My mom lives on her couch. She can’t walk or get up at all (it’s been like this for 15 months). She eats, drinks, watches tv, and yes even goes to the bathroom (on pads) on this couch. Her husband passed away 3 weeks ago. He was very ill for a long time. She just turned 76 and is of sound mind. We can’t force her to go to a facility. She has a few bed sores that we noticed when she slid off the couch and said her back hurts. The bed sores are pretty big in size - like the size of an orange.
She wants to live like this and my brothers and I have a routine to get her meals, do laundry, etc.
She refuses medical help, too. So, I would like to know at what point do we call 911 to get her to a hospital to treat the bed sores?
So. If only to cover your own behinds, get professionals involved.
Not to get the bed sores treated in hospital, but to get professional eyes on her and professional methods of communication to her. She isn't listening to her children but she might listen to someone in uniform.
She probably doesn't need to go to a facility, seeing as she's only 76 and you don't identify any reason other than disinclination for her immobility. She needs someone competent to tackle her deep mental distress. Take that small first step - you can't possibly make her any worse off, and she can always tell them to go away.
I would explain to your mother that bed sores are dangerous and you were going to call 911 and get an ambulance. If she says "don't do it". I would say, I am going to do it anyway, then do it. I have done this with my husband at least 4 times. She might sign an AMA (Against Medical Advice) slip and not go (husband did this last time). OK, the paperwork is started that show the world that you tried. I got a copy of the AMA, if you can't get a copy, take a picture and record the time and date. If she does go, when she can come home, tell them there is no one to care for her and it would be a "unsafe discharge" (hopefully these are magic words, so use them). document, document, take videos and photos.
So she gets mad, she can't get off the couch and hit you can she LOL.
She isn't in her right mind and cannot be reasoned with, so it will have to be done against her will for her own good.
Will she go to her doctor regarding the sores?
This getting sores in someone who does move about is unusual. Is your MIL diabetic?
I cannot know what you are evaluating as a "bed sore". As big as an orange? The big doesn't matter nearly as much as how deep, and in a "real" bedsore as big as an orange there would be depth that would be startling, often down to the bone.
So even as a nurse, from what you have said I can have no idea what you are evaluating as a bedsore.
Bedsores themselves do not kill. The resulting sepsis from not caring for them can kill and kill in days even for a tiny sore, so again, what is needed here is medical evaluation.
Being of sound mind means understanding that medical evaluation is needed. If she refuses this, then her condition is self limiting in that it will REQUIRE medical transport to ER at "some point" whether that is days, weeks, months or even years.
My brother died of sepsis from a tiny wound on his shin that was none healing and that he kept hidden. By the time he understood that his 3 days of illness was NOT "that flu I get every year" he was confused, and found to be in a state of no return; he had a reisistant bacteria and was dead in less than two week time from multiple system failure.
It's not to say the patient isn't getting good care, but the sores need to be dealt with and require 24/7 changing and care.
The first time I saw a really bad bedsore, I threw up (in the bathroom of the NH where my gma was) You literally see her spine (by her tailbone).
She could not move, she was actively dying and these moron CG's kept telling her they'd have her 'up and dancing' in 2 days. She wasn't stupid. She had me roll her over and look at the bedsore and made me tell her what it looked like.
OMG.
She didn't last a week in this NH, not from lack of care, b/c that was 'fine', but because she was dying. Giving her false hope and being all perky and cheerful just made her feel like she wasn't trying hard enough. Good grief. I spent my time with her just talking and singing and 'remembering when'. Either mom or I was there most of the last days of her life.
Gma's bedsores were not painful. She actually couldn't feel anything on her body, as the ciculation in her extremities got worse and worse. I guess that's a blessing, she was able to be coherent and chatty to the day she died.
As my Mom's son and caregiver, I was big on making sure she did not get a pressure ulcer under my care. Every two hours, I assisted her as she walked (with her walker) to a different chair. At least three times a day, I helped her change her pull-ups. At least twice a day, I put Calmoseptine on her behind to form a barrier. The only time she experienced an ulcer was when she was in the nursing home after her hip surgery (So much for "rehab"). When she came home, my daily routine with her started, and it worked well.
The "sores" you're seeing that are the size of an orange are in their earliest stages and can still be treated and healed. If they weren't she would be crying in agony.
You say your mother is of sound mind. She is not. No one in their right mind lives like she does.
No, you cannot force her into care but the state can. Please call APS and explain what's going on with her before her become to serious to treat.
Bedsores | Johns Hopkins Medicine
You mentioned that she is "of sound mind." Hmmmmm...It sure sounds like she isn't. Your willingness to serve her and care for her is admirable, but it is the reason she can continue to live on the couch in such a deplorable existence. Please call 911 and get her transported to the hospital. Refuse to pick her up until they have the results of a 72 hour psych eval stay. A Hospital Social Worker can make it all happen and start the process for a state placement.
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