I've posted before about in-law care-giving. Aged mother in law, lives in same town.
We are at the tail end of a visit from sister in law from several states away. Sister in law has been here for 3 weeks caring for her mother. A much welcome respite.
It had been discussed, prior to her arrival here on the scene, she would be talking it over with her mother, to try and get her mom to come up to her home, for a stay of maybe a few months.
This, in my opinion, is absolutely essential, as I am expecting twin grand-children, due in about 1 month (if they don't come sooner, as is the case a lot of times with multiples pregnancies). The expectant mother also lives locally here, and has a 4 year old daughter. I will be on that front, helping .. as much as is needed. And not on the front with mother in law and care-giving, and have made that as obvious and apparent as I know how to make it. It would be great if mother in law would agree to go to her daughter's home (several states away) for a period of a few months .. and allow me the latitude to put my energies where I want them to be, on my daughter who will have had a c-section .. and my grand-daughter (4 years old) and new twin babies.
Nothing doing. Mother in law has dug in her heels, and will not hear of it, going to stay with her daughter for any period of time.
What are her reasons?
In mother in law's defense ... her daughter ... I don't even know how to describe it. I will say that when her daughter comes here to visit, she all but breathes for her mother and if she could find a way to do that, she'd do that too. She is the most nervous nelly, never sit down - ever ... worry wart, do everything, all the time .. person that I've ever encountered.
A great example, as I was taking her to the airport yesterday for her departure, . I reached into the fridge to grab myself a bottled water and shut the fridge and turned to walk away, as I've done for all of my 50 plus years living on this earth .. and she said to me, "Oh make sure that fridge shut". WTH???? Like I don't know how to shut a fridge? That's just a small, very small slice of what she is ... how she is.
She is so very hyper-vigilant, seeing to every minute details down to it's finest most minuscule point, fine tooth comb, questioning every point along the way, "should we do thus and so, but maybe if we do thus and so, then such and such will happen, maybe we should do it thus and so .. but then so and so might happen, maybe we shouldn't do thus and so, but do "x" "y" and "z" instead, but if we don't do it that way then ..........", on and on and on and on it goes. And usually in hyper warp speed, as to every single friggin thing.
If her mother moans .. "what's wrong mother?, why did you moan, are you alright?".
Mother: "Yes, I'm fine, I was just sighing out loud".
Sister: "Why did you sigh? Are you hurting, are you sure you're alright, why are you sighing what's the matter?"
Mother: "For God's sake __________________, I was just sighing, .. calm down, I'm fine".
Sister: "Are you sure, .. because if something is wrong you need to tell me".
Mother: "Everything is fine, I'm fine".
Sister: "Are you sure, we did a lot yesterday, did we do too much, maybe we shouldn't of gone to two doctors in one day .. was that too much for you, are you too tired now, maybe we need to move those other doctor appointments so we won't have two in one day, is that too much for you, for one day .. is that why you were sighing .. what's wrong, are you sure you're alright".
Hopefully that kinda gives a little bit of a snapshot of what goes on when sister is in the ring directing things.
So in mother in law's defense.. I do get it, why she wouldn't be chomping at the bit to go to her daughter's home.
BUT ....
The only experience she has with her daughter, in the last years as mother in law has aged and been unable to go anywhere much, has been the daughter coming here, periodically, for periods of about 3 weeks at a stretch. When her daughter comes here, she moves heaven and earth for her mother and then some, and doesn't sit down, doesn't stop .. the WHOLE ENTIRE TIME.
Is there a possibility maybe (as I said to mother in law, when she expressed that isn't happening - talking to me - her going to her daughters .. ever) .. could it be possible that maybe if you would go to where she lives .. she'd be more busy managing her own life in that setting than your's and she would get out of your backside .. and not be as hyper-drive-vigilant as you experience in her, when she's here, could that be possible.
The daughter is retired, lives several states away. Does come here, generally, every few months .. and stays for a period of about 3 weeks at a stretch. I wish I could make a list of everything the daughter did when here this last time, but it would take up the whole character allotment:
I think SIL might do better to leave "Mom will love this place" off her checklist, and evaluate the options more clinically. MIL is not going to like any of these places. It's just not a reasonable expectation. And quite honestly she'll have bigger issues to worry about than her fellow residents' scintillating conversation.
