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Old 11-12-2011, 11:20 PM   #1
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Angry Update on my mom

Up and down we go

Here comes the rant:

I got a call yesterday (of course it was a holiday--holidays and weekends are the days you can't reach anyone) informing me that Mom had a follow-up appointment with the orthopedic surgeon on Monday. WHAT!?! I cancelled her appointment Tuesday and I tell them she's not going so they make another freaking appointment on Friday?

It was the PA's doing--she told Social Services on Thursday that Mom HAD to go see the doctor. Social Services told her that wasn't going to happen; that she could call me if she wanted, but I was going to refuse. So she had one of the nurses make the appointment and had the wound care nurse call me.

Mom's surgical incision is definitely infected; they've given her one round of antibiotics and that didn't work. Therefore, I'm supposed to transport her to the surgeon's office--agitated, in pain & hyperventilating--so he can look her over and order more antibiotics. That way, the NH & the PA's collective butts are covered.

I DON'T FREAKING THINK SO!!

I tried to get Mom's doctor on the phone, but he's never available--I swear to you that I'm not exaggerating when I say I've probably spoken with him a total of six or seven times in the past eighteen months. Seriously.

So I called social services, and that's when I found out they had already told the PA the day before that this wasn't going to fly. I suggested another round of antibiotics--if that doesn't work, Mom probably needs to be readmitted to the hospital anyway (and the orthopedic surgeon can see her there).

God Bless Social Services! They had already asked if a culture had been done on the infection (of course not) and suggested that the doctor order that and then another round of antibiotics that might actually target the infection and we'll go from there. Still waiting to hear back from the doctor--in the meantime, keep your fingers crossed for my poor Mom

I'm also having them put a signed statement in Mom's chart that absolutely no outside doctor's appointments are to be made without my permission. I'm not blaming the nurses for obeying orders, I'm just tired of cancelling appointments!

Rant over--thanks for letting me vent.

You know, I really hate having to waste so much time and energy on this stuff because I'd rather be spending my time and energy on Mom. I can't get her evaluated for hospice until after her rehab is finished; if she's accepted to hospice, insurance won't pay for the rehab. So we wait. Today she was in pretty good spirits, drank a cup of coffee & had a few cookies (diabetes be danged!) while I was there. Her smile lit up the room. That's what I need to focus on--her smile. I don't want to get so distracted by these stupid little battles that I lose track of her.

Take care and I wish y'all the best
Love, Kren

 
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Old 11-13-2011, 11:28 AM   #2
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Re: Update on my mom

Hey Kren -

Sorry for what you're going through . I'm glad social services was able to intercede on your mom's behalf though! I hope the infection can be taken care of sooner than later. This disease is tough enough on its own. Seeing our loved ones in physical pain on top of it really bites!

Hey - please rant anytime! I'm glad I'm not the only one! Don't know what I'd do without this board.........take care -

 
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Old 11-13-2011, 03:48 PM   #3
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Re: Update on my mom

Rant on Kren.... we know your frustration so very well. Thankfully social services has some sense! I can understand not letting the infection rage but there are things they can do without transporting your Mom. Beyond that, the doctor doesn't have a clue how to treat until a culture is done so he will know what to treat it with. Pat answer to anything is "bring her in". They don't get that it is traumatic for the patient and the family member that has to go with them. Not to mention doctor's that don't return calls and medical staff that is only concerned with covering their butts. Makes you want to rip out their hair!! Kudos to you for standing up for what is best for you Mom! Stand tough. You are her best advocate in this crazy medical world

The right antibiotic is critical and I am not sure why they don't culture. Mom had a recurrent UTI for 18 months. After insisting that she have a urine culture they discovered she was on the wrong antibiotic. It would knock down the infection a little but as soon as it was stopped the infection would come back worse than before. After the culture and the right antibiotic... it was cleared up quickly. GRRRRR!!!! Something so simple that can make a world of difference and they just don't do it.

