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Old 10-01-2008, 08:12 PM   #1
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Help A Newbie- How Do We Get Mum To The Doctor?

Through no fault of her own, our 84 year old dear mother while carrying groceries to her own car, was knocked down by a car backing out of a parking space. She endured 1 emergency hip surgery and an elective surgery and spent 6 months convalescing. Family provided 24 hour attendance during the hospital stay. We saw dramatic personality changes, including severe depression. Had we not been present, she may have died.

We feel the accident exacerbated her mental challenges.

I sold my own condo and moved in to help her in her home. We did a lot of homework and research, learning about cognitive decline,memory loss, dementia etc. We built a plan. almost 3 years later, she is still in her own home, but it is taking 3 daughters, 2 of them a lot of travelling, to keep her there. She is lonely, but we have to facilitate her getting out to meet new people. We have no outside help. We are exhausted. Mum at present resides during the day at home alone with no company. We are not happy with this. We are all exhausted and our own health is deteriorating as a direct result. We have a good comprehension of possible caregiving resources and alternatives, but at present we need to deal with some of her physical ailments to prevent other ailments from developing.

For some time now our biggest challenge has been getting mum to accept care from anyone but her daughters. She has refused most efforts. It takes a lot of finesse on the part of the youngest sister in particular. Mum has ailments that need to be addressed. Our last effort failed and left us very unhappy. On top of her usual pains, Mum has an unusual mole that needs to be removed. We drove her to the doctor. She refused to get out of the car. Inside the doctor's office, the secretary did not volunteer to come out and try to coax my mother in. She made no effort to consult the nurse or the family doctor. I was informed by the secretary that mum should be placed in a nursing home. The mole was not removed.

We are aware of options resources including CCAC but have not yet made contact. We are aware of the waiting lists etc. In the meantime, we just want the mole removed.

**My question** to the members of this forum - is one that we have been coping with for several years. We are familiar with the use of little white lies, and other strategies to resolve many of our daily challenges communicating with our mother and achieving our goals where her daily care is concerned. The one challenge we have not succeeded often enough in conquering is that of our mother's refusal to attend appointments - hair, toenails, dentist, family doctor.I am hoping the members of this forum can share with me their ideas, however unusual, on how to help a person with cognitive disorder, poor ability to rationalize, memory loss, fear of being removed from the home, mistrust of the medical community, and potential for emotional catastrophe at any moment when placed under duress, attend an ambulatory care clinic for removal of an abnormal mole.

In her better days, our mother would not have left any ailment unattended, let alone a blackened mole that could be cancerous. So we have to help her through this, until the time comes when we can get reliable daily assistance in the door, or when she herself in a nursing home. Hopefully, some members here will have some ideas we have not thought of.

I apologies for the wordiness, I realize my sentences are running on a bit. Hoping for some responses soon.

Dotters.

 
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Old 10-01-2008, 11:11 PM   #2
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Re: Help A Newbie- How Do We Get Mum To The Doctor?

Let's try this again since my internet crashed as I was posting the last attempt..... and welcome to the board dotters.

I have not had problems to the extent that you have getting either of my parents medical attention. My Dad did refuse to get out of the car at the podiatrist once. The next day we took him back and he went right in. Mom initially refused cognitive testing but later went "to prove me wrong". My Dad (Vascular Dementia) is relatively easy and if one of us girls go with him he is usually fine. Mom (Alzheimer) on the other hand can be impossible. If she decides not to do something.... you can't drag her there. The problem with her is that it is random when she refuses. We have given Dad his PRN antianxiety med before doing something we know might upset him. That seems to take the edge off his anxiety and I think it truly helps. It doesn't seem to be effective with Mom.

We were in much the same situation that you are trying to keep Mom and Dad at home. Four sisters exhausting themselves. Mom refused inhome help and was determined to stay at home. Yet she was not happy. Between her psychotic melt downs, burned pots, shorted electronics that burned the wall and carpet, broken windows, Mom's broken arm, Dad's hospitalization for a medication over dose, Mom and Dad physically fighting, and other disasters, it became impossible for them to be at home alone. We hired a caregiver. Dad loved her. Mom was miserable. This care giver was an angel and put up with Mom's antagonism until Mom started hitting her. That set off a chain of events that even Mom couldn't stop and less than a week later they were in Assisted Living. Mom is still miserable.

As soon as they were safely in AL I went to the doctor myself. I am due for my one year check up and hopefully I have repaired most of the damage I did to my health while trying to keep Mom and Dad at home.

