Today was not a good day for mom, I don't know what is going on with her today. I had to go get my grandmother's old wheelchair from my aunt because my sister in law couldn't get her to the bathroom. She is really weak and shaky and her knees buckle. I had trouble getting her into bed. I have been doing this for 2.5 months and it has never been like this. She isn't heavy, I am just worried about hurting her if I move her wrong. She acted like she was in pain so I had dad come in and help pull the bed mat over. She is only 89 pounds. The bed is a little too tall for her too.
You might want to get a bedside commode so you don't have to schlep her to the bathroom. Incontinence underwear should be used as a backup so that speed isn't necessary.
I dressed my mom in jogging pants because they were warm, comfortable and could work as pyjamas and daytime wear. Most importantly they also provided a sturdy waistband that I could grab to help me with transfers.
Getting her out of the recliner will also be easier if you have a sturdy waistband to grab, she can put her arms on your shoulders while you brute strength her onto her feet then turn and pivot to the wheelchair.
If she can sit up without supports the easiest way to get her out of bed will be to move her legs to the floor then reach around her back to help her sit upright on the side of the bed.
This all presupposed she is able to weight bear, if there is any doubt it may be safest to not attempt any of these manoeuvres.
When I contact our geriatrician (primary care) about a new problem, the first question she asks is how long has this been going on. She always emphasizes that if it is a sudden onset there may be an underlying cause. If it has been gradual then it may simply be a progression of aging or the disease process.
If it is sudden she investigates a lot more thoroughly. If an issue is identified, once treatment is begun improvement usually follows. The ER doctor and other specialists do not know your mother, the same as her primary care provider does, because they only have time to check records for what pertains to the current visit and/or what applies to their specialty.
A few years ago our cardiologist suggested we consider hospice based on a red flag due to number of trips to the ER. I told him that some trips related to caring for his PEG tube (which always requires an ER trip) or falls that I needed to verify he had not broken anything. Very few required ambulance transport and/or admission.
If you do not already have one, I strongly recommend finding a geriatrician for primary care for anyone 65 and older for the same reasons most choose a pediatrician for babies and children. Most geriatricians specialize in internal medicine first. Geriatricians often allow a lot more time than a simple 10-15 minute visit because they understand seniors need more time to communicate their concerns.
Yes, you could hurt her.
She should be in a hospital bed so you can adjust the height.
And perhaps get a very experienced caregiver in to help you -
If it were my mother ... If you have to keep her in ... your home (?) - hire a social worker or someone who can help you / support you to get the equipment / care she needs. Call hospice? Senior Services through your county.
She certainly could fall out of bed. I would get her to a facility for care wherein they can provide 24/7 care with bedding, equipment, personnel available to support her needs.
Gena / Touch Matters
Have you noticed any signs or symptoms of illness yourself?
UTI? Fever?
Can Mom communicate how she is feeling? If any pain?
Having a wheelchair to use sounds a good practical idea in the short term. But finding out what is going on will be important.
I will also recommend calling the hospice agency of your choice and have them come out to do an evaluation, as it sounds like she may qualify for their services.
If she qualifies, they will provide a hospital bed, and any and all needed equipment, supplies and medications along with a nurse coming once a week to start to check on her, aides to come bathe her at least twice a week, and you'll have access to their social worker, chaplain and volunteers. And all of this is covered 100% under your moms Medicare, so please look into this.
She didn't seem to be in pain this morning when she sat up in bed. We were going to go to the bathroom, but she didn't know how to get out of bed and I dont want to move her too fast if something hurts so I let her lay down for another hour to see if she will be less confused.
A Sit to Stand if she can support some weight or a Hoyer Lift if she can not support weight.
In the mean time maybe the best thing to do would be to keep her in bed.
The key to safely keep her in bed you need to move her at least every 2 hours. And to move her all you have to do is shift her a bit in bed either up or down or to the right or left.
