We sold our own home and moved into the lower suite of my 85 year old mother-in-law's home 2 years ago to help her stay in the home as long as possible. Until this spring she was golfing, bowling and square dancing weekly, a social butterfly and a gorgeous lady. In May she went for a massage for an old back fracture and ended up with nerve damage. Since that time she has had back pain and has gone from the busy vibrant lady she was to housebound and not dressing or moving from the couch. She has had a difficult time getting any pain relief because she is on warfarin so she has on had Tylenol for pain. Physiotherapy has not helped. She is now waiting to get into a pain clinic but that is 4/to 6/weeks away. I finally demanded the doctor give her pain meds and he gave her a butrans patch 2 days ago so we are waiting for some relief from that. Our main concern is that she was told that she should be walking and perhaps swimming and.or using an exercise bike (which we have and we have gotten out for her) but this very previously active lady is now not moving AT ALL. If I don't go up to make her a piece of toast for breakfast and phones her 89 year old boyfriend and has him come and do it for her. So she is pretty much moving from her bed to the couch and back. She must be going to the washroom so I told my husband that if she can do that she should be able to get to the kitchen for toast, particularly if the doctor is saying she should be on an exercise bike and swimming! Am I being cruel? I make her supper and my husband takes it to her. She used to eat out with her boyfriend at least 4 times a week and lunch out with friends almost daily. That was only 3 months ago. The other day when I mentioned it to her she said she had been on one of the medications for her nerve pain (which just happened in May) "way longer than 4 months".). She just got it from the doctor in July. So now I'm beginning to wonder if she doesn't realize what state she is in in that living room day in and day out. She has a TV tray in front of her that is covered with stuff that I am continually trying to clean off but can't keep it clean. It is like trying to clean up after a toddler but this one doesn't move around. Tuesday shewas to go to physo and I went to get her 3 times and she was still sitting watching TV. Finally I had to say are you getting ready? And then she finally realized what time it was even though she has a huge clock right above the TV and I had been up 3 times and mentioned it. She is very strong willed. She complains all day about the pain but shoots down every idea and plan anyone has to help. We have a home TENS which she has been told would give her some relief but she won't use it. She won't let me open the curtains of air out the room which smells like urine. I feel like the few friends and family that do come to visit are probably judging my husband and I but she is very strong willed and set in her says and stubborn and doesn't realize that what she is doing is bad for her health and I believe will put her in a wheelchair in no time at all or worse. I think this thing is quickly going beyond us if I don't get some help. Who do we turn to? Her doctors? Elder care in the area? We live in Canada. My husband is going to talk to her boyfriend this evening and tell him to quit helping so much. She needs to get up, I think. Do you agree?
Pain changes everything. If it is excruciating to take a step, all the "tough love" in the world isn't going to help. If the pain could be managed better if it weren't for the blood thinner, think long and hard about dropping the blood thinner. Who cares about preventing a possible stroke in the future if you are in debilitating pain in the present?
Do everything you possibly can to address the pain.
And then consider the depression. It sounds like this poor woman has already tried several things and they did not work. Can you blame her for being discouraged, and for not wanting to get her hopes up again? Work on trying to convince her that, "Yes, the acupuncture didn't work. But SOMETHING is going to work and we have to keep trying until we find it. Maybe the tens unit will help." No scolding or ordering, please, but some empathetic coaxing.
It sounds to me like she needs and deserves some help. Could you offer to help her get ready for the day each morning? Help find something in her closet that would be easy to put on. Maybe even buy a bright mumu that would slip easily over her head. Or at the very least help her into a nice housecoat. It may seem to her too much effort and it won't help the pain, but psychologically we feel less like invalids when we are dressed. Then settle her on the couch or a chair where she is least uncomfortable. Set up a card table next to her. Make her toast. Serve her tea or coffee in the prettiest cup in the cupboard. Fuss over her. Comforting love may be far more appropriate in this situation than tough love.
Come back up at noon and heat her a bowl of soup. Make sure she has enough water to last the afternoon. Help her to the bathroom if she needs it. If it helps the pain, have her lean against the wall as she walks. Consider getting her a walker.
Encourage her gentleman friend to come over and play cards or watch movies with her -- to help get her mind off her pain. Ask him to rent some comedies if they like watching those. Ask her golfing and bowling friends to stop by. Square dancers are the friendliest people on the planet. Let the group leader know MIL could use some cheering up.
