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Old 05-13-2011, 10:37 PM   #1
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What's always the same!

Meg is going to LOVE this one.

I received a call this morning from the unit director. "Hello, how are you?" Blah blah blah... Your Mom fell outside and hit her head on the concrete. HUH?? Well, she didn't sleep well last night. That's probably because she has a nasty post nasal drip cough from her allergies. Her ankles are swollen. I know, they were yesterday when we were at the doctor.... and have been off and on for the last two years. Well maybe we need to give her an.... ATIVAN!!!! Oh hello no!!!

It was April 9 that they gave Mom the last Ativan and I flipped out because it was an old PRN prescription that should have been discontinued in November. So I personally talked to the doctor and had him discontinue the Ativan on April 11. How could they give her an Ativan that she didn't have a prescription for? Beyond that why would you give Ativan to someone with a potential head injury to put them to sleep? First rule of head injuries is DON"T let them go to sleep.

When I arrived Mom was definitely agitated and delusional. She would not sit still. Just getting her to sit down was nearly impossible. I tried to get her to lay down and that was a lost cause. She even pulled at the covers and picked at the air. She acted like she was on that Ativan side effect agitation. All she did all day was pace. Any effort to get her to be still resulted in agitation. I had finally concluded that they found an Ativan for her anyway.

I also found out that she had not fallen outside, but outside of the office in the hall. She did not hit her head on concrete but on the wooden back of a cabinet. Despite the assessment of the nurse and unit director she does have a nice knot on the back of her head.

So I stayed through supper, helped her eat, walked with her because she was so exhausted from being up the night before that she was a fall risk. Then I showered her and got her ready for bed about 7:30. I ask for her night meds. I stood there and watch the night med tech pull the morning meds off the roll before she could get to the night meds. They had NOT given her any of her morning meds including three of her psych meds (which explains the agitation and delusions), her diabetic med, and her allergy med!! I was FURIOUS! 20 minutes after she had her night meds which included three psych meds and Melatonin... she was sleeping like a baby. I called back 3 hours later and she was still sleeping!

I will also say that the only time the unit director showed up today was to ask if Mom had slept. Uhhhh... not until I am sure there is no head injury! And I never did see the nurse because she never came down to check on Mom. Guess she's too busy doing paper work.

So like Meg I am after the Facility Director. What I do appreciate is a call I received from another family member who was there. I got the straight skive on the fall from her It does pay to make friends hehe

Love, deb

 
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Old 05-14-2011, 07:48 AM   #2
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Re: What's always the same!

I just checked on Mom. She slept well last night... and woke up this morning her "usual self". Erased any doubt that she might be able to get off the psych meds any time soon!

Love, deb

 
Old 05-14-2011, 05:45 PM   #3
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Re: What's always the same!

NOOOOOO!!!!!!!! An ativan? I swear they are just begging to rile you up. You need to put a large sign on her door and over her bed... NO ATIVAN!!!!!!
In fact, you might have to add the F word in front of the word "ativan" to get their attention!

I DON'T BELIEVE IT!!!! BUT, sadly.....YES I do!!
I am just shaking my head. And why in the world didn't they give her the morning meds. That just makes me furious. Again, do we have to stand there all day to make sure they do their job!

And like I told our director yesterday, it is hard enough to watch them die a little each day without having to deal with all this unnecessary incompetance.

I hate that she is falling. Please please please I hope she doesn't break a hip !!

And it is interesting that you were wondering about when or if to take her off some of the meds. I was going to bring that up to you to see what you thought...wondering if they will get to a point in the disease where it isn't needed....but I guess you found out. I have been waiting for the hospice doc to bring it up....at this point if it isn't doing them any harm, leave it alone. We know what it was like before!

Mom has spiraled downward...and I wonder if, for her, it had to do with the removal of the Namenda. The timing is right. I know most seemed to have bad thoughts about this drug but she never had bad reactions and since we took her off we have seen a marked difference...but that is neither here nor there...at least, if it is the reason for the downward trend, it is not keeping her in a place we don't want to keep her in any longer.

