Perhaps Elvis is alive and visiting nursing home You never know on planet alzheimer!!!
My first introduction to Alzheimer was back in the 70's when my grandmother was diagnosed. Since then several of my aunts and uncles have had it. Then I spent about 8 years working in a long term care facility with dementia patients. Next my Dad was diagnosed with Vascular dementia and then my Mom with Alzheimer. I didn't have much choice but to learn about the disease and with that the ailments of the elderly and the medications that go with them. I like you spend time on the internet now learning all I can.
I am not sure how much benefit hearing and eye examinations would do.... especially the hearing. It takes patient participation to do an adaquite hearing examination and it's obvious your Mom would not be able to participate. Both of my parents have hearing deficiencies but they can communicate to some degree. Dad has had his hearing aids for so long that he puts them in without thinking about it... with or without good batteries in them. It is not unusual for him to be sitting there trying to make sense out of his surroundings not being able to hear because the batteries are dead. Even with his hearing aids he has difficulties. We have had him to the hearing doctor and they have done all they can for him. Mom only got her hearing aid after her dementia began. She rarely, if ever, puts in her hearing aids and if we insist she wears it (she refuses to wear two) the first time we are not looking she will pull it out and stash it somewhere to be looked for later.
Mom using her hearing lost as an excuse for her inability to associate with others on a meaningful level. I know it's not the hearing because she is the same whether she is wearing her hearing aid or not. The basic problem is her inability to process what she hears which was documented in her cognitive testing as a critical deficiency. But on planet Alzheimer it can't be them.... it has to be something else.... so she blames her hearing. For Dad, having his hearing aids working does help. With his vascular dementia he has more ability to process what he hears even thought he forgets it almost immediately. I can explain something to him and sometimes he "gets it" and even gives me back what seems to be thoughtful answers. Then he ask the same question again. He processes just doesn't retain so hearing is helpful in the moment.
Mom and Dad both had cataract removal on both eyes before they became as bad as they are now. Then Mom went back and had Lasic surgery on both eyes. Her visions is excellent but Dad needs glasses. Again, he has worn them so long that they are second nature to him and he keeps them on.
Any examinations like this are confusion to dementia patients. You need to weigh the possibe benefits vs the angst and confusion not only the examination but the new appliance will have. It definitely depends on your Mom's temperment, level of cognitive awareness, and the potential benefits.
That is not a definite answer to your question but it is my thoughts. Maybe something there will be helpful. I am truly sorry that your Mom has declined so rapidly. I am sure my day will come as well. Right now our battle is keeping the lid on Mom's aggitation and each appointment just makes it worse.
"But on planet Alzheimer it can't be them.... it has to be something else...."......
Reading through all your posts is so interesting and I often see comments where I think "these people are living my life", none more so than the comment Deb made above! My MIL refuses point blank to accept anything is wrong with her, and always blames something or someone else!!!
I love the way you all deal with your situations with humour, something my husband and myself also try to do. I see the difference too with Vascular dementia and Alzheimers. My FIL (vascular) has been "stable" for the last 12 months or so, having had no more mini-strokes, whereas my MIL (Alz) definately is on a constant downhill spiral.
We are still struggling with water infections - and if I hear once more that she "really does drink a lot" I will scream! Like you have all said, you can be sat in the room with them for a couple of hours, and still only get a few sips down!
Deb,
Thanks again for help. Do you feel used yet? Got a new one for you this morning! As I've told you, mom spent five days at a geri-psyche unit a couple of weeks ago being evaluated for possible medication to help with confusion. Seroquel had caused havok. After many evaluations and tests, it was decided that no antipsychotic would be of benefit at this time and could prove more dangerous. They are still hoping that she will stabilize with her walking. She will walk about 15 steps fairly well still on a walker. Everything they considered also had the effect of making her less stable if she got up unexpectedly.