I have read more Care Quality Commission reports on nursing and residential care homes than I can count; and more of them do a better job than you tend to think when you're sitting there feeling depressed about it all, as I often do. But I know of two (2) where response times would reliably be quick enough to get to a person with mobility problems who needs the loo in a hurry, and then not every time. Every time takes one-to-one care. You are not going to get close to that ratio.
There are two things that might be of practical help to MIL: 1) my grandfather's advice that "an old campaigner never misses an opportunity" -MIL can ask to go to the bathroom every time an aide is on hand, whether she particularly needs to or not; and 2) accept the use of pull-ups and/or bed pads thinking no more of it than better safe than sorry.
But here again, you know, for you and SIL - if talking to MIL makes you or her miserable and doesn't get you anywhere, drop the subject. This issue is all part of her rehab and not something you can hope to solve.
Even with intense in house PT I doubt MIL will get back on a walker. We can hope I guess but her health is just not going to allow that I am afraid. If visiting PT could work on upper body strength to allow her to assist in transfers I think that is being hopeful at best.
Just a thought I had this morning regarding low BP. My grandmother was hospitalized in her late 80s. Lethargic. Low BP and or heart rate. The culprit was a med she had been on for 40 years. Her geriatric GP caught it during her hospitalization. Granny didn’t need that med any longer. Med discontinued. Problem solved. MIL has so many things going on the low BP could be just about anything.
The fact that MIL would be miserable even if she wasn’t feeling like crap is one thing but pile on uggghhh the health problems I just feel horrible for her.
If she continues to decline cognitively, those outings are just more stress and more behavioral junk to deal with. Physically, same.
I truly do not even know what to say---everything is just kind of falling to pieces despite your manful efforts to shore things up.
I agree with the poster who said the "cognitive impairment" wording seems pointless--MIL has full blown dementia now. Whether that "clears up" or no--who knows, but in her current state, not even being able to be aware of time/space/people....well, I don't do cog evals but I bet she'd fail anything, epically.
I just hope you can get the new POA signed (sigh) and finally land on a rehab place that works for MIL. Doesn't sound like this one is--they are probably assuming MIL is a LOT more 'with it' than she is.
And yes---in my experience, PT can come to you..you do not have to be in a specific ortho rehab place to receive rehab. Really, how sad, after this fall, MIL will now belong to the ranks of the must despised "slumpers". Do they even expect her to rehab to using a walker again? So many other issues at hand.
As far as her 'numbers' being wonky--I took DH to the ER on Sat night, since he was having what he thought was another heart attack---thank God it was not, just a bad food poisoning or something, but his BP was sky high, his heart was bouncing all over and his electrolytes were crazy--and he was simply dehydrated, and having a major panic attack. I was bored silly in the ER, once I knew he was OK and they knocked him out on Valium, Morphine an Zofran and started running IV's to rehydrate him..so I chatted up the ER doc for a bit. Asked him if we'd EVER get used to the "bumpity bump" of a panicky heart and not immediately assume another heart attack--and he said that panic attacks can mimic so many other conditions--add to that age (DH is only 67)...anesthesia can takes months to wear off in older people (he had 2 major heart procedures and didn't come back completely from either of those yet)..well, just shop talk. He talked about how one "system" gets out of whack and that in turn can set off alarms elsewhere. (Thinking of the "impaction"--ugh I've been there and it's miserable--) So, really, MIL is just kind of going through "all the things" and they pin one thing down, deal with it and the next day there's a whole new problem.
Eye opening, really. Nice doc. Hope I never see him again.
I have no words of wisdom. I had my own day of trying to get panic attacks of my own under control.
Dorker--I do hope you are talking care of yourself. And SIL, too. Your attitude about her incredible energy has changed, have you noticed? The first post 2 years ago was about how intensely 'crazy' she was---and she hasn't changed. Aren't you glad for that? She does have the patience of a saint. I have only my high maintenance DH to worry about and he makes me insane...I could NOT do for my mom or DH's mom what your SIL does. Over caring, maybe, but, you do have to admit she's been in this mess in FL right up to the elbows (literally).