I understand that tough love is real love. I KNOW your motives are to keep her out of a wheelchair. But your message is "We don't really believe you about your pain. We believe the doctor that you should be able to walk!" I'd much rather hear "We are so sorry about this awful pain that is no fault of yours. We'll try to help you as much as we can. We love you. I'm trying to get you into the pain center sooner, and until then I'll help you get through the day."
And, BTW, walking or moving in water is MUCH less painful than on land. See if there is a rehab center or hospital in your area that offers water therapy. She would need a lot of help, probably, getting dressed afterward, but it could be very worthwhile. I took arthritis exercise in such a pool while therapy was going on. Sometimes the person had to be wheeled down the ramp and only gotten out of the wheelchair when they were submerged, but in the water they could do what the therapists wanted them to.
And I'd be a little careful about making a wheelchair sound like a terrible things that will happen if she doesn't cooperate. With or without her cooperation she may wind up in a wheelchair, and it may be the very best thing. Try not to make it sound like a punishment or a sign of failure.
Bless you and hubby for moving into the lower suit so that MIL could remain in her home. Bless you for caring and trying to do the right thing by her now. I hope what I've said hasn't sounded like criticism. I do admire your efforts and know that your heart is in the right place.
I have seen my mother and one sister in constant pain over long periods. It is not pretty! I have not experienced anything that severe myself, but the few bouts of pain I have had convince me that I want to feel loved, accepted in spite of my inability to do what I used to be able to do, a bit pampered, reassured that no one has given up and there are other things to try. The last thing I would have wanted when the pain caused the 45-second trip to my bathroom to take 10 excruciating minutes would be for someone to tell me I had to get my own breakfast.
I sincerely hope the pain can be managed eventually. Maybe MIL can go back to some of her old activities, but start preparing yourself mentally that that may not be possible. You and your husband's roles may change.
(And, wow!, you are good on that tiny keyboard!)
You also explain how little respect you have for her medical providers and why. Why are you torturing yourself trying to implement what these (in your words) "quacks" are telling you?
It is precisely because this lady "was golfing 18 holes twice a week, bowling in 2 leagues a week and square dancing every Thursday night," that for her to suddenly not be able to do anything is suggesting to me that something is drastically wrong. And besides that you describe her as fiercely independent. Such people do not suddenly decide they'd like some attention and fuss and moan about pain they don't have. They do not ask for someone to make them toast. They drag themselves to the kitchen just to prove they are still tough and independent.
Either she is having very legitimate pain problems or something has gone haywire in her brain, or both.
If you were going to insist she do something she doesn't want to do, I'd vote for getting her to a big-city medical center, to specialists who will actually examine her.
For your own sake there is nothing wrong with a little tough love. Tell her that what she is doing will result in her ending up in a nursing home because there is NO WAY you can care for her if she becomes wheelchair bound. It's hard watching our moms decline right before our eyes isn't it?
You might want to check out the thread started by dmanbro about his mother, www.agingcare.com/discussions/moms-stubbornness-is-confounding-to-me-184838.htm
Physical therapy didn't do squat for me.... finally doing "traction" worked... only two sessions and I was back to normal and since then rarely had any more back pain. Of course, each case is different, maybe traction won't work for your Mom, but it would be worth asking about it.
And if that is an option, tell Mom that the massive traction machine isn't what we saw on TV shows back in the 1970's, being in bed with weights hanging down. It's a nice small bed that you use for about 20 minutes for each session.
When you have someone in their 80's who has declining mental and physical abilities, I don't find that tough love or ultimatums are helpful. To me, it is requiring the patient to do something they simply are not capable of doing. Why add to their pressure? Pulling yourself up by your bootstraps may be fine for middle aged people, but for injured, sick seniors, it's just not fair, IMO.
Pain can cause a lot of symptoms, but I would watch your mom after she gets her pain under control to ensure that the pain is what is causing her mental decline. It could be something else that is causing this change in her.
She's on War far in for "just" artherosclerosis? Not a heart valve or some more serious cardiac issue? My impression (I am not a doctor, my husband has an artificial valve and has been on Coumadin for 10 years) is that there many other blood thinners that can be used for other applications. Is this doctor of hers very old, or very old school? It might be worthwhile getting some other opinions.
She most likely can't attach the TENS leads herself, and may not know how to work it. She is 85, after all. Just because she was fine before, an injjry and pain changes a person, and especially elderly.
I agree to try to get her into pain management faster if possible. Can her regular dr or clinic get her something until she gets in?
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