How do you convince a stubborn 88 year old with vascular dementia that thinks he is still a young man who can do anything that he needs to use a wheel chair when the love of his life assures him that he doesn't need it?
As most of you know Dad has taken several nasty falls lately. He has not broken any bones yet but is missing all the skin off the back of both elbows which is healing slowly. His skin is so very fragile. He has also had to be taken off his blood thinners because of this despite his recent disgnosis of afib. He is unstable on his feet. He walks too fast, getting his body ahead of his feet and down he does.
Because he walks so fast he is unsafe with a walker. He is in his second week of "walker training" and he is not slowing down at all. You and I both know this is because the brain is not processing the training but it is also because Mom sabatages all that is done. He got the wheel chair when he felt worse, from the afib episode, than he does now. He did use it twice. Then the dining room was closed because of a rampant stomach virus in the facility. Mom turned the wheel chair in because it was not being used. No it wasn't because they were being served meals in their room. When the dinning room opened Monday they took it back to the room.
Monday at lunch he refused to get in the wheel chair. The PT person and Sister 4 was there. Sister 4 finally wrote a contract, had Mom and Dad agree to it, and had it signed. Dad got in the wheel chair and went to lunch. At supper he refused to get in the wheel chair so Mom pushed it to PT with him walking and left it there. Today at lunch Sister 4 is again trying to convince Mr ICanDoAnything that he needs to ride.... without much luck...... and Mom is saying that he doesn't need it.
In the mean time Mom says that Dad is walking better and doesn't need it so she's not encouraging him to use it..... she is actually enabling his stubbornness. According to her he is resisting because he knows when he stops walking that he won't walk again. Perceptive on her part but not what is needed at the moment. In reality it is her that thinks that.... she is notorious for transfering her feelings to Dad. That is how she deals with her disease. In the mean time there is a persistence by the facility that he use it because of the fall risk and their liability.....
A little history about my Dad. He had his first heart attack in 1977. He was not supposed to survive and shocked his doctor by pulling through that one. He actually went back to work, walked through the angina pains, and develope amazing ancillary blood flow to his heart. He was evaluated in the mid 80's for heart bypass and told that was not an option. In 1987 he had his second heart attack. He was air lifted to a heart care facility where he stayed for a month. They finally decided to attempt bypass surgery. We were told he had less than a 50% chance of even surviving the surgery but it was our only option. There are 7 major arteries that supply the heart. He had 5 bypasses and 2 were destroyed by the previous heart attacks. Since then he has had two stints put in his heart and another heart attack. Now he has afib and pad (probably from all the veins stipped to do the bypasses)... and the man has not slowed down yet. He has outlived all of his siblings except one that is 10 years younger than he is. He's a fighter that refuses to sit down.... in a wheel chair!!!
Mom, in her dementia, is in complete denial of his condition and thinks, like him, if he sits down in a wheel chair he is doomed. She is scared of losing him so she encourages him to keep going which enables his thinking.
The PT person today finally said that it was not going to work as long as Mom was encouraging his resistance. Having two to feed off each other makes ten times worse. Sister 4 has all she knows to do. PT has exhausted their bag of trips. So now what do we do?!?!?!
PS.... in the mean time Mom is having regular melt downs again. She blamed it on constipation but I was there and knew she actually pooped... though she forgot that she had. Remembering the last time Mom was in this state, I suggested they do a urinalysis. Sister 4 actually listened. They have a urine specimen and are waiting for it to be transfered to wellness and tested. I so hope she has another UTI!!.... that would explain the abdominal discomfort that she labeled constipation and also explain her current mental status. Dealing with her melt downs and Dad's wheel chair issue has not been fun...
This has not been a good couple of weeks, has it? DO you think that maybe there could be an increase in your Mom's meds-if it isn't a UTI-to get her to settle down and calm dwon. Oil on the waters so to speak.
As for Daddy. I've been wraking my brain for wat we did with Daddy. Would it work for you to ask him to use the chair for a week so that it would give his skin a chance to heal and because of the change in meds he needs to ride instead of walking..I don't know Deb..I'm trying to be creative. Because his meds are changed his feet need to heal and the best way is to have the wheel chair. Only for a week. Then he can use the walker...
Have they given him a walker that has brakes on it? Will that help him? That way he can stop himself from tipping forward. My walker-Ella-has a seat and handbrakes-that you can set also. It's made by Hugo. Sold in WalMart and Costco. Under a $100. Look them up on line. Do you think that may help him? I know that your mother is frightened of his not being able to walk ergo her not being able to walk and it's a vicious cycle that you can hardly break without separating them or taping your mother's mouth shut! Fat chance! LOL. Can you convince your mom that daddy needs the rest in the chair to help heal his skin for a week?