I have now entered the NH five days in a row to be hit with medication questions. On Tuesday afternoon, I found out that they had put her on depakote two days before. The next day, I received a message that they wanted to talk to me about medication. When I entered the nurse's office they already had an order ready to increase Xanax to four times the amount she was put on in geri-psyche. I would not okay it until they called the physician that had seen her. He absolutely refused. He agreed to trying the depakote for a while. I asked one male nurse upon this questioning," what would he do if this was his mother?" He quickly replied that if it was his mother, she wouldn't be there anyway. She needed 24 hour care. It cut through me like a knife, and I said nothing. By the next day, it had got to the second in line of the nurses on staff. She called me outside and apologized. She said that they were a 24 hour a day facility, and if he didn't like it, he didn't need to be on the staff. The next day another young female nurse complained that she was taking up too much time. She was the one who had requested the order for 4 times xanax dosage increase. She said that it was frustrating to the staff working eight hours to be constantly answering a beeper on her chair to make sure she was alright. As I followed her to the office, she was met by her superior. The nurse overheard the conversation. She told the nurse that it was her job to answer the alarms! When she saw the order, she couldn't believe the increase requested. That's when I refused, and they called geri-psyche. Both of these orders were written and the first administered for two days, the upped xanax had been given only one time when I was notified. Is it out of line to request to be notified before mother is put on new medication. I realize they know more about meds than I do. However, they really pushed the geri-psyche evaluation, but now don't want to abide by it. If she thinks she was frustrated, she should be standing in my shoes and watching the changes day by day only hoping you are doing the right thing. The worst part, from what I understand, these orders are okayed by the DON and signed by a doctor AFTER administration when he comes in once a month or so and signs all orders for medication that have been written without even knowing histories of patients. Is this the NORM?
I can't answer anything about the drugs they are using. But there is one thing that jumps out at me in your letter.
The staff is there, paid, and trained, to answer the needs of every patient on their floor during their entire shift. Nothing needs to be done by the family. (like feeding, walking the patient etc.) You are paying good money to have her there to be cared for 24/7.
The thoughtless complaining remarks made so far by 2 staff members may have been the exeptions to the rule. But if it turns out that the general atmosphere there is 'getting the patient quiet so I can relax and not have to work" then the place needs to be investigated by the proper authorities.
From my experience with my mother, nothing medical was ever changed until AFTER the doctor had seen her and decided. Until then, the staff had to live with it.
I am sorry your situation is so hard. It has to get better!
I completely agree with everything Martha said OCharlotte. NO medication could be given until it is signed off on by the physician..... especially the types of medications you are talking about. There are standing orders for things like Milk of Magnesia, tylenol, and other general meds for occassional use but otherwise the doctor has to be notified first and orders approved prior to administration.
As for the comments of the staff.... I am glad the administration heard what was being said to you about your Mom. I hope appropriate action was taken out of your range of hearing. That is uncalled for and if I had employed that staff member and heard that..... she would be out the door!!!! I fired more than one for less than that. Patient care is first propority and if you have to answer a buzzer 100 times a day.... you do it. I would have a discussion, even if you have to make an appointment, with the nursing administration about what has been happening. You will get a sense of what the top is thinking and what they don't know they can't fix. So don't go in angry or upset, just matter of fact and with logic and fact, and see what happens.
I would also make sure that they understand that NO new medication are to be given to your Mom until after you are notified and you want assurance that the geri physician has signed off on the order prior to administration. And keep your eyes open to what is going on. You will know if it is ok and these are just isolated incidence or if there is a pattern here.
Our state has a Department of Facility Services that monitor facilities. They have an anonymous tip line. You can file your complaint, without giving your name or the patient name, and they will investigate. Sometimes it's a pain when there is an honest misunderstanding but most times it is effective in alerting authorities to bad situations. Check out your state and see what is available, what the rules are, and what your options are.
If you find a pattern that you are not willing to put up with... move your Mom. That is not the only facility and I know there are good ones.
Love, deb
PS.... if I can be used to make a situation better or make a caregiver feel better or get better care for a patient... USE ME!
You never know on planet alzheimer!!!