Tomorrow will bring a new set if issues with MIL. Sadly, that's just what it's going to be like until that cloud comes. I think at this point all you can ask for is for her to be comfortable and not freaking out all the time. And to push the nurse call button instead of calling SIL.
( imo) if one needs practise climbing stairs. MIL is never going to do stairs again, so no PT room necessary.
I agree with whichever poster said that mil will not be happy any place. Emphasize to sil and dh that looking at what her needs are objectively and choosing accordingly is the most important thing right now.
MIL though. Goodness!
They had come to get her for PT .. they were able to get her up .. and into a wheel chair and on down to the PT room. She said she wasn't feeling well .. .but pushed .. so wants to get on with what needs doing .. (at least she's motivated to get up and "try"). But .. didn't feel well at all.
Got there, and I guess whatever they had her doing . sounds like some kind of bicycle thing . not terribly taxing .. but she threw up and almost passed out . fell over, . just about to pass out.
It was determined she had to low of BP .. and .. dehydrated.
Ugh. I just don't know. On the one hand you want to get upset .. "WHY ARE THEY LETTING HER DEHYDRATE". But it's her .. and the setting she's in I suppose. They come in periodically ... and they take the old water cup and they do mark on it . how much she drank (almost none) and give her a fresh one .. and counsel that she needs to drink more (she doesn't).
A doctor was brought in .. a blood pressure specialist of some sort. Said he's going to put her on something that will raise her BP some. Going to start an IV for some fluids.
She's always had BP on the low side .. always . as long as I can remember . but I guess .. being dehydrated . the weakened state she's been in now . maybe it's so low now that she can't even function at all. So the doc is going to rx something to "raise" her BP.
I didn't even think of any pertinent questions to ask other than, "She's not gonna now have a stroke right?".
The only answer given: "Oh no .. not at all, it won't raise it to the point she has high BP .. no .. we'll be monitoring that".
Doc counseled her that part of the problem is her dehydration and told her he wants her to drink 3 to 4 of those cups (pointing at her styrofoam cup) per day.
I asked him, (this part was frustrating) .. "what do you suggest ... I mean short of someone sitting here with her to remind her to take sips of water .. like continuously . it's not going to happen .. she simply doesn't do it .. she doesn't remember to do it".
He then asked, .."Does she have dementia?".
At that I answered but so did SIL at the same time . talking over one another.
My answer: "Not formally dx'd no.. but she definitely has some cognitive impairment at this point . short term memory issues".
SIL answering at the same time: "There's been a decline in her memory since her surgery for sure .. she just doesn't remember what happened 1 hour ago, much less a week ago .. she's really struggling".
I guess the fact that I had answered with: "Not formally dx'd no" .. I guess the doc heard that part, . .and so the assumption there is . no dx of dementia . then we'll go with it .. and so he was on that path again, .. pointing at the water cup and showing it to her, that she has to drink 3 to 4 of those daily.
SIGH
She AIN'T gonna do it, she can't . she doesn't remember to do it. Pointless.
These are what I'd guess to be maybe 12 oz styrofoam cups that are provided to her with ice and water in them . and periodically staff comes in . takes what was there . and gives her a fresh one . noting what has been consumed from the one that she's had. I bet in a 24 hour period . if she drinks 1 whole 12 oz .. I'd be shocked. I bet she does not.
She did spend a few mins talking of how her heart breaks . that she is heart broken that this is what it all comes to .. that she's lived so long, too long . that this is what her life has become . .and that she will now lose her dog, her home . everything that matters to her .. and that it's a hard pill to swallow and one that she has struggled with coming to terms with ..
I tried Emily Sue's ploy .. "Yea I know it's a really tough situation, you're right, one
One that most people would struggle with just as you are .. but ya know . you should remember, you were able to stay in your house all these years . you worked so hard at being independent . that's really something to be proud of".
Her answer to that (she wasn't being flippant or smart azz): "You know you say that .. everyone says that kinda thing to me, but it doesn't help . not really . it doesn't . the reality is this will be my path . going forward .. until I die . and I just .. I don't know why I didn't die before now .. I have just lived too long . that's all there is to it".
