I'm a caregiver for my mother. She was recently discharged from the hospital because of an infection in her lungs. Before she went to the hospital she was able to get around with her walker, when she came home she's gotten worse. Won't listen, stubborn, we also noticed she has a bad bed sore on her backside. Her doctor as well as a nurse has told her as well as many others about sitting down. She is not listening as I am reaching out. She's in that chair, she will not listen. Are there any suggestions on what I can do? I've been doing this for 7 yrs with no help from family. I'm way past done with being her caregiver, my stress level is at an all time high.
7 Answers
Helpful Newest
First Oldest
First
She should not have been released from the hospital with a pressure sore without in home care being set up. You need a woundcare nurse to look at it and dress it. She may show you how to do it and what to look for. When down at the base of the spine, very hard to heal because not much tissue there. Roho cushions ate one of the best but also expensive. Like at least $400. They are pockets of air. You blow them up to your comfort.
I agree, may be time to place Mom. They do become 24/7 care and only a Saint would have the patience to do that much caring.
My mother's first recognizable symptoms were repetition of statements and questions, over and over and if there was a "reminder", it could go on for days! She was often like a record with a scratch on it - same thing over and over until you could tap it past the scratch! Short term memory pretty much shot, but...
I got a Boogie Board LCD to assist when she wasn't hearing well, even with her hearing aid. She quickly learned how to push the button and clear the screen AND retained that knowledge!
Another memory that stuck around was regarding treatment for a Basal Cell on her face. She'd had treatment for some others before, when living alone (funny that I asked several times about the first one, looked like a scab on her lip, but she brushed it off. The doc treating her Mac Deg told her she should get it looked at and off she went! By then there was another on the side of her nose and they had to graft skin from near her ear to fix it. Sure, don't listen to us!) But, because of her age and the dementia and the fact they wouldn't allow me to stay with her for the MOHS surgery, he tried a punch biopsy instead. They check the piece and can see they didn't get all the edges, so we had to go back for another (it was relatively small, and they tend to grow slow, but the location was bad.) It had been several months, so when I arrived to take her to the new appt and said why, she said "Didn't they already take care of that?" So clearly she DID remember that!
The biopsy was a bit more intensive, so it might lend itself to some part of memory, but the LCD button?
Sores are nothing to really fluff off. Mom "bruised" her leg just before the planned move to MC. Her neighbor told me about it. Mom never said a word, and I was not in any habit of checking her body for anything, so we could have missed this. It wasn't a bruise (at least not by then) and she developed cellulitis, which could have killed her. The timing was fortuitous as she didn't think anything of it and wouldn't have said boo. She wasn't close enough for daily checks and sometimes wouldn't hear the phone ring. It took 2 rounds of antibiotics, leg stocking and wound cleaning/dressing to clear that up - at least several weeks. Thankfully most of the care was done in MC (OB was the first one to change dressing and clean it. Just after he finished, she ripped the bandage off and said she needed a new one! NO thank you!!!)
I should think you could ask the doctor for a visiting nurse, who can come daily to check it, change dressing, treat it or whatever needs to be done. Some medical equipment, such as the pressure pillow, Medicare will cover, either to buy or rent, from a qualified place, if the doctor orders it. These may be your best options, since she won't listen to you or comply. Often people will respond better to an "outsider" such as a nurse.
The following link is NOT Medicare, but covers a lot about this situation and what help you might be able to get with doctor approval:
https://www.medicare.org/articles/does-medicare-cover-bed-sores/
ADVERTISEMENT
Hire some homecare too if she doesn't have any. Start small. One aide who comes for a couple of hours at a time. Many times the senior behaves better and is less "stubborn" with a stranger then they are with family.
You have a hard situation which will get harder with time. While your mother is still home and lucid enough to understand, make it known to her that you will put her in a nursing home if she won't accept help and do what she needs to get better.
I'm thinking if I was elderly, had a recent lung infection, maybe my memory is not so sharp & I am tired - I am going to sit in my chair - a lot. Not much else I could really do...
But I'm also thinking sitting is much better for her breathing than lying in bed all day.
Regular pressure relief, change of position, short walks would be good for the bedsore. Encorage (use tricks!) as best you can.
A good cushion can be frightening expensive, but can be hired. Ask Wound Nurse service or Doctor (whoever is dressing the wound) for hire company. They will advice type of cushion ie gel or ROHO.
Are you your mom's PoA? Is anyone her PoA If so, and she has a medical diagnosis of cognitive/memory impairment then you can check the document to see when the legal authority to act on her behalf is activated. At this point you can decide that a good facility is the best solution for both of you. You can transition her even if she doesn't want to. If money is an issue, you can apply for Medicaid on her behalf. You can find the app at the Dept of Human Services website for your county, usually in the Services for Elderly subtopics. In the meantime you can contact social services to see if she qualifies for any in-home services (like light housekeeping, meal prep and such). If she doesn't have a medical diagnosis of dementia then if she goes back to the hospital to get her sores treated you can ask her doctor to perform the tests while there.
If you are not her PoA (and no one is), then if she goes back to the hospital because of her pressure sores, this is an opportunity to discuss with the medical staff (or hospital social worker) about transitioning her directly into a facility because it would be an "unsafe discharge" (use those exact words). Don't let the staff pressure you into taking her back to live with you again because they most likely will try hard.
I hope you are able to work it out. May you gain peace in your heart and a solution for the both of you.
Your mother may be unable to thrive at this point. You may need to consider LTC now. I am so sorry, but inevitably, for almost all of us, it comes down to our human limitations, and their failure to thrive.
https://www.healthline.com/health/stages-of-pressure-ulcers#stages-and-treatment
Wishing you the best of luck getting through to her. If she has dementia/Alzheimer's as your profile says, that may be why you're seeing such a level of stubbornness. Have you thought about placing her in a Skilled Nursing Facility (with Medicaid) where she can be looked after 24/7? That may be a good option for you at this stage of the game.