So she's in her second week of rehab. Every time I visit she just wants to "lie down". Plus she has a completely unbelievable fear of falling, I mean she's comfortably in bed and gripping the railings like she's on a boat being tossed at sea. She says there's no vertigo or dizziness there either. Today I merely tried to raise the bed a little so she could eat properly and see me and she starts carrying on like it's the worst torture imaginable.
So I was talking to the therapist and she tells me that on Friday they had to change the mattress so there was no other option but to get her in the wheelchair for a while. This has been a goal since day one. She tells me that after a brief struggle she did get in the chair and remained there for a few hours with no issues. I was astonished as Mom never mentioned it.
So today I'm there and we figure let's go for it again. They sit her up and immediately the death grip begins. This little old lady who's always too weak to move was fighting off three people and resisting with everything she had. There was no risk whatsoever of falling. Eventually the therapist had to give up and i could see the annoyance there, as I felt it too.
I'm wondering if maybe it's me. When I'm there she never stops with the hapless routine and the fear of falling, then I hear that while I wasn't she's actually doing something. Perhaps i should skip a few days and see if it helps?
Babalou: Working on that right now. I'm supposed to meet with the Medicaid person late this week (apparently she only sees applicants on Thurs. and Fridays). They're already pushing re: discharge, however I'm "tuning it out" until I see how her procedure goes first. She might return to the rehab center (under a different protocol, obviously), however the copay is an issue right now so I have to work out some sort of payment plan there (again). As hesitant as I was to bring her home before, I'm definitely not going to mess around with a spinal injury, as I already feel terrible enough about how her prior rehab stint played out.
It also must be very gratifying to see a smile on your mother's face and know that she's feeling better.
With regard to payment, just remember that you are using mom's money for these expenses. I seem to recall you are not POA? So you are not signing anything with your own name.
Babalou: Yup, that's it. Also, we have a shared account so accessing it isn't a problem. She was "bilked" out of some money a few years back so at that point I began helping her out with that stuff. I also have a little money put aside that I can use if need be, not a lot but it's a start.
Social workers...(sigh). Today I heard from #6 (I number them now, it's easier that way) and she asked me if I've contacted "ABC" regarding a Medicaid appt. I said, uh, no, you gave me "XYZ's" number and told me to line up an appt. with her and all I get is a "this VM box is full" message. "No, I said ABC"..."no, you said XYZ, I wrote it all down" and etc. All I could do was laugh, it's so absurd sometimes.
Glad the procedure went well and that she's in CCU where they monitor your every breath. Hold steady, this looks like it's starting to go well.
I think having the cardiologist involved may slow down the discharge drums....
I would double and triple check on any civil action to recover damages for your mom's medical treatment. I would confirm if recovering any money would disqualify her for Medicaid Or if she would have to spend it, before she would qualify. I don't know the answer, but I would confirm that recovering damages wouldn't hurt her in the Medicaid process. There is no guarantee of what amount she might get, but unless it's an awful lot, it might not be enough to pay for her care for that long, but just enough to mess up her qualification.
You have a lot to be proud of; were it not for your persistence, those fractures may never have been discovered.
But then again, nothing would really surprise me at this point. I could very well get a call tomorrow morning (sixty seconds into my wake-up shower, no doubt) informing me that she's waiting at the curb in the rain for me to pick her up and I'd better make the Medicaid appointment immediately but the office is closed until Thursday. This hospital SW (#6) keeps telling me she'll call and set me up with an appointment, then the next day she acts like the day before never happened. So I'm assuming I'll just end up doing it myself and really it's just easier and less frustrating that way anyhow. IF she gave me the correct number this time, that is.
Today I was informed that she's been accepted back into rehab (the same one) which means I'll be discussing money again with these people. It has to go differently this time around, though, that's for sure. I also heard from another Medicaid "pre-screener" today for some reason and wow, what a grim robot she was. Apparently it's all done by mail here. You apply and a few months later you either get a card or a rejection letter. First she told me that Mom probably "gets too much" to be eligible and then she asked me if her house was "listed yet". I mean they don't even try to pretend they're not coming for everything. When I asked re: exceptions she pretty much sneered at me before explaining my options there. Not pleasant.
This time around they'll be able to focus on treating her actual maladies instead of guessing and I think there's at least a fighting chance that eventually she'll be able to return home. I'm not sweating the money end so much this time around, they're just going to have to accept a payment plan as she simply doesn't have a huge lump sum to plop down right now. She has around 25-30 days of those $157 copays to cover which isn't insurmountable or anything. She probably needs a few days of post-op recovery before she can do any real PT and again, this time around it's not going to be a rush job. Still waiting for her biopsy results although her specialist was guardedly optimistic re: that.
I'm wondering if there is anyway that the Hospital/rehab could be convinced to reset the clock given the errors. Couldn't hurt to ask.
And it's good she's complaining! If the soup is too hot, she must have an appetite and is hungry. If she doesn't like the cable line up (and who does?) she must be interested in watching tv.
I'm so glad this journey is back on track and headed in the right direction.
And thanks for keeping us updated.