She then went on to talk about our daughters (who she values and has a bond with): "You know your daughters all come up here to visit . this isn't what they want . to come up here and see me so sick . and so out of it . and unable to really interact with them . they want to be able to come to my home . like they've always done".
Me: "Ya know .. there's a lot to learn in all of this FOR ALL OF US . .. they are learning too . and that is .. that they still will value you, no matter where you live . and be a part of your life . and that's at the feet of all you did to enjoy them when they were young and spending so much quality time with them . they love you and they will continue to be a part of your world . and for that . you should be grateful .. I know they are . they love you very much".
MIL: And I love them too . I always have .. I always valued spending time with them and enjoyed them so much . nothing I ever did with them .. hiking . playing tennis . hauling them to the beach . whatever it was . tea parties in the floor, baking cookies . none of it was *because I had to* .. I enjoyed every minute of it".
Me: And they enjoyed doing it too . and now .. they have that bond with you . that they so enjoy you, that it doesn't matter where you reside . they still love you and want to come see you".
At that SIL changed the subject to her parents and their respective demise each .. and the stories there, imparting to her, that she didn't ever have to cross this path w/her parents . .. and that her dad . while he lived to be 84 years old . and the last couple of years . or thereabout . was jockeyed between he and a sister . that he didn't have to have help to dress . that he didn't have to have help to shower .. etc .. and that had he lived a few years more, she too would've probably been in our shoes .. and she acknowledged that's probably true.
I hate it all for her. She has been a ROYAL PITA . for the last few years .. and God knows what other PITA stuff awaits ... I'm sure a lot. But .. I hate all this for her . it's nothing any of us would ever want ..
Who wants to live in this state of being? One thing after another as to maladies that keep coming up .. screw all that!
SIGH. But back to the water cup issue. As I was leaving I was urging her (and it occurred to me, she won't remember what I'm saying to her, 5 mins after I've left) .. "Now remember if you're awake . you need to have that water cup in your hand and drinking it okay?".
MIL: "Ya know . the problem with that is that if I drink and drink then I have to pee and pee, . and that is a problem .. ".
Me; "yea but you have to remember, . that water .. that makes you pee all the time is also gonna make you stronger .. and when you get stronger you will be able to get out of the bed and into the bathroom and not have to use a bedpan anymore, just remember . you have to drink, to get stronger .. ".
Occurring to me, all of it, as I'm saying it . she won't remember to do it . she simply won't . and that lack of executive function . me pointing out to her,
A. Drink Water
B. Yea you have to pee more
C. But that means . more water . the stronger you'll get
D. Then you'll get stronger you can get to the bathroom to pee
All of it . sequencing . lost on her . wasting my breath.
SIGH
I don't know .. I guess one talks just to hear their own voice.
Yes it would be great if she would get with the program but she is depressed, feels hopeless and this simple issue doesn't really get solved.
Before my mother entered AL during the whole hospital and rehab process she had a night that she wet herself. That one night was the time she complained about greatly and asked us why we had put her there. Obviously there was alot of confusion going on but I remember that time vividly and felt awful for what I could not control and the lack of care she was receiving. She was cold and wet and nothing was done through the night. Fortunately she left there to go to rehab and that didn't happen again.
… dementia is diagnosed only when both memory and another cognitive function are each affected severely enough to interfere with a person's ability to carry out routine daily activities.
— The Journal of the American Medical Association
It is not a dirty word.
What do you suppose the doctor would have said and done if you had simply answer “Yes. I believe she does”. Perhaps devised a plan to ensure mil was more closely monitored in her hydration - perhaps?
If mil is ever gonna get any closer to receiving the level of care SHE NEEDS - y’all are gonna have to get past your avoidance of using that word.
Just my opinion, of course.
Next time you guys talk to the doc, you might ask about if a cognitive assessment would be feasible and say that you think she does have dementia (make sure to use that word too rather than just the term cognitive impairment) based upon her memory loss and the impairment you are seeing. I know it's frustrating trying to get an assessment or a diagnosis, as I went through that with my mom too. As you saw, the doctors tend to want to take the path of least resistance unless you really push them to do further testing. I had to wait months to finally get mom a neurology referral. I think that the doctors and staff believing that MIL is more capable than what she is is a big part of her not getting the level of care that she needs. The less the staff has to do, the easier their job from their perspective, but that is what these facilities get paid those outrageous sums to do.