When I look back.... my only regret is that we didn't move Mom and Dad to AL earlier. Mom knew Alz ran in her family. She bought LTC insurance for herself. She would be disheartened if she knew the physical tole it has taken on her daughters. She understood all of this until the time came. Then the tangles and plaque clouded her brain. She has been miserable since she realized she was having cognitive difficulties. My positive happy mother suddenly became depressed. She told us it was just having to take care of Dad. If we would just help a little bit all would be fine. This didn't make a lot of sense because he is so easy to care for. When it became obvious that there was more than just depression I did have her tested and she was well advanced in her dementia. So we spent all of our spare time at home. She was not happy with us being there. If we would just leave her alone she would be fine. Then the caregiver who she was very unhappy about. She finally hit her several times and swore she would be just fine if that woman was not in her house. Then Assisted Living which she is even more unhappy about. Now if we will just let her go home she will be fine. It finally occured to me..... it is not where she is that is the problem. It is the confusion in her brain that distresses her. At least now they are both well cared for and safe.

I do hope you can find a way to get your Mom to the doctor. I am sure it will take more than a little white lie. Maybe you could even tell her that she is just going with you. Let the doctor notice the mole and volunteer to take care of it. Perhaps a PRN anti anxiety med before hand might help because it is the anxiety that is keeping her in the car.

Know I keep you all in my thoughts and prayers that you will find a resolution to your problem....

Love, Deb

 
Old 10-02-2008, 08:53 AM   #3
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Re: Help A Newbie- How Do We Get Mum To The Doctor?

I had to use a trick with Mom. We told her Medicare will no longer cover her if she doesn't get an annual physical. Another time we told her I needed to see a doctor and I felt nervous going alone.

It is very important to prepare the doctor and his practice helpers for the Dementia - let them know what her diagnosis is, how she has been behaving, what she may do. I can understand that there was no time or motivation on the part of the dermatologists's receptionist to go out to the car - that is not in her job description, nor is dragging a protesting patient into the practice.

The idea of offering your Mom ice cream after the short doctor's visit sounds good.
Finally Mom did have to go to a nursing home and suddenly all those hassles were no longer a problem. We were never asked to pick her up and take her to a doctor, dentist, specialist or whathaveyou. The NH had their own doctor, and they transported her to specialists when needed in the wheelchair-equipped van.

In my opinion NH care is the absolute solution to 90% of the caregiver's problems, and as an added bonus, my Mom loved the place and was happy there for 2 of the 2.5 years of her remaining life -- and after that she was not unhappy but indifferent to where she was, fading fast, and ready to die ....

Love,

Martha

 
Old 10-02-2008, 06:24 PM   #4
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Re: Help A Newbie- How Do We Get Mum To The Doctor?

Thank you for replying Martha and Deb. Will keep you posted. Your experiences will help my sisters and I refresh approach re helping mum to keep her appointments. Time only for quick reply this evening, but I look forward to future m/b-ing. Thanks again. dotters.

 
Old 10-03-2008, 04:53 PM   #5
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Re: Help A Newbie- How Do We Get Mum To The Doctor?

We had to take stepmom to the dr the other day from the nursing home and she was refusing to go. I finally told her that I wanted to take a ride and would she please go along with me - that I needed her advice on some things. She lit up like a Christmas tree when I told her I needed her help. We got her in the car and she forgot that I wanted advice. We got to the doctor's office and she got out with no problems. I didn't say where we were - that it was time to get out. It worked out fine! Best of luck. I'm new at this myself.... Ry

 
Old 10-03-2008, 06:05 PM   #6
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Re: Help A Newbie- How Do We Get Mum To The Doctor?

Ry - Good JOB! That's just how dad is, too. If I need him to get in the car, I make sure it's something he WANTS to do. And you are right - as soon as you get them settled in the car, they forget all about what you said. Dad has never once thrown a fit, refused or even questioned when we get to the doctor's office. But if I bring it up at home, there is hell to pay.

Now. Use that newfound technique on other things. Need to go to therapy? Off we go! No discussion. Need to change her outfit? Off we go! Think of yourself as the worlds' greatest nanny with a bullheaded 3 yr old. That's how I get dad's tshirts changed. "Dad, I have your clean tshirt here. Let's get this dirty one off..." and as I am talking, I am gently removing the tshirt.

I never ask, "Dad, are you hungry?" Because even if he says "no", he might really be. So, I use the same technique - "OK, dad, time for lunch!" and I help him to his chair, hand him his fork, tuck in his napkin, and while he is still spinning from all the activity, announce, "Chicken Fettucine today! Yum!" And he digs right in.