The mental aspect is going to be tough IMO. See the "stubbornness" mentioned in the title of this thread. Trying to get a "straight" answer out of her is impossible sometimes and it can be extremely frustrating. I'm hoping they can put together a practical PT program for her that might give her a sense of accomplishment that she can build on, as "too much too soon" is just going to cause her to withdraw and make excuses to dodge it. Right now she's maybe 25-35% "there" which is definitely a step up from the 1-10% before, but still a lot of work to do.
I have an appointment with the rehab people on Tuesday to discuss "her treatment and therapy" (and probably "her assets and money" too). My goals here are realistic, I'm not expecting any miracles or anything. I want to see her regain some modest physical functionality and confidence which could lead to more mental stimulation too, which I think she really needs. I hope they're on the same (or similar) page here and that they don't try to push some "wham bam discharge day" idea on me. Yeah I'm cynical, I know.
I think this time around it's crucial that we can get her comfortably in a wheelchair, as she not only needs the mobility but she needs mental stimulation. She's been in and out of reality in hospital beds for a while now and it's definitely making her weird and squirrelly. But this time she has to ENJOY things like talking to people and being outside which won't happen if she's in pain, so right now getting her to a point where she can sit upright for a few hours without being miserable is the first goal IMO.
I think you need to get clear what her baseline was before. Was she declining cognitively ? Having trouble managing bills and such?
She may have had a TIA or small stroke somewhere along the line. She may not be able to clearly express "I have pain here, or I can't swallow that pill". Loss of cognitive function often leads to much anxiety and depression. Getting a clear picture about those issues is key in getting her the right meds and the right help.
If you don't feel that the psych people at the rehab are seeing her clearly, you might think, down the line, about taking her to an outside neurologist who specializes in dementia.
The big question is ALWAYS or NEW? Is mom's stubbornness a new development or has she always been this way? Usually cooperative or usually impulsive and pigheaded? Compliant with doctors or dismissive?
Knowing what I do now, I think it all played out something like this. According to what her doctor just recently told me, she was treated in 2004 for a back injury, which became the lower back fracture she was suffering from. I never knew about this, which is totally understandable as my sister was probably involved and her view of modern medicine was completely bizarre, as was her desire (and Mom's) to "not worry me" by telling me about things like that. This injury became a degenerative thing which Mom chalked up to "arthritis" in her "hip" which was always her go-to complaint.
The second upper back fracture occurred far more recently, my guess is sometime in mid-June of this year. I have no idea how or when and if she knows she isn't saying. This injury was so painful it forced her to adopt a posture which in turn put even more stress on the lower back which led to a snowball effect of sorts. At the exact same time she became very withdrawn and disinterested in everything as the pain and the fear of having that pain diagnosed and treated kicked in. From there it was almost like she was in shock, as she became non-communicative and even more withdrawn.
Right now the best way I can describe it is that it's almost like she's emerging from a coma state. She's all achy and sore from the lengthy period of inactivity, she's shocked that so much time has gone by, she's surprised to have survived it and she's still exhausted from the whole ordeal. I can see her personality peeking out here and there but it's tough to say how far it's been buried as of yet. Hopefully I can get her assessed based on what actually happened to her as opposed to what the first impressions doctors have of her are, as IMO it's all symptoms from the same thing.
Like I said, stubborn is a broad word and to properly describe it would take all night, but yeah, she's always been like that. Example: My mom is from that generation that thinks every new piece of helpful technology features a self-destruct button that must not be pressed so it's just safer to unplug the device entirely (wouldn't want to start a fire!) and go back to the old way of doing things. Phones, TVs, VCRs, DVDs, car radios, you name it, she's afraid she'll somehow "break" it by using it. I've forced her to adapt, she loved the new TV I got her a few years back, yet she still has her old rotary phone, I kid you not. She can be incredibly resistant to the simplest things sometimes and if it involves money in any way she's SURE it's a scam. She'd call the water department to ensure that the bills were real then she'd pay them in person just to be safe.
A few days ago my niece was visiting and she sends me a panicky text saying that Grandma is moaning and carrying on complaining about being in pain and etc. and that she seemed pretty bad. So I visited later that day and she was OK, nothing unusual going on. So today I asked her what the deal was with that. First she said she didn't remember but I didn't really believe her as my niece hadn't visited in a few days before that and I knew Mom noticed and wasn't pleased about it. So I asked her, "were you just putting on a show to make her feel guilty there?" and wouldn't you know it, she cracked a grin then tried to hide it. I keep telling these medical people, you gotta watch this one, she's got cards up her sleeve.
I want to posit an alternative interpretation to your mom's saga. Mom injures her back and at the same time, has a TIA iron other vascular event which also goes undetected. Now , using the reasoning skills of a 5 year old (it hurts, if I don't tell anyone, it will get better), she resists and evades intervention. What I'm saying is that it may not be the pain that has caused this; it may have been a vascular event that caused both the loss of cognitive skills AND the injury. Just something to ponder. The important thing is that she's getting better physically. Cognitively, you'll have to see where she is.