I smiled at the cookies! I got all kinds of grief for giving Mom ice cream. She is not a true diabetic but has that diagnosis which was a result of steroids. She was seen after a round of steroids because she was having chest pains. She was treated for a possible heart attack and given a diagnosis of diabetic. What she had was an adrenal reaction to steroids which had caused a panic attack and elevated sugar level because of the steroids as well. That was almost 10 years ago and I am still dealing with that flipping diagnosis... not to mention she ended up in the heart cath lab for heart issues which do not exist. So I ended up getting a presciption for chocolate ice cream twice a day!! I feel it is our joy to bring joy into our loved ones lives!!

As you, I do get frustrated with spending so much time dealing with these stupid battles. We need to be enjoying the time we have left with our loved ones and not spending it knocking heads. I do hope you can get the culture and the right antibiotic. That will make all the difference. Then your Mom can get better, rehab, and you can enjoy some time with her. Hang in there

Love, deb

 
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Old 11-14-2011, 03:01 PM   #4
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Re: Update on my mom

Rant on, Kren! You get 'em!!

I feel your pain... similar conversation this morning with mom's nurse back in the NH (she was discharged from the hospital on Friday after the 2nd hip sx)... nurse said surgeon said to call and make a follow up appointment. I looked at nurse and laughed (she smiled...she's nice, but not necessarily personality plus) and I said Oh, I'll take care of it. I thought "really?!?! Are they kidding?!?!"

And I don't mean to hijack your thread, kren, but get this: before we left the hospital friday, the hospitalist came by. He had been concerned about mom's liver enzymes and said that they'd come down a lot, which was good. But he was going to take her off of her valporic acid because that's all he could think of that would raise her levels (he'd forgotten that I'd told him early on that she'd been on low dose scheduled lortab from the first hip sx 7 weeks prior).

So I'm standing there thinking "oh, uh-uh. no you're not taking her off of that!" when mom pipes up and says something out of lala land, and the hospitalist looks at me and says "does she have dementia?"

DUH! So I say "umm, yes."

He says "is she on anything for that?" (which cracks me up... like it's high blood pressure or something)

I say "well, I think they tried her on namenda..."

and he jumps in and says "oh, well, you don't just start on namenda, they put you on aricept and then add namenda."

and I say "nevertheless" (do any of y'all remember when Kathryn Hepburn in The African Queen says that to the ship's captain after telling him the story of what Humphrey Bogart had done to sabatoge the ship....the captain said something like that's impossible and she says "never-the-less..." but I digress)

So he says "well, when she gets back to the NH, they need to do what's called a mini mental exam, which is a test.... blah blah blah and proceeds to explain it to me, ending by saying that the highest possible score is 30.

I say "yes, well, on the last one she took, she made less than 10."

and he says "Oh, so she's severe."

Uh, YEAH! Did you not read the chart??!! Let's see, she's 84, she's just had a 2nd hip surgery in 7 weeks, she's always got a family member with her 24/7, she's on low dose valporic acid, she lives at the NH..... not to mention it is (or should be) in the chart! and this is at least the 3rd time he's seen her in as many days!

But I said none of that, and just decided to disregard anything he'd said previously.

Sigh. It just galvanized our conviction that one of us needs to be with her whenever she's in the hospital or at the doctor's office or where people don't know her. I just did not appreciate his making these pronouncements about what we should do after discharge when he hadn't taken the time to learn something basic like that. Shoot, who really cares about elevated liver enzymes in light of everything else?!

Phew...I feel much better now! Ranting is good!!

