My mother is in a NH, post-stroke and with vascular dementia. She is wheelchair-bound and needs total assistance with toileting. She also thinks she needs to go to the bathroom extremely frequently. Her cognition has worsened rapidly in recent months and she now seems to have forgotten how to call for help (she has a remote with a call button but does not recognize it; a hand-held bell also did not help). She will sometimes yell loudly when she needs something but she seems to be forgetting how to do that as well. The strange thing is that she still (sometimes) remembers how to call me and wants me to come to the NH to help with whatever she needs. No amount of "coaching" by me while we are on the phone helps. She just gets panicky. Any suggestions for how to deal with this? I sometimes just end up calling the nurses' station myself (they are not easy to reach though) and asking them to go into her room, but that cannot be the solution all the time. Thanks.
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Which is why the care plan HAS to include getting her up, dressed, and OUT of her room every morning where the staff can see her. Then she has a cue to ask for help and/or the staff ask HER every 2 hours about going to the bathroom. If shes toileted every 2 hours while wearing briefs, that should do the trick.
If OCD and panic set in regularly, ask her PCP about a mild sedative like Ativan .25mgs. That can be VERY useful in getting her off the kick of "having" to use the toilet constantly.
I'd also consider having mom evaluated for hospice if she continues to decline, as she can forget how to swallow at some point. My mother was in the same position as yours is now. Wheelchair bound and insistent on getting on and off the toilet herself bc she thought she could. She fell 95x from thinking she could walk and trying to get up from the wheelchair, toilet or bed. She fell 45x while living in Memory Care, and 50x while living in regular AL due to sheer stubbornness. I couldn't afford to hire her a companion, nor do I think she wanted one. Being that the girls got her up and dressed, cleaned up and wheeled into the activity room every day, that gave her plenty of others to canoodle with AND caregivers in constant view to see to her needs.
Wishing you the best of luck with a difficult situation
One other note: she had been on Ativan for quite a while and her anxiety was through the roof. Her geriatric psychiatrist kept fiddling with the dosage and nothing helped. So he just weaned her off of it (while increasing her Seroquel dosage and putting her on a low dose of depakote) and all of the sudden she is much calmer. One of her nurses said that she has seen this with other residents -- that the Ativan can have the opposite, rebound effect in some people. Who knew? So, while she still cannot really remember how to ask for help, the panic she had felt before seems to have dissipated - at least for now. Hoping the information about Ativan can help others.