1. Mom was successfully placed in a great Nursing Home on Long Island this April. Well run, friendly staff, beautiful grounds...
2. Took some acclimation. Doing great now with help from Aricept. Not Alzheimers. 87 y.o, plus MBI from repeated falls & head injuries. Does not remember the past 10 years. Knows family members and her new environment.
3. Brother lives 5 minutes away and sees her almost on a daily basis. Good guy.
4. PROBLEM: -They delayed getting her ambulatory after arm fracture healed bec. she lacks balance even with a walker and could topple backwards. She can walk.
SO she spends way too much time in a wheelchair, to the point that she requests that they pull her from the great "community space" room and let her lie down in her bed because her back hurts her from so much sitting. My brother walks her at every opportunity.
Can he demand a written plan from staff to guarantee a daily quota of individual attention for her involving say 30 minutes of assisted walking down the halls? Must this be couched as a therapy order?
Second, she is a naysayer, meaning, even before all this she would turn down requests to go out to eat with is or favors be done for her. Case in point, they have nice courtyard - garden areas with raised boxes and she is growing tomato and pepper plant with my brother's help. They do not get watered by anyone but him.
How do we get the staff to be more proactive with her needs and take her out daily to visit with her garden - she was an avid gardener........
Brother is a charmer and has a great relationship with staff but not enough is being done for her anyway.....
The staff will not take care of the garden--its not realistic, in my opinion. They are--and should be-- focused on patient care. They just dont have time for one on one activities.
Finally, no matter how great or good the establishment is or what great care they provide --it's likely you willbe let down and disappointed. It is super hard work and the turnover is VERY high. Finally, no matter h9w great the place you must let them know you are very involved and know what is happening with your mom's care.
It also helps to bring flowers and cookies!☺
My mother is in a NH in Connecticut, and it is VERY assistive. But they are simply not allowed to make people do what they decline to do. That's all anyone was trying to say. I hope you'll reconsider and stay.
My mother's current problem is that in the US nursing home stuff is assigned only nursing and custodial functions (food & pill dispensing) but not assistive, like in Europe. Sorry I erred on Aricept. This site is not very helpful.
I think it's your standard serotonin uptake assist mechanism in
Aricept. Since then, I have stayed on it because my husband says I am too volatile emotionally without it. Before the injury, I was very laid back. So, it keeps me in check. Would I rather get off it: yes!
Really, the impetus was that my brother was extremely pained by seeing her so distressed initially, and since I have always been honest about my using Aricept he thought he would ask the psychiatrist for it. BTW, I have found that such honesty often backfires. People that I have told about my MBI symptoms and "mild" dementia - not intellectual BTW (more losing focus at times), soon adopt the concept & run off with it and start treating you differently with condescension. In retrospect, I wish I had not told so many people.
The funny thing is that in the last year I have become the most lucid & acute & creative than I have ever been incl. college days. Rather than Aricept, which I've been on for almost a decade, I ascribe it to the healing properties of the Island Life -- the Aloha Spirit prevalent here and finally de-stressing to the max.....
When my mom was in rehab, before we discovered she had developed Vascular Dementia, she misinterpreted a lot of things. She felt abandoned in a dining room of others, she thought people were demanding money from her, she was convinced that she was "in charge" of her own meds. And oh yes, that the male CNA was having sex in her bathroom, as the bins filled with dead bodies was being trundled by her room.
Getting her seen by a good geriatric psychiatrist and getting her on two antidepressants and a low dose of antianxiety meds, with extra available as needed has proved a Godsend in evening out my mom's mood, agitation, willingness to "roll with the punches" a bit.
So once again I'll ask, has the possibility of an antidepressant or an anti-anxiety pill ever been discussed for your mother?
My mother does not have Alzheimers, but this second concussion (Feb. 2016) in 2 years has had a permanent & tragic effect. The mental decline & fog followed immediately. She does not remember the fall (bathroom) or the apartment she loved so much for 10 years. Aside from this amnesia, and irascibility she was acting extremely stressed and agitated in the new environment. Questions: How did I get here? When did I get here? IS this my furniture? What happened? This is all so unbelievable! I don't understand!
She is still sharp & and her long term memory is pretty good. Her recent short term memory seems functional. So, my brother figured that since we are genetically close and I do well on Aricept, he should have them try it out on her... She still does not approve of some of the staff and the more confrontational residents but the agitation is gone and she is behaviorally miles from 2 months ago. The problem now is to get her ambulatory.