Love,
Sarah

 
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Old 11-14-2011, 04:40 PM   #5
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Re: Update on my mom

Sarah, I think you rant goes very well with Kren's. We need a thread entitled... "Doctor's say the dumbest things!!" I had a similar situation with my Dad. He had fallen and we needed a hip x-ray. A fresh out of med school doctor showed up. I started by saying "My Dad has Advanced Vascular Dementia!" He fell and needs a hip x-ray thought I don't think there is anything wrong with his hip. He has degenerative back disease and I am sure that is the issue. With this the doctor said he needed to talk to Dad. OK!!! He tried to converse with my very confused Dad. He had gotten out of bed, fell, and was shipped off to the ER in his underwear. He was NOT happy!!... and more confused then normal. The doctor walked back over to me and ask if he had hit his head. I said NO!! Well he must have hit his head. Why? I ask! Because he is confused and I think we need to do a CT scan of his head. I literally burst out laughing. When I composed myself I as the young whipper snapper doctor what part of "Advanced Vascular Dementia" he didn't understand. Please go get one of the last four CT scans Dad had made and then come back and explain to me why Dad was confused. "The swiss cheese appearance of his CT scan should be a clue! But a different doctor came back and said he understood my Dad was confused. I said yep. He then started explaining to me about Alzheimer's and those same meds. I let him talk himself into a corner before I explained to him that Dad's diagnosis, which was on his chart was ... Advanced Vascular Dementia. I never saw that one again either.

You are right, I never let one of my parents be at the hospital or ER alone. They don't get it. I have left Mom once because they were ready to transport... she ended up in four point restraints... and Dad once for 15 minutes to pick up my phone charger... he ended up with an Ativan overdose. I have even gone into CT scans and X-rays with Dad. They "didn't need me" for about 2 minutes and then came and got me

I have talked at length with our local Alzheimer's Association president concerning the need for medical personnel training related to dementia diseases... especially in the ER setting. I am not sure she understood the extend of the problem but she gets it now and hopefully it will make a difference in the future.

That is why I say, we are our loved ones best advocate. We have to be informed, persistent, and stubborn in what our loved ones need!!

Love, deb

 
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Old 11-14-2011, 10:33 PM   #6
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Re: Update on my mom

Thanks everyone for your support!

Sarah, don't you worry about hijacking this thread--I'm so glad to hear that your mom made it through the surgery and is back at her NH. It's no walk in the park, but at least you know the "lay of the land."

"Nevertheless..." LOL--that really cracked me up! Hope you don't mind if I use that next time

Quick Update: This morning (Monday), I got a call from the PA She heard I was looking for her or Mom's doctor (actually, I was trying to get the doctor so I could go over her head ). I told her Mom was not going to the ortho for a follow-up visit. Dead silence. She kept trying to convince me, then started talking about "outpatient wound treatments." I told her Mom wasn't a candidate for outpatient anything, but she just wasn't listening.

So, the bottom line this a.m. was that Mom's doctor never responded & no one ever ordered the culture. Two more days wasted when they could have been giving Mom another round of antibiotics. Yes, she could have a bone infection, but it could also be a superficial infection from lying there in bed in dirty diapers.

I called Social Services again and they recommended that I talk to the Head of Nursing, who managed to get Mom's doctor on the phone. The doctor agreed to order a culture as long as the Head of Nursing explained to me that Mom might have a bone infection and made sure I understood the risks. God Forbid the doctor would call me himself. So I said yes, I understand, what do I need to sign to cover their butts?

Social Services told me later that everyone had tried to reason with this PA, including the Head of Nursing, the shift supervisors, the wound care nurse, etc etc and she wouldn't listen to any of them. I can make an official request that only the doctors oversee Mom's care, so I'll probably be doing that if and when she's stable. Mom was much more confused today, more delusional & generally NOT a happy camper. Things could go either way at this point--we'll just have to wait and see what happens.

Love, Kren

PS I've found that no matter where you go, some people "get it" and some just don't. They get easier to spot, too And I always assume NO ONE reads the charts--if they actually do it's a pleasant surprise.

