My mom is 79 years old, and she is very difficult to care for. She doesn't like doctors, and she hates hospitals even more.
About 6 months ago, at her last doctor visit for a check-up, her blood work revealed her glucose was 521. The doctor told me to take her to ER to get her glucose under control, but she doesn't want to go.
What am I supposed to do??? She does everything her doctor told her not to do. When I take her grocery shopping, if I don't buy what she wants, she throws a fit, and what she wants are foods her doctor told her not to eat.
Now, earlier today she had vaginal bleeding she claimed she never had before, which I find very hard to believe, as I saw her bloody underwear in her bathroom sink. Google recommends I take her to ER, but she'd rather go to the doctor first, so now we have to wait until Monday, and even then, I'm not sure her doctor will be available to see her right away. I just don't know what to do...
Any recommendations?
A blood sugar level of 521 is a huge emergency. You had to put her in the car to drive her home, so why didn't you drive to the emergency room instead? If a doctor tells you in the office to go to the ER, you go, you don't just wait six months.
And yes, vaginal bleeding in a woman her age is serious.
Regarding groceries, instead of taking her to the store and fighting, let her order her own groceries and have them delivered. They they are not your problem anymore.
I find myself with a lot of questions regarding your situation. I am wondering what conditions, exactly, your mother has and what, exactly, you are doing as her caregiver. Are there things she needs help with? Or are you just living with her because she is older and not in good health in general?
Has she always been stubborn and resisted doctors advice? hospitals? made poor health choices?
Do you have POA for her?
There are so many factors that could make a difference in how you handle this situation. Yes, you could have an ambulance take her to the ER, and refuse to have her released to her home, claiming she is unsafe. She would then likely be transferred to a skilled nursing facility.
If her issues are treated successfully and she is stable enough to go home and is not mentally deficient, then she is free to go home and live with her own unhealthy choices. There is not much you can do to change that, and it will only frustrate you (and her) if you try to control her diet.
You are already very frustrated with her behavior. Its like dealing with a spoiled child. If you have POA, and it has been invoked because she is deemed incompetent to make her own decisions, then you call the shots and have her treated as you think is appropriate. Until that happens, you can only wait until an emergency forces her into the hospital.
Learn to let go. Her resistance to you is causing you undue stress. It's not worth arguing with her over every little thing you want her to do and she refuses to do.
But, you don't have to enable her. Don't go shopping with her if it's contentious. Let her figure out another way to get what she wants. Don't give her an opportunity to have a tantrum. When she does, simply turn around and walk away. Just like a child, she does it because it works.
You may need to step back and stop doing so much for her. That's why I asked what exactly she needs your help with. Are you simply enabling her, making her life easy? That gives her a false sense that she is just fine. She may need to struggle and fail a bit to gain an understanding of her reality.
* She could be
- depressed (likely)
- mad, angry, 'tired of living' and doesn't care (depression)
It is important to consider her 'quality of life.' If she is 'so' intent on self-destructive behavior, so miserable living as she is ... then you need to consider these 'factors' in how you proceed. In other words, do you want to keep her going as she is - if she is that miserable? And this depends on if you can actually 'do anything' to improve her condition, which you may not be able to do.
Often the best you can do is understand your limits, legal boundaries, and then decide to let go and let nature. take its course. Stop fighting ... stop battling...
"If" you decide to keep fighting for her to live as quality of life as is possible (which seems somewhat futile now), you may need to tell her she is going out to lunch or something she'd like to do ... and then take her to an MD appt you've already made.
Decide on what your limits are.
Get her medically assessed for dementia and/or 'unable to care for herself' so you can get legal authority to make decisions on her behalf.
It is a GIVEN that if you start making decisions for her ... she will fight you tooth and nail. You must be prepared for these situations / outbursts. You need to not let them bother you... you expect them ... you let her get the energy out ... you (may) say "I understand ... you'd rather be home." Underneath her ranting is fear ... of the unknown, of losing her independence. She is 'acting out' the only way she knows how. It is up to you to decide how you interact with 'it' - you want to maintain your equanimity (inner balance) as much as possible.
Often when expecting these behaviors, you can more so decide, in advance, how you will handle them.
Take care of yourself first.
Realize you can do so much and then need to let go. Get into therapy.
If you continue to 'fight' to keep her alive (against her will), you will lose yourself too (emotionally, psychologically, mentally, physically). You will exhaust yourself.
Gena / Touch Matters
Your Mom isn't behaving in a rational manner.
Does your mother have other symptoms that may indicate dementia?
If your mom lives with you, and if you are her POA, at some point you will have to get her into care via ambulance.
Clearly your mom's blood sugars are indicative of someone with severe diabetes. Blood sugars this out of control would lead to confusion, eventually a coma. They indicate a need for a call to ambulance service to ER.
To live as long as she has lived, with that so very out of control and poor diet, is somewhat a miracle. IF she doesn't have dementia, and does choose this was of life I would tell her you will not enable it by purchasing things/shopping for her that may kill her. As to her tantrums? So what! THEY at least won't kill her.
At some point we all die. She's lived a long life. And a long life given she's this diabetic. If she is not suffering dementia, you may need to understand you cannot control her.
Light vaginal bleed MUST be checked out, but it isn't an ER thing unless blood loss is heavy. It is an issue for the MD to check.
I am sorry. Not everything can be fixed. She may require management, but that cannot be done other than legally, and if she doesn't fit the legal requirements, then this will go to your getting "the call" and finding that she is either hospitalized or you are speaking with the coroner.
If the hospital, contact Social Services and speak with them about options for any better management they can think of.
I am so sorry and I wish you luck.
Therefore, a strategy is to call 911 and tell them you think she has an untreated UTI and has therefore not been taking care of herself. Do not tell the EMTs you think she has dementia because that in itself is not a medical emergency and they might not come. She needs to be made to go to get treated and possibly held as an "unsafe discharge" since she's totally neglecting herself and is resisting your care.
If you are her PoA then bring all that paperwork to the ER with you. Make sure to tell the discharge planner that she's a 100% "unsafe discharge". Then ask to talk to a hospital social worker about discharging her directly into a facility. If you are not her PoA (and she doesn't have one) then she may be on track for a court-assigned 3rd party legal guardian.
Do not take her back home. Try to intercept people she might call to bring her home, explaining the situation to them. If you aren't her PoA then you really have no power in this situation and you'll have to wait for the chips to fall (ie a more severe medical problem that causes APS to remove her from her home and get her a guardian faster).
I'm so sorry for this distressing situation. The dichotomy is that, if she doesn't have a PoA, the more anyone intervenes to help her, the more her actual solution is delayed.
May you receive clarity and wisdom and peace in your heart on this journey.
I'm sure they will be more than willing to oblige.
I think sometimes if the problem doesn’t cause extreme pain we think we can wait it out, see if it goes away.
Since she already needs to go to the ER due to the blood sugar, I would take her now. Why wait?
She could be feeling better by tomorrow.