I'll continue to congigate on it. Sometimes I'll have a great idea at 3 am when my legs wake me up...you're in my prayers girl...you could always stuff a clean towel in your mom's....never mind......
hehe.... I like the towel stuffing idea. I have wrecked my brain trying to come up with a solution and as you said.... as long as the two of them are together, feeding off each other's fears and confusion, I am not sure what can be done.
Part of the problem is the time interruptions. Walker training was started last Monday, then interrupted for the holiday and weekend, so we are back to square one today. Dad's short term memory, even mid term, is GONE! He has no memory of me being there Friday and Saturday. When I talked to them today he was anxious to see me because it has been so long. Dang.. I just got home last night. His normal pace is full speed ahead. Even if they get him to slow down with the walker at the moment.... it's gone the next time. He out walks the walker and is in danger of tumbling over it. The same is true of the wheel chair. Even if you get him in it for lunch.... it's a repeat performance at supper time. Mom goes to breakfast and gets his breakfast because Dad sleeps late and he eats in the room when he wakes up. The chaos is at lunch time when the PT is there for walker training and to get him in the wheel chair. By supper time it's gone again and Mom returns the wheel chair to the front desk or PT and they stumble to supper.....
We have tried the written contract idea. It is hanging on the bulletin board and was given to them this morning but no go. We have used the elbow excuse as well as the fear of him falling and breaking a hip and never walking again. "I walk just fine" echoed with "He walks just fine now". ARG!!!! I have even ask if he would do it as a favor to me.... "Trust me"... and for the first time that was a no go as well because he swears he doesn't need it. Then there is the issue of what does that thing cost. I assure him that it is paid by the insurance but that doesn't seem to matter.
PT and sister 4 threw up their hands.... and Dad walked to the dinning room with Sister 4 on one side and Mom on the other. Then Sister 4 called in a mini melt down sitting in the parking lot of KMart because she had to get out of there. She is probably back by now to see what the doctor says when she makes her house call this afternoon to check out both of them....... and we have not heard from the urinalysis.
Keep thinking because I am.... and can use all the help I can get on this one.
Urinary tract infection. My MIL doctor told her she needed to drink more water to flush out the bacteria and to flush out all the meds she was taking and to also drink cranberry juice. She is constantly at the doctor's office, at least once to two times a month for UTI's and it's exhausting to constantly tell her to drink more water. Her reply 'I don't like water'. So she must like UTI's more? Also elderly can become incontinent and the bacteria will give them UTI or the lack on cleaning that area. UTI's in AZ patients make their symptoms worse and need to be treated. Sometimes the change in their personality is the only way that you know that they have a UTI since they can't communicate that there is a problem. However, they say that antibiotics in AZ patients worsen their condition. It's a long frustrating battle.
Not sure about lunch.... but tonight my Dad pushed the wheel chair back to PT and told them that if they put it back in his room he was going to hire a lawyer..... and walked to supper! Mom was strolling along behind him grinning. I do believe we might as well just give up.
Sister 4 has decided I am evil again and decided not to update about the UTI etc today so I will call wellness in the morning. She did tell me yesterday that the doctor was putting Mom back on her antidepressant. I want to know WHY she was ever taken off. She has been on them for about 5 years with major suicidal episodes of depression. She went to a Geriatric Psychiatrist a few months back and he put her on what she was on. I just don't get it. I will also find out about that....
PT did not come today (I do believe they have given up) and the "rolling chair" has not been return to my Dad. He walked to lunch. He is doing better than he was when the wheel chair idea was born. Sister 2 and I have also obtained risers to lift up the chair he sits in so he can get up easier which has been the most help. I am at the point...... if he falls so be it. He is not one that sits down for an illness. He has been with me 31 years because of this attitude so keep going until you can't.
Also..... Mom did have a UTI!!!!! I suggested it, sister 3 poopooed the idea, I insisted again, the report came back yesterday and Mom is already on antibiotics but nobody bothered to give me that information. I called Wellness this morning to find out.
I called Mom a short time ago and she is happy. She has antibiotics, increased antidepressant, and the rolling chair is gone which makes her and Dad happy. I'm praying for a little staus quo here
Who holds the medical POA on your folks? is it sister 3 or 4? or is it you? The only reason that I am asking is that would it be possible to have an annotation put in their records that when there are changes or instances, such as your Mom's latest UTI (that your oh-so-darling-sista-failed-to-inform-you-about), that they would call you and let you know that she had one and is on antibiotics? Or could there be a an annotation at her doctor's office that will notify you? Seeing that you are the eye that catches these things quicker than either one of the other dooffusses of sisters that you have...see how irritated that have made me again? It would smooth the system out and certainly make it easier with the staff and ease the call load that you make. As one of the ministers in this area says on his infor mercials..."not a sermon, just a thought."