That technique is invaluable. Glad it helped.

Peace and prayers,

...lil' deb

 
Old 10-04-2008, 05:00 AM   #7
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Re: Help A Newbie- How Do We Get Mum To The Doctor?

Thank you Ry for your comments, and skimps46.

Chicken Fettucine! Funny you should mention that!

Our mother has been a very fussy eater. She knew well how much time and effort we were putting into helping her. After emerg hip surg/ convalescent care, the "dotters" began providing support with meals. Initially, mum wanted to make life easier for us, hated the clatter in the kitchen and she loved getting out after being inside all day. Daytripping evolved to the most important activity of her day, after my work day. Food strategies had to be clever, and we needed to watch our diets as well. Nutritioin has been of great concern for all of us. Frozen meals have been an ideal back-up. We researched what was available and came up with Lean Cuisines - minimal salt, no MSG, good proportions, nutrition etc. One day, when mum was being fussy about wanting to get outside fast, and the sun was going to go down soon, I pulled out the a frozen entre of chicken fettucine, heated in up and put it down in front of her, stating when we were finished we would go out for coffee. Hooray! A new find. She never ate pastas before. Always pareferred the meat and potatoes. The sauce on the pasta was a big assist. So while the fast food still has a place on the menu, and my other sisters' fabulous home cook meals are the most appreciated, the chicken fettucine has been a great back-up.

It's Sat a.m. here. The days are getting shorter and cooler but still bright. Leaves haven't turned yet, but apparently in Algonquin is blazing with color. Mum seems to be feeling the chill more than usual. I've been making hot chocolate with new iron-fortified chocolate syrup, buying the high-iron nuts etc. Anybody have ideas how to get more iron in the diet?

Tomorrow my younger sister is providing me a day of respite. I am taking one day bus trip! My older sister and husband arrives in town for a week to help around the house. Will keep in touch.

 
Old 10-04-2008, 05:13 AM   #8
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Re: Help A Newbie- How Do We Get Mum To The Doctor?

Ry - we too have found that if we convey to mum in some fashion that we are in need of her help, she suddenly feels valuable, and she rallies to "rescue" us, recognizing her cooperation is just what we need. It's not always that easy, but it is a trick I don't utilize enough I think. Thanks for reminding. The household is waking. Bye for now.

 
Old 10-04-2008, 12:47 PM   #9
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Re: Help A Newbie- How Do We Get Mum To The Doctor?

A good way to get iron into everything is to cook in an cast iron skillet. A significant amount of iron does transfer into the food and is usable when ingested. Mom cooked most of her food in iron skillets or pots. Nobody in my family had an iron problem. After Mom and Dad moved to AL Dad was noted to have low iron levels. Could it be the pots? I believe so....

Love, deb

 
Old 10-04-2008, 03:28 PM   #10
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Re: Help A Newbie- How Do We Get Mum To The Doctor?

I'm just reading, reading, reading everyday here. I'm learning so much, so many great tips, soaking it all in. You all are such a blessing!

MIL comes in 1 week.

Emily

 
Old 10-04-2008, 03:41 PM   #11
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Re: Help A Newbie- How Do We Get Mum To The Doctor?

I have an even older recipe. It's folklore, I have no proof it really works. Growing up in the depression, Mom used to take an orange and press 10 or 12 iron nails into it. She left it for a few days, then carefully removed the nails, peeled and cut up the orange, and gave some to each child. There were rust colored stains in the orange but it tasted good.

None of us ever had an iron deficiency even though there was no money to buy meat.

As I said, it is an old folk remedy with no guarantees. I wonder what a doctor would say about it.

Love,

Martha

Last edited by Martha H; 10-05-2008 at 04:30 AM.

 
Old 10-04-2008, 05:45 PM   #12
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Re: Help A Newbie- How Do We Get Mum To The Doctor?

Martha, your mum was clever!

 
Old 10-05-2008, 05:18 PM   #13
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Re: Help A Newbie- How Do We Get Mum To The Doctor?

Lil Deb,
Thanks for the words of wisdom! They are truly appreciated. At first I was asking stepmom if she was hungry and she'd always say no. Now I say, time to go to the dining room for lunch. I don't even ask anymore. The other day she had a box of candy in her room and I took out a piece and said, "Look, Chocolate, we both love it! Let's have a bite." She only took one bite - but she seemed to love it. She always seems so sad and so withdrawn. She knows us but doesn't know to ask how we are, what is going on, et cetera. I am taking the memory book tomorrow and see if she enjoys working on it together. I'll let you know how it goes. Hugs. Ry

 
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