Medicare will also pay for an adjustable hospital bed. The height is moved up to help dress her so that you don't have to bend over, and down to transfer her in and out. You will need to be taught what the proper heights are for each task. You won't own the bed unless you choose to buy it, and it will be picked up when no longer needed.
Firstly, can I say that your mum isn't "acting" as if she's in pain - she is in pain.
Even if she was in remission, your mum's body would have been affected by cancer and she is also recovering from a fracture; all of that is a lot for a frail body to deal with. However, your mum does have cancer, so she will be in pain from that as well.
You also say that your mum is recovering from pneumonia, a disease that strikes the frail and weak. My mum worked with the elderly and always said that pneumonia was a friend to the old and ill.
Your mum cannot recover, so she is at end of life. It may be weeks, months, or even a year, before that becomes easily apparent to you, however that is the situation. Everything now should be geared towards your mum's comfort, not rehabilitation or recovery.
There will be ups and downs, good days and bad; yet, overall, there will be a downward trajectory. Don't be fooled by those odd days of sunshine, but please do enjoy them. They will become treasured memories to make you smile.
Just before my mum went into hospital for the final time, I had a disagreement with her husband. He was getting the carer to walk with Mum between the bedroom, living room and bathroom, giving minimal support. She was clearly in pain and struggling to breathe.
I told him that Mum was too weak and in pain, that the wheelchair should be used the few metres between each room. The carer then felt brave enough to say that she was uneasy making Mum do more than was good for her (a more experienced carer would have done what s/he thought best).
My stepdad's position was that Mum needed to build up her strength before she was no longer able to walk. My point was that it was too late for that; Mum couldn't get better and that her body needed what little strength it had just to keep her going. Plus, there was no need for Mum to be in pain or distress.
Just a few weeks later, Mum was admitted into hospital with yet another chest infection and the decision was made to send her home on palliative care. She was prescribed morphine for her pain and other end-of-life-care drugs for her comfort.
The GP had previously referred Mum onto palliative care (although she wasn't yet deemed to need a regular nurse or end of life drugs), so she shouldn't have been sent to the hospital. But it turned out to be a good thing, as the hospital arranged for a hospital bed to be sent to Mum's home, which made looking after and transferring her easier, and she was more comfortable on the air mattress.
The palliative care team were on call 24 hours. They told us to phone them if Mum was in pain or distress, but, when I wanted to call them, my stepdad said it wasn't that bad, at least not bad enough to call out a nurse. However, a person at end of life shouldn't have to deal with any pain or distress if there's medication to take it away.
In the end, once he could see Mum's pain and distress, the palliative care team were called frequently. Each time a supplementary injection was given, the same drug was increased in the syringe driver.
Mum was assisted out of bed to use the commode until it became unsafe to move her. In fact, she was helped out of bed longer than the carers were happy with because Mum insisted she used the toilet instead of wetting the incontinence pads. The district nurse (one came each morning to deal with the syringe driver and check on Mum) tried to put in a catheter, but Mum's bladder was empty. Then, it was no longer needed.
Once the hospital doctor said palliative care should start, I accepted Mum's refusal to drink her meal replacement shake. That caused another disagreement, but there's no good in trying to extend life by days, weeks, or even months, if you're making someone unhappy in their last days.
Once recovery is impossible, the person at end of life should only be kept comfortable.
Quality of life is paramount. If there is no quality, there is no life.
If you are saying you can’t handle it at home if she’s not mobile , just have her placed in a facility now, if not a hospice than SNF. Don’t go through trying to get her to leave the house again .
Diet is a big factor in available energy and warmth. The less they eat, the less energy they're going to have and the colder they'll be.
Also, if she can't stabilize herself, you may want to put a transport belt on her any time she stands up to give yourself something to grab hold of without hurting her. You can make a really nice belt of parts from a hardware store. They sell 2" wide web strapping (in a pretty blue) by the foot and plastic snap buckles. That makes a belt that's much easier to get on and off than the metal threaded buckles at the hospital. Plus, the blue is much prettier. I've made several of these and have them stashed around where I might need one.
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