My husband and I did meet with the director yesterday. DH didn't do much of the talking...he was my "muscle" sitting there. I have learned that sometimes you have to bring in someone with you. They usually deal just with me but this time him sitting there with no smile on his face put the exclamation point on the end of each of my sentences.

When I explained to the director what had happened..leaving mom in a wet bed til the others were fed, infuriated and saddened him. Again, placing mom in this compound of facilites on the same grounds over three years ago has once again worked to our advantage. This director knew mom before the ravages of the disease placed her permanently in the wheel chair unable to speak...and because he remembers the fiesty, outgoing, dancing, partying, necklace wearing woman jetting around with her walker, it just sickened him to think of her now being confined to a wet bed. He was genuinly sorry. He promised he would take care of it. We'll see. And boy oh boy will that one nurse be ticked at me. Oh well. And Deb, while in there talking to him I kept in mind that they are trained to deal with emotions...not facts. I was calm and factual...though later I laughed when my husband said he would have jumped over the desk at a moment's notice if need be.

Let me know if you want me to send him up there to sneer at your director too.

Glad that your mom was back to her normal self this morning and hope the fall doesn't cause any further problems.

Love, Meg

 
Old 05-14-2011, 06:58 PM   #4
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Re: What's always the same!

What's funny Meg... the unit director wouldn't ask me about the Ativan. She KNEW! She handed the phone to the nurse instead of asking me herself. It was a bit awkward and I didn't understand it until later but it did make me laugh. At lease one got it!!! ... but then it was the unit director that caught the brunt of my furry over the last Ativan. The ativan still being on Mom's med list was the mistake of the Nurse. And they all wondered why I didn't trust the nurse to fix the problem and called the doctor myself to have the med DCed. She still didn't know it was off Mom's list a month later

Why Mom didn't get her meds... I have NO idea. It is stated and I have screamed it from the roof tops frequently that Mom has to have her meds by 7:30am or as soon as she gets up. I thought maybe she slept late but then remembered that she had not gone to bed. The meds were marked as given but they were still in the drawer. The thing that baffles me is the med tech that day is one that I really do like and have not had a problem with. I bet she marked them as given and then got distracted and forgot. No excuse but the only explanation I can come up with.

I had questioned if there was a time when Mom could come off of some of the psych meds she is on. Yesterday told me that this was definitely not the time. She was wound up way too tight. I would try to get her to sit down and she would not bend. If I did get her seated she would not lean back and would try to get up almost immediately. If I prevented her from getting up you could see the frustration building. She would try until she broke out in a sweat. She just paced all day long. Anything in her way caught a bit of her angst. I could see it building and that was just missing a half day of meds which meant there was some still in her. I also saw delusion which I had not seen before. Nope, I am not going back.

As for the Namenda... who knows Meg. There are way too many variables to say for sure. Just like with Mom. She was taken off the Namenda and Aricept, in February. Then they changed her psych meds that same month. In March they tried to move Dad separating them. In April they moved here. In May she was in the psych unit. Somewhere in all that her cognition took a steep decline. Any one would be but it's probably a combination of all that is the reason.

I love that you had muscle!! I am glad the director was receptive and promised to fix the problem. I hope he follows through quickly. I resorted to e-mail which works well between the facility director and I. I will hear back from him on Monday. I did talk to the unit director today. She was "shocked" and was going to check into the meds not being given. I have heard nothing else from her and probably won't. The one I have left to talk to is the nurse.

Mom did hit her head and she did have a knot on the back of her head. Yet this nurse suggested Ativan to put her to sleep. Every Mom with a child who hit their head knows... you don't let them go to sleep. HELLO!! You definitely don't medicate a potential head injury into sleep. But what really torqued my chain was that she never came back downstairs to check on Mom. Then I found out she didn't get check Mom out before they got her up. ... but she's supposed to be great at "paperwork"

I agree with your statement to the director and I have said the same myself. It is hard enough to watch them die a little every day without having to put up with all this incompetence... What I would give for my old Rem Director back

Love, deb

 
Old 05-24-2011, 07:16 PM   #5
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Re: What's always the same!

Deb

I just read your post on your mom hitting her head
I guess I need to do more searching to see whats new.
I am so glad to hear she is ok.