 
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Old 11-15-2011, 07:41 AM   #7
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Re: Update on my mom

Good for you Kren. Keep standing strong for what is best for your Mom. I'm with you girl! You are right, you quickly learn how to spot those that "get it" and will be on your side. At least you got the culture ordered. Yes it could be this or that or something else but if you know what bacteria you are dealing with (regardless of the location) then you know better how to treat it. And you can do this without transport! My question would be... "Can the doctor see the bone and know that it is infected".... HUMMM!? Maybe he will share his x-ray glasses

I know Mom has rehab in her immediate future, but if this infection is not resolved you might want to opt for hospice rather than rehab. That way you have a doctor that will visit in house. Then if Mom shows marked improvement you can go back to her regular doctor and rehab Just a possible option. You can also check to see if there is a "Doctor's on Call" or other home visit group of doctors that will see your Mom. Mom and Dad had visiting doctor's at their other facility and not there are visiting doctor's at their current facility. You already know that lab work can be done in house, and I bet X-ray can as well. I am not sure if bone infection would show up on x-ray but it might be an option to request. Just know where there is determination there will be an answer... and just keep pushing for Mom!

I do hope she will get the right antibiotic and respond well to treatment. Know I will keep you both in my thoughts and prayers Keep us informed please!

Love, deb

 
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Old 11-15-2011, 06:13 PM   #8
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Re: Update on my mom

Thanks for everything, Deb--you are such a lifesaver!

You know, it never occurred to me that you could start and stop hospice. Thank you so much!

This morning I got yet another call--this time from the ortho surgeon's office. Someone called them from the NH last week and they were just getting around to calling me. No, we won't order a culture, she HAS to come in, the whole rigamarole all over again. "We don't do wound care over the phone" and I'm thinking who the heck asked you to? According to the doctor's liaison (never the doctor, always some go-between), what I was suggesting--a culture followed by another round of antibiotics--was so far outside the range of normal care, they would consider it going AMA. Great. Now if I don't take her into the office & she does have to go to the ER, I'm going to get a raft of it for not following doctor's orders AND her health insurance may not cover it.

I called social services and was told the culture had already been done this morning, ordered by her NH doctor at my request. I was happy about that, but explained that someone had really screwed the pooch by calling the ortho and getting him in on the culture drama. So all of Social Services and the Head of Nursing sat down with me (I was having a meltdown at this point ) and basically said they had my back if it came down to it; it was their screw up and they'd find a way to fix things. I'm hoping it doesn't come to that.

They also told me that the PA told them that I said I would consider taking Mom out for an office visit if the second round of antibiotics didn't work, which is a total lie. I have been adamant all along that if the second round doesn't work, then Mom probably needs to be in the hospital anyway. The social workers said that's what they thought, that's what I've been telling them from the beginning. At least someone is hearing me!

Sorry to go on so, but I'm almost done. Here is where Deb (my hero!) comes in:

I asked Social Services if Mom does develop osteomyelitis, can we suspend rehab, call in hospice and then if she does manage to recover, restart rehab and/or restorative care? Absolutely! And it's covered by Medicare! Hooray! So that's the latest battle plan. THANK YOU DEB!

More good news: Mom walked three times in PT today, her temperature is still normal, her white blood count is going down, not up. All good news. And another corker--the hospital released her on a minimum dose of her anti-anxiety meds, so she's only been getting about a third of her usual dose. No wonder she's more confused & delusional.

I think I'm taking the day off tomorrow--I need a break. Thanks again for being here--all of you! And I owe you big time, Deb

Love, Kren

 
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Old 11-15-2011, 10:51 PM   #9
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Re: Update on my mom

Kren You just gave me a great big smile. Take the day off tomorrow!! I am You battle and confront and scream and yell and swear a little with a few melt downs and then somebody hears you! The corner is turned and life melts into that crazy normal we live with daily and the drama abates until next time. And we know there will be a next time... until the last time. One thing you can say about this journey... it's never boring

I hate the medical go betweens. I think they have a degree in witchiness They throw around ultimatums and demands like they are speaking the gospel. I am sure it ruins their day when they find somebody with the same degree they have hehe. It's about taking care of Mom, not making the ortho flunky happy! At least the NH group is listening. My best is she has a local infection and the right antibiotic will clear it up. With the temp down and white count going down... that's a really good sign!

