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My mother is in an AL and on hospice - she has COPD and CHF and is no longer able get out of bed without help. However, she refuses to ask for help getting to the bathroom and recently had a fall. After the fall she’s been a lot more confused than usual – when I went to see her the day of the fall, she insisted that people had attacked her. I told her that the only thing that attacked her was the floor. It had been her decision to value privacy over calling for help. We all told her that she would fall. And she accepted that as a consequence of her insisting on privacy. Now every time I go see her, she says that that was quite a fight she had been in - look at all her bruises (from her fall). She tells me they force her to take her pills - that they shove the pills in her mouth when she refuses to take the pills. I know they don’t because I get called every time she refuses her meds and the med tech tells me that mom didn’t get her dose because she refused.


She also has trouble with time/memory. She complains that no one comes to see her anymore when we come to see her almost every day. She also has a private health aide for 10 hrs/day, she has a hospice aide come in to give her bed baths twice a week, she has chaplain that visits and the hospice nurse comes twice a week - she has more visitors than anyone I know!


How should I be responding when she thinks that something outrageous has happened and it really hasn’t?


Is there a way to leave her something so that she knows that we have visited? She’s not tech savvy so having a picture taken with her phone with her wouldn’t work. She will also make outrageous comments about the staff at the AL that her private caregiver will clarify for me when I talk w her away from my mom. I’ve stopped arguing w her but I don’t want her to be afraid of being attacked/forced to take pills even if these are just in her imagination. Some of this is probably due to the COPD- she’s on max O2 but her brain has got to be affected by lack of O2 because of the disease progression?


Thanks for listening!


Suzanne

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Is there a way to leave her something so that she knows that we have visited? She’s not tech savvy so having a picture taken with her phone with her wouldn’t work.

only thing I can think of is a guest book. you could make one from a 8x11 note book. write on the front. in black letters. GUEST SIGN-IN BOOK. she may like looking at who visited and when.

but maybe she is past help with that....

if she says no one has visited - just apologize - say you are so sorry. she's just not remembering...my mom(AL) doesn't remember anything I do for her either. she acts like ive been gone for a month.
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I would say it all has to do with not enough oxygen getting to the brain. How are her hemoglobin levels. Low means not enough oxygen is being carried in the red blood cells. Don't think how much oxygen you take effects this problem.

She has two things going on here bad lungs and a heart that is not pumping blood effectively which carries the oxygen thru her system. With CHF the lungs can fill up with fluid. Not good in Moms situation.
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Toward the end of my dad's life he was tortured by delusions. He was in a nursing home and when I'd visit he'd tell me about the people who are out to get him. It broke my heart and while I knew these were just delusions they were very real to my dad. I spent most of my visits reassuring him that he was OK. I didn't try to convince him that the delusions weren't real but I would tell him that I would take care of it, that he didn't have to worry, and that everything would be alright. I comforted and reassured him.
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If I had to guess, I'd say she's developed vascular dementia.

Don't guess. Bring this change in mental status to the attention of her health care providers. Meds may help. She doesn't deserve to be in this sort of psychic pain.

She might also have a uti, which can cause psychiatric symptoms, but not physical ones in elders.
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