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She had surgery on her back in August. Arthritis and bulging disc etc. Doctors here refuse to prescribe effective pain meds. Though he did another epidural. She is 81 and is expected to do Physical therapy. She can barely walk.
Lots of good advice here. Just a few thoughts, based on previous responses: Why are we worrying about an elderly woman developing some 'dependence' on pain medicine? She might need it to accomplish the exercises. Learn about 'passive range of motion' exercises appropriate to her condition and try to help her get started by 'doing it for her/with her' at first. Depending on her current mental status, motivation in the form of "a change of scenery" can be helpful as can rewards for cooperating and trying. What about therapeutic massage for comfort and to promote flexibility? And if 'pain meds' won't be prescribed, how about muscle relaxers to avoid spasms and reduce anxiety (which results from pain). Last but not least- marijuana can also be ingested, a boon for nonsmokers.
A Tens Unit can be quite effective. And Medicare covers it. Got one for my mom for a shoulder situation. She did not like the buzzing feel. But I got fractures in all my teeth from stress and was in dire on my knees pain and the Tens Unit was amazing....kept me going til they healed. And now my friend's mom is trying it for her backpain that nothing was helping and she is getting relief.
Medicare won't cover PT if there is failure to progress. Refusing to do it will quickly equal failure to progress and the end of the rehab period and Medicare coverage for those services. There were so many days when inside I wanted to put a boot in my mother's backside to make her get in there and TRY DADGUMMIT!! But, she is not able to understand. She just fights and pinches "the mean people who are trying to hurt me and won't leave me alone".
Liz, go with her, witness the exercises and be sure she repeats them on her days off. For a reward, some nice warm compresses with Epsom salts. Promise her a pedicure after the first week.
Is she seeing a pain management doctor? It might be a good avenue to explore as many have dual specialities (like orthopaedics and pain management). They could do nerve blocks are whatever is necessary to alleviate some, if not all, of her pain and be able to coordinate other therapies (like PT) to work in tandem. She does need to do her therapy, but she may be afraid of the pain, so if the pain is dealt with effectively first she may then do the therapy. I agree with sandwich that if your mom has dementia and cannot be reasoned with this may very frustrating and may not work at all. When my mom broke her knee ( she was in mid-stage Alz, then) there were times when she refused to cooperate with anyone at the rehab facility. My dad and I had to be present for every session of therapy and 'motivate' her. Some days it was just a lost cause as she could be very stubborn, but on others it really did help. If she is in a rehab facility they will not continue therapy if she is not progressing; and ,in our case, the therapists were not too interested in motivating her. So it was up to us.....sigh....I'm sending you big hugs
The PT is essential after surgery to get moving again. The best Physical Therapist my mother ever had was one that used to be in the military, and would talk to Mom (really good looking guy) while he literally held her up while she was crying and saying she couldn't do it (I almost wanted to hit him the first time). But he got her up and moving, and pretty soon had her walking and smiling. She would never had gotten to that point if he hadn't gently ignored her comments that she couldn't do it and just made her do it anyway.
God bless the magician who could get my mom up & moving after any surgery. She simply would not, and never connected her subsequent problems with failing to do therapy and lying around, still as a corpse as much as possible.
If your mom is able to understand, then you can talk to her about the exercise being mandatory to get well. If your mom is not at full cognitive ability, then it might be an uphill battle you might not win.
Try offering her a reward for cooperation. Rewards work for all ages.
I appreciate the feedback. She starts PT Friday. Chicago 1954, I asked her if she would consider marijuana. (it's illegal here, though not a smoker I don't see anything wrong with it) She wasn't willing to. It's just so difficult to watch. I feel helpless. Hearing from others does help and I thank all of you.
I'm with Ola on this one. You want to make sure that your mom's pain is not coming from a new problem, say a fractured pelvis that is being overlooked. A new set of eyes is in order here.
Also, I would put real weight on what the physical therapist recommends. Has mom been evaluated for PT? She may fear going, but needs to be seen so that pt and doctor can work together.