I’m just wondering when does it become apparent that rehab is not the appropriate setting? My FIL just did a 2.5 week stint in rehab after a nearly 3 month hospital stay. Rehab Rehab had a progress conference with his kids and said they can’t justify keeping him there because he is declining. He improved in 1 area-he could walk 30 ft when he arrived and was now up to 60 feet. But in all other areas he declined. He cannot do his ADLs on his own. Kids pretty much said ok thanks bye. No one took things by the horn and got the ball rolling on LTC or even asked “where do we go fr here”. So last week rehab sent him back to the hospital last week with “pneumonia”. I would not be surprised if they used the fluid on his lungs as an excuse to send him back to the hospital since they are no longer getting paid by Medicaid for him to be there. (Malnurishment, low blood pressure and fluid on the lungs are what sent him to the hospital in the first place. They’ve not been able to get rid of the fluid on his lungs). He’s weak and depressed. I have no idea what comes next and no one seems to care. After a lot of thinking, it’s dawned on me that......of course his kids don’t really care! He’s a grown man, he’s 64, has all his marbles. He can make his own decisions, he’s responsible for himself. At what point does it become his kids responsibility? Right now it’s his responsibility IMHO. I just want to know what’s next? Back to rehab? Or do we get another call saying the hospital wants to meet with everyone and they try to get us to take him home? And who is really responsible at this point? Him or the kids? Is rehab even still appropriate if he doesn’t have the desire to get better? Seems for your MIL, rehab isn’t providing adequate care. For my FIL, he’s not making an effort while your MIL is.
Anyway, I really feel for your MIL at this point. I totally get the water thing. For someone in her condition, having to urinate constantly is a problem. If she’s not able or willing to drink more, is it time to really get the ball rolling on placing her somewhere else? Or is rehab still appropriate? Where does she go from here? I can’t over what happened to her today at PT, getting sick and falling over! The poor thing! She’s trying to make an effort but doesn’t have the strength :(
Sorry - but my panties are in a great big bunch!!!
Its been determined mil doesn’t have enough sense to drink a frickin’ cup of water in the name of saving herself - but she’s allowed to say “sure, I’ll give PT a go - even though I don’t feel well and I’m light headed”. Of course the poor old gal puked her guts out.
Are these people smoking crack?
Are the therapists communicating with the medical staff about her condition?
This sounds like a real cluster f$ck of a situation.
PT should be taking her bp before they take her to therapy .
I wonder if the dementia question from the doctor was a gotcha?
If she were deemed competent then would it follow that her not drinking water is some sort of noncompliance that could lead to discharge from rehab? Every question is potentially loaded in these situations where the insurance rules. I suppose I’m a bit paranoid. But at least they are allowing her to take the IV at the rehab and hopefully make it back to PT.
The only reason I would hope for her to stay at posh until she gets a bit more therapy is that at least there the focus is therapy and hopefully she’ll get a bit more built up before continuing through the land of nod on her way to the cloud.
One little tip on drinking water is that it is sometimes harder for some people to drink ice water in quantity plus it probably makes MIL cold.
I buy my aunt the small bottled water. The 8oz size. We keep a few near her chair. She can drink one of those down at room temperature. Drinking an iced drink is just not going to happen in aunts case.
My dad didn’t like to drink water for the same reason - the constant peeing - but for mysterious reasons he would drink it if it was flavored.
Just a thought. But at this rate my nasty post from last night seems to be closer to hitting the mark. No one seems to want to step in and speak up... and at this rate POSH is killing her. Sorry to be a big mean drama queen - but seriously? Just how much more of this will her already compromise 90 yr old body take? Barb said it - an exercise bike?!? Are these folks on crack??? At this point wouldn’t just walking her up and down the hall a time or two be a better approach? For effs sake!!!
Where is M? Get M down there. I bet she’d crack a few heads together. And jeeeze - it sure sounds like its needed. At a minimum.