We finally took my dad off meds a few weeks before his death
It comes a time when BP meds are not needed,, but did keep him on percoset

Meg..how is your mom this week? Its pretty tough, I know
There is a man at the nursing facilty,,where mom is.
that has been there 3 yrs and is finally passing
but even after not eating for one week..he is still hanging on
family keeps 24 hr vigil .....its a nite mare for them.

Hugs to all of you.
chris

 
Old 05-24-2011, 08:50 PM   #6
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Re: What's always the same!

Chris, most of the medication Mom is on is for what I call "Chemical Contentment". Just missing one morning's worth of pills caused angst and told me she needed to stay on those. Other than that she is on her diabetic medication, a maintenance dosage of antibiotics for recurrent UTIs, and her allergy medication. Even deep in her dementia that post nasal drip annoys her. She was taken off everything else over 2 years ago. Yep she survived the fall and head bang... and has fallen once since with no injury. She is getting slower and her balance is not what it was.... but it's the weight loss that is worrisome. She is eating and gets 2 Ensure Plus a day... but is now down to 103 pounds. Starting weight was about 130. I will spend the day with her tomorrow

How is your Mom doing Meg?


Love, deb

 
Old 05-25-2011, 03:45 AM   #7
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Re: What's always the same!

My sister has been in hospital for a couple of weeks due to spinal surgery, and the old ''why don't they pay attention to their charts" problem has popped up. My sister cannot tolerate anything with gluten in it, along with several medications. It is amazing what a fight my BIL has had with hospital and now rehab center staff. Although it plainly states on her chart that she is unable to eat wheat, rye, barley etc, they bring her breakfasts of waffles, croissants, desserts of oreo cookies. No fresh fruit ever, no fresh vegetables. Half her stuggle is to get well and learn to do everything with a permanently ramrod stiff back, the other half of her energy goes to telling staff over and over again that she canot eat practically everything they bring her! They also overmedicated her with pain drugs to the point that she could hardly breathe. They also fitted a back brace so poorly that it cut in above and below.

I am so sorry your Mom is still struggling to get good care. I am constantly reminded how lucky I was when Mom was in the NH in New York. There were no such problems. Or, the fact that my brother hung out there almost every day and kept an eye on things prevented such problems,

Just want to say hello after not looking at this Board for weeks. I read that the stronger Aricept pill is gong to be recalled ..too many digestive system problems. It never helped Mom one iota.

Love,

Martha

 
Old 05-25-2011, 06:24 AM   #8
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Re: What's always the same!

Martha It is always good to hear from you!! I am so sorry your sister is having to deal with this unnecessary incompetence while she is trying to heal. If you don't fit into the cookie cutter mold you have to fight for what you need. I do hope she will heal well and all this will so be a memory.

I had no problems with this facility for the first year and a half. The Rem director was wonderful and ran an amazing unit. She cared for her father who had ALZ and she truly understood. The problem came when she had to leave for medical reasons and was replaced with incompetency... a corporate transfer. I am sure the facility she left, celebrated! It has been sad to see the deterioration. Just another example of... nothing stays the same in this disease.

Love, deb

 
Old 05-25-2011, 07:29 AM   #9
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Re: What's always the same!

Mom is down 10 pounds also since dec.
My poor dad lost 60 pounds in one year! It is so hard to see them fade away ....
You are so good to your mom.....She is very lucky to have you

Meg.. we hope you and you mom are ok.
Hope to hear from you

chris

 
Old 05-25-2011, 06:21 PM   #10
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Re: What's always the same!

Hi Gang...my company is gone so I can now curl up in my favorite (old and worn) bathrobe and check in on my friends. My brother was here for 6 days while I slipped away for twoto Key Largo. Much needed and WONDERFUL!! My mom's baby sister (my age) was also here to see mom. She hadn't seen her in a year since she lives in Missouri and only gets to Florida once in a while...anyway it was a big change for her to see mom one year further into the disease.