Thanks to all for suggesting I conference call in to the plan meetings! Will definitely try for that..... Hard with a 6 hour time difference!
My brother and I have very different "parenting" styles. I would "abduct" her regularly and take her with my car to lovely places like the beach, the boardwalk etc. etc. And, she WOULD LET ME. And she would thoroughly enjoy every hour, minute and second... Maybe it's that I am the oldest child (by 10 years) and the only one that remembers the old country.
He is also afraid to bring her for a visit on a weekend afternoon to his beautiful home 5 minutes away, where his wife has a beautiful vegetable garden. He never took her to restaurants either, through the years. I really do not know why or understand the difference. I do not need to. But he is doing the Lion's share of the work and has through the years for both parents (while Dad was alive) while I am basking in our new life in Hawaii.
A family member always attends my mother's quarterly care conferences. I live 30 miles away and visit once a week, but couldn't attend the most recent conference. They offered to include me by speaker phone, and that worked great. So perhaps you and your brother could both attend the conferences for your mother, if you can do it by phone.
Aricept is for dementia -- memory and confusion. It is quite useful for some patients and less useful for others. It is approved only for Alzheimer's, but is frequently prescribed for other kinds of dementia. Do you know what kind of dementia your mother is thought to have?
Has the possibility of other medications been discussed, such as antidepressants and/or anti-anxiety drugs?
Your intentions are awesome. Your view of what to expect from the facility is perhaps not quite realistic.
Is her reason for being in the Nursing Home mobility issues?
I arranged PT for my by this time 97 year old great aunt, who was still able to mobilise with assistance. All I wanted the hired PT to do was toddle her up and down the passage outside her room, and on nice sunny days sweet-talk her into sitting outside. I used to get irritated, too, at the number of times "Miss S declined" was logged in the resident's record. Came the day, perfect sunshine, light breeze, balmy afternoon, and me there to help; and darling Auntie L smiled at me charmingly and said 'another time, perhaps.' We kept up the regular PT appointment to make sure the offer was there if L chose to take it up; but I abruptly stopped feeling annoyed with the staff.
At some point, when your mother says she doesn't want to join in, you are going to have to take her word for it, you know. Even if it does feel like the beginning of the end.
If they ask your mom if she wants to do something and she says "no" and they make her do it anything, yes, that's abuse.
Your advice is well taken, but really? Wheeling her out to water her tomato plant - which will otherwise die - would constitute abuse?
Is mom on anti-anxiety and antidepressant meds? They've made a difference in my mom's life.
Had official PT, never enforced well - she bristled at being "dumped" after the session in the GREAT room for hours on end.
I know the personnel is busy. I was asking whether they are supposed to help impacted people ambulate when they can steal a minute. And, unsaid, I visit 2 times a year bec. I live, 5,000 miles away. As to my mom having changed, yes and not. The point about disregarding her negativity, is that I never would have gotten her out of her apartment if I had accepted the first 2 or 3 "NO"s out of her mouth. These people are professionals, they should know all this stuff...
Will look into volunteers for 2 or 3 days a week to supplement what my brother does, but frankly, given your response "live with it", am not
optimistic
At the ALF where my daughter works, there is individual attention for walking with residents by a trained person. Residents can sign up for daily or a few times a week walking. There is a significant charge for this service.
If mom is in a great nursing home, work with them to see how to resolve this without unrealistic expectations on their staff. Attend the care conferences. Bring this up as a concern and ask for suggestions about how to achieve your goals for mom. (And also listen to their input about what goals are realistic.)
My Dad will walk but only if his regular caregiver insists he get his behind up and out of that recliner away from his TV, and walk down to the sunroom or to sit outside for awhile. I honestly think if recliners weren't invented, my Dad wouldn't want to sit for so long :P
My dear SIL wants mom involved in all sorts of activities, taken to the dining room...mom just wants to sit in her room and watch Fox news. There's a balance of course. But don't expect the old mom back. It's very much a grieving process.
Thus the reason for the delay in getting your Mom up to walk... your Mom probably couldn't hang onto the walker as it takes months to get an arm to straighten out. And a lot of strength is gone from that arm.
I still can't lift what I use to and my injury was over a year ago. When my Dad wants me to help him get up out of a chair by me pulling on this arms, I can't do it anymore :(
Has any of this occurred? If she's specifically there for therapy, something's amiss, because she should be getting PT regularly.
Babalou makes a good point about compression fractures. You might have to ask for spinal x-rays.