Have you considered getting a second opinion on the cause of her pain? Surgery has it's risks and not all surgery, no matter how common, will provide the pain relief we often expect especially for someone her age. Did her doc explain to her what she could expect after the surgery? Did they explain to her that rehab would be painful? Did she understand what they telling her? Sometimes the best medicine is just knowing there's a light at the end of the tunnel.Rehab hurts but the rehab will help the pain subside. Perhaps you need to show less concern over her pain and provide more encouragement to work/insistence to work through it. What I mean is your constant expressions of concern over pain that may be perfectly normal after this surgery may be adding to her anxiety and fear of rehab. If we anticipate and fear pain, we are more apt to feel pain more acutely.
Do you live in a legal medical marijuana state? That is what people here in AZ. are using. Don't think that it is smoking marijuana. It isn't that at all.
But, she has to get a little relief to even start her PT. PT is quite important at all ages.
Liz,. my mother had a hip replacement at 85 and a repair at 99. Both times she did PT though it was not easy, but it was necessary to mobilize her. I am sorry your mother is having such a hard time. I would encourage her to do "small steps: literally and figuratively and work with the PT. Vikki has good specific suggestions for the pain.
TENS unit? Other modaities (cold, heat such as ultrasound), or OTCs do anything for her?
Maybe the epidural injections are missing the mark - if she's got a facet problem, a more specific nerve block would be in order. Maybe a rehab doc (physiatrist) who does "interventional" pain management would be a good bet. And a wearable back support (aka "corset") or orthosis could help as well.
Yes PT hurts, especially after surgery. MD's are pushing patients to lose weight and get exercise instead of handing out pills. Mom has to do the PT or pretty soon she won't be walking at all. He is trying to save her from a Nursing Home. Nobody said it would be easy.
What kind of pain meds is she receiving? And yes, she would be expected to do physical therapy which would do her a world of good. Did she go into rehab? Then that way she could get off some of the pain meds that she is now taking. Otherwise, stronger meds would have to be prescribed and she could become overly dependent on those.... and they might interact with what other meds she is taking for other age related issues.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Why are we worrying about an elderly woman developing some 'dependence' on pain medicine? She might need it to accomplish the exercises.
Learn about 'passive range of motion' exercises appropriate to her condition and try to help her get started by 'doing it for her/with her' at first.
Depending on her current mental status, motivation in the form of "a change of scenery" can be helpful as can rewards for cooperating and trying.
What about therapeutic massage for comfort and to promote flexibility?
And if 'pain meds' won't be prescribed, how about muscle relaxers to avoid spasms and reduce anxiety (which results from pain).
Last but not least- marijuana can also be ingested, a boon for nonsmokers.
If your mom is able to understand, then you can talk to her about the exercise being mandatory to get well. If your mom is not at full cognitive ability, then it might be an uphill battle you might not win.
Try offering her a reward for cooperation. Rewards work for all ages.
Also, I would put real weight on what the physical therapist recommends. Has mom been evaluated for PT? She may fear going, but needs to be seen so that pt and doctor can work together.
Surgery has it's risks and not all surgery, no matter how common, will provide the pain relief we often expect especially for someone her age.
Did her doc explain to her what she could expect after the surgery?
Did they explain to her that rehab would be painful?
Did she understand what they telling her?
Sometimes the best medicine is just knowing there's a light at the end of the tunnel.Rehab hurts but the rehab will help the pain subside.
Perhaps you need to show less concern over her pain and provide more encouragement to work/insistence to work through it.
What I mean is your constant expressions of concern over pain that may be perfectly normal after this surgery may be adding to her anxiety and fear of rehab.
If we anticipate and fear pain, we are more apt to feel pain more acutely.
But, she has to get a little relief to even start her PT. PT is quite important at all ages.
Maybe the epidural injections are missing the mark - if she's got a facet problem, a more specific nerve block would be in order. Maybe a rehab doc (physiatrist) who does "interventional" pain management would be a good bet. And a wearable back support (aka "corset") or orthosis could help as well.