But I am glad that-not that she has one-the reason Mom was acting up was the UTI and the lack of her depression meds. Why woud sister have taken her off of them? that truly befuddes me......in fact that is so confusing I think I'll need to go sew on a quilt and work that out.....
All things being equal, your folks should settle down for the weekend please..you need to rest.......and it's your turn to wash the towels. I did the last three loads....
Last edited by ibake&pray; 12-06-2008 at 10:53 AM.
I got the wash in now, the towels will be ready to dry when I finish this note!!! It's clean towel time
..... something else I discovered in my investigation was that Mom was NOT taken off the anti depressant. The doctor increased the dosage which is very different from putting her back on the medication which is what I was told to begin with. I had the same question you had IBake... WHY did they take Mom off and I ask Sister 4 to verify that information. Not sure she understood what I was asking. It was not done, so while I was yacking with Wellness I checked on that too, only to find out it was increased not started again
Sister 3, the nurse, has the medical POA. Sister 4 is the one that has direct contact with the physician. She's not happy when I interfer because of "continuity". My brain is not incumbered by medical protocal but I have enough knowledge and common sense to make educated assumptions. So I fumble though my knowledge base and observations to come up with an answer and then stumble through the gauntlet to figure out how to get the answers or action I need. It is what I do to keep the peace.
I just hung up from talking to Mom.... and all is well today and I am making sour dough bread!
Your bread wouldn't be sour if your sisters didn't make it so....
And you don't stumble through. You are usually the one who sees the issue first and has to start the ball rolling on calling for a check to see if it is a UTI or issues with dad-don't give me that crap that you don't know enough. You aren't standing up for yourself with those women again! You are far smarter and more atune with your parents than any of the other three, and the reason your parents are in as good health as they are in because of the sixth sense that you have with them. Book learning itsn't all that matters most times and you know it...I still think you need to have an annotation on the medical records so that you are called.....so there.
I will now stumble down off of my jammie covered box, climb in the hot tub, then go to bed. As momma used to say, Morning comes early.....
Last edited by ibake&pray; 12-06-2008 at 10:00 PM.
I'm truly sorry deb that your sister #4 has decided your evil yet again. How childish. You have my sympathy. Good luck with her........
I'm also sorry about your Dad. I apologise for laughing at your story. I'm sure its not funny to you. I have a mental picture of your Dad handing over the wheelchair and threats of obtaining a lawyer !!!!!!!!! Sounds just like my Grandpa. I once cut his fingernail too short and I hurt him........He held that finger in the air for two days and told everyone that would listen what I had done to hurt him. He couldn't remember how to fill a glass with water........ but he knew to tell on me!!!!!! He also remembered my name????
I got some much needed sleep last night. I hope you did the same.
I truly don't know how you keep up with both parents. I'm losing it over one little old lady. You have my deep respect.
Thank you for the smile your story brought to me this morning.
I was not questioning myself..... I am frustrated by what I have to deal with every time I deal (specifically one, sometimes two, but the third is cool) with my sisters. My stumbling and fumbling is related to what to do with what I get from especially sister 4, and occassionally sister 3.... compared to that Mom and Dad are easy!!
I even understand the dynamics. Every time there is a crisis with Mom and Dad Sister 4 is there. She's local and put herself as first to call, which is practical because of their location. She feels that she is on call 24-7 and hangs by the phone with anticipation anxiety but she doesn't do anything until that crisis phone call comes. There is nothing proactive about her. Then she sends out a loud mayday when a crisis occurs and I respond because sister 2 and sister 3 work full time..... so what happens is logical. Sister 4 thinks she has it under control but is truly over her hear and doesn't know how to deal with my parents situation. In her frustration she lashes out and it is normally in my direction. She gives a litany of all that she has been burdened with, trashes any idea that somebody else gives, and screams woe is me. Then blames it all on everybody else not liking her. It's NOT about her and she can't get that. If we say anthing to her, she will just stop giving us updates or we don't need to come back. She hold Mom and Dad as her trump card for emotional blackmail.
Her latest. Sister 4 has had almost no connection with my daughter, other than the mandatory birthday card and holiday hello's, for years. Sister 4 sent out e-mail, after I ask her not to, telling the grandkids what they should do for their grandparents. That was less than a week after my daughter spent the afternoon with her grandparents. My daughter ask for context and clarification for the demand. Sister 4 just typed back.. ask your Mom. My daughter sent back a nice letter explaining that she truly wanted to know what Sister 4 thought. Sister 4 picked a time when my daughter was trying to finish a 10 page research paper and called 5 times in a row, text her, e-mailed her to call her NOW, and then called me to tell me my daughter was screening her calls. Yes she was.... she was immersed in finished a major paper in one of her hardest classes. The culmination of the episode was my daughter telling my sister that she acted like an authoritarian witch and she was not in a class room and could not bark orders without explination. Sister 4 called yet another niece..... told her my daughter had called her an authoritarian witch (which she didn't, she explained that was the way she was acting and she was not saying she was that).... and the niece agreed. hehe.... I'm sending the both a trophy!