Question... what anti anxiety medication is she on? ::holding breath::: I am just happy she is less confused and deluded! Take tomorrow off... do something special for yourself.. and know I have you and your Mom in my thoughts and prayers

Love, deb

 
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Old 11-16-2011, 03:24 PM   #10
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Re: Update on my mom

Deb, you are right that some of those go-betweens are so cranky! It annoys my because here we are, trying to care for a person we love who is leaving us slowly, but not necessarily "gently into that good night" and it's difficult, and then we're trying to have some semblance of a life for ourselves, and in some cases, trying to maintain our obligations to other family members... those cranky people obviously have no such issues in their lives or they'd be more compassionate, right?

Last week, when mom was in the hospital, I developed a sinus infection. I called my ENT and made an appointment for 3:30 on Thursday. My brother was supposed to come at 3 so I could make it on time. Well, he didn't get there until 3:40, so when he got there I called and said I was running late. Well, the woman who answered the phone is generally a little snippy anyway, but she said in a sort of warning tone, or maybe a condescending tone (or both!) that they had told me 3:30 and it was the doctor's last appointment and now it was too late. And she started to say something about being on time for appointments or some such..... well, I lost it! I started crying and told her "my mom has dementia and is in the hospital for a broken hip and I had to wait for my brother to come be with her because we can't leave her by herself and he just got here and I really need those shots so I can have the energy to spend the night.. boo hoo hoo" (I was so worn out from staying at the hospital and feeling puny that I didn't have the energy not to cry!) I was embarrassed, but also a little glad to let her know it wasn't OK for her to act like a jerk!!

Have y'all ever seen Shrek the movie? In it, Donkey gets stressed out and says something like "you'd better look out! I'm a Donkey on the edge!" That's how I felt! I was a donkey on the edge!!

Love,
Sarah

 
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Old 11-16-2011, 11:20 PM   #11
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Re: Update on my mom

Sara, there is nothing wrong with letting people know that you are the "donkey on the edge" and they just gave you that push you don't need. They don't know your situation and there is nothing wrong with letting them know that they have just thrown your life into further chaos. Don't be embarrassed for being honest! She needed to know. Maybe next time she will be a little more empathetic. She is the one that should be embarrassed and I hope she was after you vent I hope you gave your brother a few words as well.

Suggestion, go by an urgent care!! The "doc in the box" is always there. They take walk ins and I have found that the wait is not that long during the day. I have taken Mom to urgent care a few times. I can be in and out in less than an hour where as the ER takes hours... and I don't have to wait days for an appointment. Then you can have what you need sooner

I do hope you are feeling better soon!!!

Love, deb

 
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Old 11-17-2011, 11:02 PM   #12
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Re: Update on my mom

Hi again

Yesterday was lovely--I never got out of my pajamas

Today I had a pretty good visit with Mom until she started sundowning. One of the physical therapists got her into a wheelchair for me and we rolled around the halls for awhile, visiting her usual room for a minute and saying hi to everyone.

I left at 5:10pm and at that point they were about to start her on her new round of oral antibiotics for the infection--Cipro this time. Okay, fine.

Well, I got a phone call at 6:40pm--an hour and a half later--from Mom's nurse. The doctor has decided to change the order to IV antibiotics administered at the NH and wants her to go to the orthopedic surgeon for a follow-up appointment. Here we go again.

I told the nurse that there was NO WAY Mom was going for an outside follow-up visit, that it was not his problem and I would talk with Social Services, the Head of Nursing and whoever the heck else I need to tomorrow to straighten it out. He agreed that it was not his problem. I thanked him for keeping me informed and hung up.

When I got home (I wasn't even home yet), I called and left a message for the Director of Social Services explaining the phone call & that they already know where I stand on outside doctor visits, and if it's time to call hospice in then so be it. I also added that I've decided I don't want that PA anywhere near my mother ever again, and that I expect all of this to be worked out tomorrow. Whew!

To answer your question Deb, I'm sure you can guess that they have Mom on: Lorazepam (Ativan) for anxiety & Trazodone for depression. I've done battle with the Geriatric Psych about this before, but Mom puts on quite a show for him and he thinks she's "just a little anxious." I'd love to know the cocktail that works for your mom--feel free to PM me if you don't want to post it here. And thanks! That's the next big battle brewing on the horizon....

