My mom has multiple fractures in her lower back from osteo and was supposedly going to get better with rest and time. We found out she had these back problems from her hospital stay in July 2022 when she had surgery to remove massive blood clots from her lungs. She almost died but the Mobile Help bracelet we got her saved her and got an ambulance there and her to the hospital. She is 89 years old. She also has two bad knees. She was recovering at home from the bad back since July 2022. We had an LPN staying with her at night so when she had to go to the bathroom or get up, she had assistance. Her house is a split level and doorways are small so moving around is difficult. She does have two chairlifts that move along the wall that she can sit on to get to each level of the house, but she needed a cane to get around. One night in late January 2023, the LPN left her alone and my mom fell and broke her hip trying to get to the bathroom. She had partial hip replacement surgery on Feb 3, 2023 and was moved to a Rehab Facility on Feb 7, 2023. Part of the problem is the LPN. I do not trust her but my mom really likes her and does not see what I see. I believe she has interests in her finances as she asked about them. But because my mom likes her, it will be difficult to get rid of her. Plus she's not through an agency. There's more to that, but I'm trying to keep this short. So now she is in a horrible Rehab that the LPN suggested and I wanted her to go to a much better one, but my mom would not listen to me. Now my mom hates it there (since day 1) and all she wants to do is go home and have this LPN take care of her. But my mom still cannot move out of bed on her own and it's been 10 days since the hip replacement surgery. Each day it's going to get harder. She cannot support herself even with a walker. And she holds in her pee/poop and does not go to the bathroom all day, which then makes her constipated which complicates things too. She will not listen to me but just keeps saying I want to go home. I have a meeting with her doctors on Wednesday to discuss her progress or lack thereof. I'm very curious as to what the doctors are going to say. She gets about 10 minutes of PT/OT a day. That's it. It takes about 20 minutes just to get her in a wheelchair so they can bring her to PT. My sister and I have POA but my mom still has her wits about her, but I see signs of decline. She repeats herself and forgets things. But she only listens to this LPN. It's driving me nuts. Why won't my mom listen to me. I'm trying to get her to a Rehab Facility that will really Rehab her so maybe she can get home. But I don't think that will happen. Before the blood clot surgery in July 2022, she was driving and going to her knitting club and doing things herself. But in October 2023 she got this LPN (that's another long story of how that happened) and now she only listens to this LPN. And the LPN is responsible for her falling. I don't understand it. I'm at my wit's end. Please help or give advice. I'd love to move her to a facility that will try to help her. Let me tell you my mom is German and stubborn! But she's scared too. Personally, I think my mom will not get better and will need to be put in an assisted living facility which will most likely have her freak out. Not sure how to handle all this. Plus it's taking a toll on me. I live an hour away and have dogs. So I cannot stay very long. But the LPN is kissing her ass and showing up. So I'm persona non grata.
If the doctors are there ask them about a procedure where the fractures have like a cement put in them. It helped my Mom when it was found she had a fractured vertebra. It takes away the pain so they can heal.
The LPN is licenced by the State and must keep that licence up yearly. In my State the Nursing Board is in charge of the licences. If you think this LPN is putting too much influence on Mom, you could report her.
Mom has history of other health issues + poor mobility.
*Mom wants to go home*
Of course! Home is where she felt good. Comfortable. Felt in control. Could walk.
Mom can WANT whatever she WANTS really... To win lotto, write a bestselling memoir, take a year long luxury cruise, dye her hair pink.
This does not necessary mean these things are actually possible. Or possible today (not even 2 weeks after surgery).
"I want to go home" is certainly not any instruction or command you need to obey or make happen.
It is not up to you.
(Although knowing what she values most can be useful).
What to do?
Answer emotion with emotion.
"Yes Mom, I hear you.
You want to go home.
(Add empathetic sad face).
I want you to go home too".
Then let the future unfold. Maybe a slower pace of rehab Mom can get back on her feet & able to get home? (if this is available). Or alternatively, if her health &/or mobility plateau or worsen, other options will be needed.
Believe me, rehabs have met patients that came from home but are making s.l.o.o.o.w progress many times. Family meetings come next, where the medical team update the family. Nearer the end of the rehab funding/stay, the discharge plans begins to take better shape - either A) home or B) other.
So hold her hand. Be her support. Let the future happen.
PS If she gets too cranky at you, tell her to "walk out & walk herself home".
Look for a psychologist or psychiatrist trained in geriatric care, and ask if they will assess her during one of your visits.
If you learn from her cognitive assessment that she needs supportive care (or more) you will have a reason for releasing the LPN, which under the circumstances sounds like that would be an advantage for your mother anyway.