There is so much more but I have bored you all way too much. What I fumble with is how to do what I know to do without causing the volcano to erupt and while stumbling through the guntlet that my sister lays down to impeed what I should do. I don't doubt myself..... I just never know when I am going to step on yet another land mind laid by sister 4. Damned if I do and damned if I don't. What I have done..... is stop letting it get under my skin. I would like to find a solution because she is there with Mom and Dad. They need her availability and those of us not there do need some input as to what we can do for them. But instead of crying..... I laugh at the stupidity of it all..... and have learned to go around her. I am considering your recommendation.......
Thank you IBake..... you always seem to say what I need to hear, validate what I know, and put my thoughts in prespective You are at your best on that jammie covered soap box of yours.
BTW.... the bread is nicely soured. It's sour dough bread.
Chris, do not apologizing for finding the humor in that situation. When Mom told me what had happened... I laughed myself. My dad is about 6'2 with an air of authority when he stands up straight. I have met the PT lady is short and she's definitely not authoritarian at all. I can so see the scene. Dad towering over her telling her what she will do. Yes, I do search for the moments of humor even in the midst of a crisis. That is what keeps me going. So if it brought a smile to you face... it was good for both of us.
Don't take anything away from your situation because you have one and I have two. It's still the same frustrating horrible situation and we deal with the same problem with our parents and within ourselves. We are in this together and hold each other up
I am glad you got some sleep. Hopefully you are more prepared to face whatever the day will bring with a little sleep under your belt. Remember to take care of yourself, and especially that knee. You are no good to anybody if you are not at least 90%.... I don't think any of us going through this can be 100%!!!! Hang in there..... hopefully your Mom will turn the corner and life will settle down for you for a while.
Seems to me that sister 4 likes to come off as the one that does it all. When in reality she doesn't. Yes, she may be there to receive the phone call in time of crisis but from reading all your post Deb it is you that basically reasons it all out and deals with everything in a mature and appropriate manner. Perhaps, sister 4 deliberately trys to make you feel guily for not living right there. Although that is the other thing I noticed from reading your posts whenever something develops with mom or dad you are right there in the blink of an eye. I just think sister 4 is not a happy person and likes to drag you down with her. You are doing an excellent job doing what you do Deb. You should never second guess what you think or do. I understand sister 4 is your connection and life line to mom and dad I think sister 4 knows that as well and like you said uses to play mind games with. She likes to dangle that over you and see how much control she can have over the situation. It is a very hard situation for you. Especially being far away and having to depend on her to get your info. I wish I could tell you something that could help you with this better. I just think everything you have been doing is the best. Just continue what you do Deb.
Sister #4 is a mean potty poop as we have established. The fact that no one likes her is evident, but she doesn't need to take it out on our Deb. I do think that if you could get an annotation in the record, it would often stop her in her tracks. If you can stop a problem before it gets to the volcano point, then there is no issue and the world is a calmer place for all involved. And why you wait for a crisis is beyond me, unless that is how you justify your existance...and I don't know about you, but I have far too much to do in my life than to sit and wait for the phone to ring with a crisis. BTW, is it a red crisis phone? Sorry for the sarcasm, but after all..do we need to justify what we do for our parents that way? Or doesn't she think that she is valued in what she did for them in any other way? Party poop party poop!
I do think that if the staff would notifiy you when they start to see issues arising with your folks, you could quietly suggest remedies and solutions that would nip the problems before they become the boils that need to be lanced. It would stop the "Wolf, Wolf, Wolf." that you have now. And you do end up with the crisis issues after issues. We call it "knee jerk reaction" here. What it does it makes the person who calls the issue feel important...sound familiar? Then they can also find the solution...SAVIOR!
The smart plan is to get enough resouces in place that you don't have this over and over again. Hmmm, does that sound like our Deb? Make it easy for the staff and the smart sista to operate for the good of not only the parents, but the siblings who are trying to take care of them. At least the smart ones...
Once again my eyes are gritty and it's too cold for the hot tub.ladies, I leave you for laalaa land...
Deb. We dearly love your parents and your daughter and you. Your extended group, not so much, and you never bore us..we feel like extended family.and this part of it is tired....
Last edited by ibake&pray; 12-07-2008 at 08:45 PM.