Thanks to all of you for your thoughts and prayers.

Sarah--I'm a "donkey on the edge" with you! Now if we could just get them to stop trying to push us over!!

Love, Kren

 
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Old 11-18-2011, 12:33 AM   #13
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Re: Update on my mom

Just when you think you have the world in order some little yuck comes along and throws it into chaos. IV antibiotic? Talk about a little anxious. She is not going to understand what that tube attached to her arms is and out it comes. Then it's a fight... an unnecessary fight! So they will throw some more drugs at her, probably IV ativan! Then we have zombi Mom with a double IV. Oh and after we do this let's ship her out so a doctor can look at an infection. Like he is going to be able to determine what is going on visually! Makes you want to slap somebody huh?

The Trazodone is ok... but the Ativan GRRRR. I had this same ativan discussion at Mom's facility today. I walked in and one of my favorites (feisty lady) was out of it in a semi comatose slumber. Yep Ativan. When she woke up she was so agitated they had to give her another PRN Ativan. Zonked her out again. That is not the way to calm somebody. Beyond that this class of drugs increases the fall risk because of the sedative effect, it decreases cognitive function, They decrease the cholinesterase neurotransmitters that are already reduced in Alzheimers, and that doctors use the mildly effective aricept to increase. And it is addictive! Dementia specialists and medical articles state that Ativan are inappropriate for dementia patients. Amazingly Ativan along with Xanax, Valium, and Librium all work the same way Alcohol does. Some will sleep it off and some will become highly agitated. Might as well give Mom a stiff drink This is why I flip every time I hear that a doctor has ordered Ativan as a first line against agitation in a dementia patient. I wish they would read their own medical literature first !!

I do understand why Doctors do this. The anti psychotics that truly help have been given a bad rap. In trials, the patients taking these medication has a 1.7 to 1.8 times higher rate of mortality.... according to the FDA. It was not from any single cause but included both circulatory and infection related death. What they found was the placebo groups had a death rate of 2.3% and the treatment group had a death rate of 3.5%. Is is barely statically significant! When you are dealing the emotional distress that dementia can bring on.... I am not flipping a coin for that difference when it will bring contentment to my Mom. I was 100% aware of the risk when I agreed to these drugs for Mom. Abilify (aripiprazole), Zyprexa (olanzapine), Seroquel (quetiapine), Risperdal (risperidone), Clozaril (clozapine) and Geodon (ziprasidone). Symbyax... are among the drugs included in the study. But they tacked the label on all of the newer anti psychotics.

Mom is on Remeron (Mirtazapine), 30mg once a day, Depakote (Valproic acid) liquid 500mg twice a day, Zoloft 150mg once a day and Geodon (Ziprasidone) 80mg twice a day. That is a hefty dosage of anti psychotics and your Mom probably does not need that much but it was what Mom needed for her hysteria. Dad was on Seroquel, Risperdal, Remeron, and Depakote at various time in various combinations to control his anxiety and paranoia. Any of these is better than the Ativan The Trazodone is basically for depression and I do know that it is being used effectively at the care facility I used to work for. My best is Mom would be better with just the Trazodone and no Ativan Trazodone works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance. Definitely better than the Ativan

I have fought these battles as well and know that any medical treatment can be refused! I necessary get a second opinion to get what you need and want!

Love, deb

 
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Old 11-18-2011, 08:25 AM   #14
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Re: Update on my mom

Thanks Deb--I'm saving your last post for my next battle

Mom was on Remeron for a while, and I think at some point they had her on Risperdal--I can't remember now. I even let them put her on Haldol for a short period of time--we call it the "H" word around here--after her first operation, when she was trying to get out of the wheelchair every minute. They took her off that fairly quickly, probably because they were afraid I'd tell someone and they'd never fill another bed--LOL!

