are NOT on board to be her caretaker and he will need to stand firm. Good luck.

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