“MCI vs. Dementia
MCI is distinguished from dementia by the severity of the difficulty with everyday activities and by the presence or absence of dementia-related symptoms. Someone who has dementia will have obvious problems with activities like keeping track of medications or driving. Additionally, individuals with MCI usually do not display symptoms that are seen in dementia, such as impaired judgment or trouble with reasoning.”
That needs to happen for Medicaid approval to place her properly.
SIL apparently has a POA, even if it is old, it should still be valid. If MIL is diagnosed with dementia, that still doesn’t mean she can’t sign a POA. The lawyer just has to verify that she knows what she is doing with that particular decision. AND, there is no one else who will fight this, no money involved.
They need to get the assessment. Then, everyone who interacts with MIL will be able to treat her with more accuracy and within the confines of her limitations. Then, she will get the proper “category” for Medicaid and SW Jessica can recommend an appropriate setting.
(I don’t mean you, Dorker, you obviously tried a nudge there.)
That conversation took place with MIL in the room and she didn’t notice? That would say a lot to me. Anyone with a full deck seeing the 2 of you hemming and hawing over a question like that from the doctor would probably light up like the 4th of July, lol.
I think you mentioned when MIL returned to Posh from hip surgery she was taken in a side door, a different area you guys had not seen. There the folks appeared to be more debilitated. Maybe it was SIL that noticed this.
I’m thinking that wing may be more appropriate. More comprehensive care. Even if they are in worse shape than others on MILs wing they too, some of them anyway should be getting PT. That would be my 1st question in the action meeting. Can MIL move to the wing where the more debilitated are?
If MIL was truly ready to go to the cloud today should have done her in.
Exercise bike? Puking, falling over?
Agree somebody is smoking crack or not reading the chart or getting the memos.
If she survives the wing she is on before getting moved to an area where appropriate care is provided she is one tough old gal.
Whey isn't she asking the hard questions of the DON? Why isn't she asking questions about what the PT goals are? Why isn't she pushing for at least a cursory assessment of her mother's cognitive skills? No, you can't get a neuropsych workup in rehab, but I'm pretty sure there is a geripsych who comes in to see patients? Who prescribed the antidepressant?
So not a true bicycle but something similar.
Had a chance to talk to SIL some more on it all tonight ..
I was stressing to her, that I almost feel like the setting where MIL is at present, is cruel.
It's assumed, or that would be my assessment . that she has all her faculties and as such . when instructed not to get out of bed (her prior stay at POSH where she broke her hip getting up . against advice) .. she did so anyway. She arrived at the hospital with a broken hip .. dehydrated.
She's GOING TO dehydrate .. she simply isn't gonna drink enough . she just isn't . her broken brain doesn't dictate she do so. It's not going to happen!
Thus she ends up dehydrated further weakening her, .. and probably lowering an already too low BP, which negates her ability to rehab .. she ends up impacted .. just a whole slew of other problems stemming from that one simple directive she can't follow and yet it's assumed .. no dx of dementia in place, she's capable of doing.
I will say that earlier today we'd been in the hallway and I heard SIL ask the nurse, .. "is she going to get thrown out of here, because she can't rehab?". The answer: "No, no . that's our job here, to help her to get well enough to rehab . no .. you get thrown out for refusing to participate .. she's not refusing .. no .. we just have to get her well enough to participate".
Why didn't anyone speak up when the doctor asked that direct question, "Does she have dementia". I was the one that asked how to get her to follow through on hydrating . when I know she won't . she forgets .. it is a disconnect .. her brain is broken . I was the one who asked that of the doc . and he then asked, "does she have dementia". Why didn't I answer in the affirmative . because we don't have a formal dx of dementia .. and that to me, .. would then beg the next question from him as he then opens the chart looking for that dx that isn't there .. then he asks questions as to what meds she's on for it . and a whole slew of other questions that I cannot answer, absent any formal dx of dementia.
And as to whether or not that testing can get ordered. That has been asked, and the answer thus far has been that we wouldn't want to do that at this point . she's post surgery and far too ill . and the results wouldn't be valid at this point. .
