Mother has been bedridden since a fall in mid-2011. Her (female) doctor had her put in a SNF (skilled nursing facility), but the insurance ran out before she was able to complete any kind of rehab. Unless the MD changes her mind, mom can't qualify for covered home-care unless she goes back into a (likely different) SNF for another cycle, which she doesn't want. Finding appropriate people to take care of her sanitary needs is rapidly reaching a crisis, not so much cost as availability. Nobody else in the family has thought to tell the MD what's been going on, and I'm fearful of reprisals if I try to do so. Dad, I and my oldest brother all have our own health issues, and none of us want to handle the sanitary part. Only my youngest brother might have the guts to contact the MD, but he isn't tipping his hand.
Again, dad feels mom's MD should stop trying to prolong the agony, and either seriously make the move to make mom go back to a skilled nursing facility, or change her mind, declare that mom's condition will not improve, and force their insurance to cover her home-care needs so that dad will no longer have the burden of having to unofficially pay home health aides to come here to take care of mom.
Mom feels she will not improve; dad wants to hope that she can improve.
Hope this helps.
I would say that if you have a Hoyer lift, Mom's doctor is aware that she has not recovered. Does Mom have a case manager, perhaps assigned by her clinic or insurance company? That would be a person to talk to about your concerns.
Or, as Eddie and others have said, talk to her doctor, if nothing else for reassurance for yourself.
Mom does have a bedpan, and the aides take care of that.
She also has a wheelchair and a Hoyer lift, and three times a week an aide transfers her to and from the chair with the lift.
I am deeply, DEEPLY sorry for having left those things out. As I said earlier, I, like mom, dad, and other family members, have my own health issues.
I'm trying to picture myself cleaning my own mother up. Not happening. I'd probably cry all the way through, and so would she from sheer embarrassment.
How about this. How about restricting yourself to using the bathroom three times a day? Every day.
Better yet, wear disposables and only change them 3 times a day.
OMG
She is not incontinent, you say. She doesn't get out of bed, you say. This doesn't make any sense, I say.
I don't care what your father's issues are. Take care of your mother!!!
She uses briefs along with Tena/Serenity pads, and there is an underpad on the bed which an aide, or brother #4's housemate, changes periodically.
The crisis is that our relationship with would-be aides is tenuous. One of them just decided to go to a nearby college to become a full-fledged nurse, and another nurse the family knows stepped in barely in time to help. If we go to an agency to find health aides, they could charge dad twice what he has agreed to pay the current ones.
Dad, like I said before, has his own issues. He's of the belief that mom's MD is just falling down on her job. His own MD is in the same office as mom's, so I'm thinking that dad could be of the belief that they can/should work together to address both their needs. I'm sure he's brought up the issue the few times he's been to his MD, but what comes of it is up to those doctors.
I'm going to bed now.
Your mother is bedridden. Who gets her up to go to the bathroom? Is that limited to 3 times per day?
Your original post mentioned reaching a "crisis" stage with "sanitary" issues, and now you say this is just occasional "leakage." Which is it?
I'm really worried about your poor mom, when no one in her life will stand up to her husband and get her the help she needs. Sounds like her sons are more concerned with not rocking the boat than seeing that she gets the care she needs.
Have you at least talked to your dad about these issues?
The aides are only here for no more than a half-hour three times a day, and they do a very good job to ensure that mom doesn't need to be changed more often; she is not seriously incontinent, just a occasional minor urinary leakage.
I can tell you that mom has spoken multiple times with her MD since your posts, mainly to work out the details of changing her blood-pressure medicine, but this may be the catalyst that gets her, or one of us, to get her involved with the topics we've addressed here. I hope so.
You don't say how old your parents are or whether you are fifteen or forty-five. I don't know which person in the household is best suited to contact the doctor, but somebody needs to take on that responsibility. Ask for a home-care needs assessment. The professional who comes out and evaluates the situation may recommend some additional rehab, either in-home or in a facility. Other in-home services may be recommended.
How many hours per day are the aides in your home? Who deals with changing her disposable underwear when the aides are not there? This absolutely must be attended to promptly or you risk sores and the dreaded urinary tract infections.
Maybe mom's condition will improve. But she needs care right now, both to help it improve and to meet her needs until the improvement happens.
Talking about "reprisals" and unwillingness to handle toileting issues and "tipping his hand" -- this all sounds pretty dysfunctional to me. I hope it isn't, and I'm just reacting to some word choices. But if the family dynamics are such that nobody can get it together enough to see that Mother's needs are met, then she should probably be in a nursing home.
As to sanitary, the aides dad has been dealing with of late change her briefs (without huge improvement in her lower-body movement she can not get to any toilet, not even a commode) and periodically bathe her.