If you learn that her cognitive skills are declining it will be time for you to accept the fact that you need to take charge, and that is often harder on the caregiver than the client. You may not be able to make everyone (or anyone) happy, but it may also be time to choose what’s best for her, even if that’s painful for your both.
When I had a full/total hip replacement in 17, they had me up and walking THAT NIGHT. The rehab was done at home and involved walking in the house, then outside, first with a walker and then a cane, then nothing.
Why is mom unable to move???? Has that been determined? My father never really walked again after he broke his hip at 90. He had a brain tumor preventing him from doing so.
Did the lpn leave mom alone in the house or just take a break? Falls WILL happen regardless of who's hired to watch the elder. Nobody can prevent an Elder from falling, unfortunately.
People who freak out over AL don't realay understand how lovely they are. And all the social connections that go on there daily, that PT and OT are on staff for the residents, etc. Fear comes from the unknown or thinking it's sooooo fabulous to live at home where nothing is going on all day and there's nobody to talk to except a night nurse. Your mom may love this lpn for what she represents more than anything.....the ability to live at home. But if she's immobile in bed now, it'll become impossible to remain at home without a 24/7 staff of caregivers which most cannot afford.
Tell mom she either gets UP and moving around every day in rehab, or she'll have NO other choice but to move into AL in a wheelchair. Which means her bff the lpn gets fired as a result.
Choices all have consequences including her choice not to participate in PT and OT. If need be, get Medicare pre approval to move her to a better rehab NOW where she may be able to make progress and before she's released for non compliance. Because if she's not up and walking soon, she likely never will again. Then you've got another huge problem on your hands.
I hope everything works out with all of this.
So mom is having trouble moving because everything hurts so much. Like I said, she has bad knees, fractures in her lower back and now the new hip. She's overweight too. She told me today, they took her to PT and then had her raise her arms some. Then left her to go work with someone else. I think this rehab is just milking her for money. I was there when the aide brought her back and he was rough putting her back into bed. She could barely walk three steps with a walker to the bed. And this is 10 days after the surgery.
Also the night the LPN left her alone, it was the LPN's daughter's birthday and the LPN asked can I go have dinner with my daughter. Well, of course my mom said yes. But the LPN should have called me or my sister to let us know. My sister was on the way to the house, just by chance, and she was the one to find my mom on the floor after she fell.
Thank you for all your advice and input. I did find a really wonderful rehab where they have a beautiful facility to help her get better and it's only 10 minutes from me, but she doesn't want to be far from her home. She just doesn't seem to understand the bigger picture.
I don't think mom "has her wits about her".
She is making decisions that are not in her best interests.
Which doctor are you meeting with on Wednesday?
Do you have an elder law attorney? In your shoes, I would have the lawyer write a strongly worded letter about "undue influence", "meddling in financial affairs" and "dereliction of duty".
She should have been fired immediately upon finding that she abandoned your mother.
A) that back is unlikely to appreciably improve and if you discuss with MD you will likely hear that she now has age related compression fractures. I don't know people over 80 with an xray of the spine who don't, including myself.
B) our balance goes. We will have falls. That is to say WE WILL HAVE FALLS, for whatever mishap reason. It is a fact of life for your Mom as she approaches 90 years of age.
Many of my responses are a result not only of a lifelong nursing career but as a result of the fact I AM OLD. I can identify with so many things now that my balance dictates that I fly around on the bus like a feather despite weighing more than I ever did in my life, that I back up over some mishandled garden implement and cannot catch myself as down I go, that my back is iffy on any given day and that I am now experiencing what I saw all my patients go through, the one day, one loss at a time. Of continence, of good bowel habits, of balance and spine and brain and mind and choice and and and and.
I am glad she has you. She is very lucky in that. And so glad you care. I trust you to make the decisions with Mom that you think best. You soon will be having to make those decisions without her, talk about being scared, too!
I wish you the best. The very best, and your Mom as well.
I agree with you about her back. Before she broke her hip, she could barely move around because of the pain in her lower back from the fractures. Now with the hip surgery....like I said, it's been 10 days since surgery and she can barely move.
She told me today she cannot pee, so they were putting a catheter in her. They did an ultrasound and saw her bladder was full. Not exactly sure why she cannot pee but add it to the list.
I am going to the place near me tomorrow to check it out in person. But my step dad was there and it was great. Plus I know others who had their parents there. But I want a tour and to ask many questions. The distance is only 10 minutes from me and the facility has many options to help her get better. If she does not recover fully, which is what I expect, they have Assisted Living available there. Or when the time comes we can move her to an AL somewhere closer to her house as she says she wants to be closer there so her friends can visit. I understand the importance of that, and have been keeping in touch with her friends and encouraging them to visit...and they have been.
Thank you again for your kind words. I needed to hear them. Hugs and best to you.