SIL did ask someone today . also out in the hall . I was standing there, .. "What ever happened to that psych consult and counseling?". That someone . who ever she was .. I don't know, answered as follows: "Did your mom get discharged?". SIL: "Yes . well no . well . .I mean she broke her hip and so yes . she was hospitalized for a few days . .and is now back . mending from that". This someone: "Oh okay . well I'll put in the referral again . it gets written up as a discharge and so any orders that were prior . would need to be re-written . I'll get that re-submitted.
So anyway .. didn't get much chance to debrief at all today with SIL .. not at the POSH site . I came outside to a flat tire . so that was my first priority to get on that, and move on with my day. So later when I did get a chance to talk to her, I expressed many misgivings about the setting she's presently in and how it's .. IMO .. almost cruel that she's in that setting . she's expected to be firing on all cylinders and cannot . and as such . it's just one calamity after another that befalls her . and unlike you or me SIL . we might get something go wrong . and yea ... PITA .. but we bounce back . .not her . she's so far knocked back that each of these things that befall her .. knock her W-A-Y back . to the point she's that much farther from crossing into any threshold of rehab ... I just am not at all sure
Not at all sure this is the appropriate setting for her . she needs far more care .. or it seems to me anyway ..
I suggested we talk to the DON .. or that I'd do so ..
SIL: "I"m not sure if what she is experiencing is about typical for someone with her compromised health and maybe our expectations aren't where they should be . but that is an interesting question .. I can talk to the DON tomorrow when I'm there .. Probably would be helpful also to maybe run some of this past SW Jessica to see if she has any input .. maybe I can put in a call to her also".
Me: "I will be glad to reach out to SW Jessica . if that will help you . and express some of my thoughts and get some feed back from her, but if I remember correctly at the atty meeting . they expressed .. for the sake of less confusion and less voices to have to speak to . and answer to . they'd prefer that one of us be th point of contact . rather than all of us reaching out to her, and them having to answer to each of us, is that right, do I remember that right?".
SIL: "I think yea . if it was a matter that there were 9 of us siblings and all of us hollering at her . or them . yea . but it's just the two of us . if you want to reach out to Jessica tomorrow and talk to her on our behalf and see what she can provide . and I'll try to get ahold of the DON tomorrow when I'm there . and see if I can find out anything".
So that's how it's been left at this point . that I will reach out to SW Jessica tomorrow to see if there's a feel for what it is I'm seeing/experiencing . at least form her POV . and SIL will try to reach out to the DON tomorrow.
As I said to SIL .. "I'm just not convinced she doesn't need to be in a SNF . with a rehab attached to it .. we don't have any formal dx of dementia but she damn sure has no memory to follow through on any of this .. ".
SIL agrees that perhaps I'm right .. but we both . both of us . don't know if we are speaking from a place of ignorance .. that .. this .. while yes . .she keeps getting setbacks . .. is not all that unusual. We don't know.
Mom thought she was being "sneaky" by trying not to drink much fluid so she wouldn't have to use the bathroom. But it was totally intentional, and not a lack of ability to drink or remember to drink water.
SIL nor myself have seen that section of POSH .. don't know for certain it exists.
Her memory .. is just shot to h377. Will it return some . I think SIL thinks it will .. she's just .. wearing her body thru the general anesthesia from surgery.
How long does that generally take? I don't know the answer to that, nor does she.
But I'm not convinced her memory will ever return. . Both of us looking at each other with side glances today when it was talked about .. a prior occurrence from a few years ago. SIL here in town, her mother weathering yet another bout at that point of chitapalooza. SIL had gone to Walgreens to pick up some supplies .. came back and found her mother not responsive. Sitting slumped over in a wicker chair . in her bedroom . slumped over not responsive .. nothing SIL could do would bring about any response. SIL called 911 ..
Turned out she was dehydrated . and (hospitalized ultimately where they then went at trying to see about this diverticulitis flare up).
MIL has zero memory of that.
Same as her prior stay here at POSH for what was originally the UTI and diverticulitis flare up . the stay where she fell and broke her hip . she has no memory of that stay just mere weeks back. Remembers falling and breaking her hip but nothing else about it.
And there's any expectation at all that she can remember and connect the dots to the importance of drinking/hydrating . at present. Nope . not gonna happen with her. It just isn't.. and the dehydrating is bringing about a whole slew of other problems that she can't just bounce on past to get to the threshold of even being able to rehab.