I know Deb knows this, but for anyone else reading, you have to pick your battles with the meds just like everything else. For instance, Mom is on a low dose of Lipitor, and seems to tolerate it fairly well. Now there's no earthly reason why Mom should be on a statin drug at this age, and it's probably doing her more harm than good according to the latest studies. However, I also know that the doctors get hammered by the health insurance companies & medicare if they don't automatically put everyone over a certain age on statins if they have slightly elevated cholesterol. So I use the Lipitor to wheel and deal: You can keep her on the statin (and keep medicare/health ins. off your back) if you stop/change one of her other meds. And no, it shouldn't have to be this way, but you have to use whatever you can to get what you think is best for your loved one. I don't try to bargain with the Almighty but everyone else is fair game!

Social Services called this morning to tell me they're on it--they're pretty sure Mom's doctor simply "forgot" Mom was not going to any outside doctor appointments & the Head of Nursing is going to call and remind him. And he'll probably "forget" again. Yeah, right. It doesn't really matter, because it just strengthens my resolve--if I let them send her out once, they'll be sending her out every other freaking day to cover their butts. Did I mention that I have "trust issues?"

Love, Kren

 
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Old 11-18-2011, 02:46 PM   #15
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Re: Update on my mom

Better to be an informed skeptic than trust blindly!!

As for the meds, you have to use trial and error to figure out which meds work and which ones to throw away. Many times they do not use an adequate dosage or give it adequate time. Most of these medications do not show effectiveness immediately. It takes up to 4 weeks to know how well they work. That is the charm of Ativan... It sedates them immediately! Usually it is a combination of medications that works best.... and what is best for your Mom is yet to be discovered.

Haldol is an old antipsychotic that was first approved for use in the US in 1967. It is used for schizophrenia and delirium. It does have a really bad rap and the newer atypical antipsychotics are better... but for immediate effects it does work

Forgot... what an excuse Well, I guess you can let him use that lame excuse if it remedies the problem!! Just keep "reminding" them At least you have social services on your side!

This problem of non ambulatory dementia patients that consistently try to get up because they don't remember they can't is a problem. I am a firm believer in entertaining rather than sedating. They are still going to try occasionally but if they are busy they attempt it less. Comfort is another way to lessen the need to get up. If they are uncomfortable they will want to get up and move. This is why they should not be left in a wheel chair or in bed for extended periods. They need to be transferred several times a day from bed to chair to bed or other suitable place. Especially with elderly patients who have hemorrhoids, back problems, or lack of skin integrity need to have position changes. I also believe in chair/bed alarms. These individuals should be watched carefully and the chair/bed alarms will alert them before an accident happens. Yes, it takes time and effort, and perhaps even mild medication but it can be done.

It is all part of understanding the disease and realizing that they can not learn, remember, or rationalize like we do.... so we can't expect them to act like we do We have to learn to expect demented behavior from those with dementia.

I do understand picking your battles and we can use one situation as leverage. You are absolutely right about the Statin. Until recently they were not even recommended for anybody over 85 and only those with high risk compromised cardiovascular health over 65. Now they want everybody on them, no matter how low the cholesterol. We hear a lot about the "muscle pain or weakness" side effect. What we don't hear much about is the cognitive loses. Cognitive problems can occur with statins and may also have more impact in elderly patients. I am one that Statins had a major cognitive impact! I spent almost a year in a fog that mimicked mild cognitive decline (MCD). Cholesterol is necessary for brain function... it is brain food! If you deprive the brain of cholesterol, then you directly affect the machinery that triggers the release of neurotransmitters. Neurotransmitters affect the data-processing and memory functions. In other words.. reducing the cholesterol in the brain may make you have less memory and cognitive skills. When we take statins that handicap the liver's production of Cholesterol, we also handicap the brains ability to make cholesterol as well. Yep, I refuse to take them now and wish this side effect was more widely known. I had both of my parents taken off the meds after Mom was diagnosed.

Ok.. so you hit on another pet peeve Ativan and Statins!!

Hang in there and hopefully the doctor will "remember" this time

Love, deb

 
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