Deb, I hate to hear your mom has fallen again and her weight...! My gosh...down more. I will check again on mom's weight tomorrow...it was unchanged in April and they kept putting off weighing her in May. I have asked several times so I guess I'll ask again tomorrow. She is still eating well. Not talking much...she can but seems the words that come out are reflex words...OW....or HEY when we move her chair unexpectedly...once in a great while she will say a sentence. One day it was..."let's run away". No angst when she said it...just a "let's go" kind of thing. I think she is beginning to not recognize me....I thought it would be more upsetting but she is comfortable with me and I go on about our business as though she does. It is a sporadic type of thing. My brother noticed it too. He flies in every 6 weeks or so and can really see her decline...and decline it is. But she is sweet and calm and still smiles daily.

Martha....I'm glad your sister is getting better but sorry she has to deal with the same stuff we are dealing with here .. health care incompetancy.

Chris...thanks for checking in and checking on all of us!

Love,Meg

 
Old 05-25-2011, 06:52 PM   #11
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Re: What's always the same!

Meg....so happy you got a vacation!! I am so envious!
Its been over a yr for us

Mom is being discharged from nursing facilty on sat.
Want to move her back into assisted living ..
where she was before hospital visit
Now ..the new head nurse does an assessment and now she says MOM is not accepted back because of fall risk!!!!!
I am so angry......
90% of the residents are fall risk.
Both her dr and nursing facilty say she is snapping back faster than the last stay with them 2 months ago

So I stormed down there to try and get meeting with director and head nurse..but looks like tomorrow we will meet
She is prob angry with me cause I moved all of moms stuff out after her last hospital ordeal..
Dr told me she would not survive this last seizure
Life just does not get any easier...
Guess i will have to file a medicare appeal ,,if assisted living drags there feet.
or mom will be homeless after sat or we kick in 200 a day..

Take care and wish me luck tomorrow..
Chris


 
Old 05-25-2011, 08:15 PM   #12
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Re: What's always the same!

Chris... let the rehab social worker know all the obstacles in your way and be sure she knows that you are incapable of taking her and your house is unsafe for her. They can not put her out on the street Hopefully the meeting, face to face, with the facility nurse and director will help them come to a different conclusion. Let us know how it goes.

Meg... I am so glad you had a wonderful few days off and some help with your brother and aunt there You earned it! Hope you get your weight tomorrow. I can't believe how hard it can be to get something so simple. It does my heart good to know your Mom is still content and smiling!! Mom said the same thing to me today...."Let's go". She doesn't say much that I understand but occasionally she will come out with a statement consisting of a few words that makes sense. Friday she did something strange. Everything she tried to say was in a whisper. Today, she said almost nothing... One "Alright then" and two "Alright"... I guess Alright was the word of the day. I am just thrilled you had a few good days to recharge your battery!

Love, deb

 
Old 05-25-2011, 08:27 PM   #13
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Re: What's always the same!

Chris,... It had been 15 months since we had gotten away. Knowing my brother was here and taking care of things let me release everything and just enjoy some time outside of the land of Alz. It validates that there will be life again after my mom gives up the fight she has been fighting for a dozen years. Just two days away did wonders! Luckily for us we are only two hours away from Key Largo...drinking mojitos and watching sunsets while sitting under the palm trees was like salve for a tired soul.

Deb..."Let's go"... I swear I am going to put it on mom's head stone!

Love, Meg

 
Old 05-25-2011, 08:31 PM   #14
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Re: What's always the same!

Oh and Chris...I wish you luck tomorrow...be calm in the meeting...as calm as possible that is. And be factual. Deb told me just before my last storm into the director's office that they are trained to handle emotion but throw facts at them and they can't fight it as well. Good enough paraphrase, Deb?

Love, Meg

 
Old 05-25-2011, 11:31 PM   #15
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Re: What's always the same!

You paraphrased it well Meg. Emotional outburst are not given much credence. Stand back and it will blow over But if you go in with calm logic and facts they have to deal with the problem and not you. Cry, they will hand you a tissue, and you both feel better. Given them facts and logic and they have to deal with the problem to make you both feel better. Your job is to convince them that they need your Mom... and your money

Knowing you had a wonderful vacation Meg... even makes ME feel better

Love, deb

 
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