Need helping coping and understanding.

[djetok]

My widowed mother (73) has recently had Medical issues. After a month and half in the hospital (hospital and geri psych ) . She had a TIA stroke that brought on offer issues. Resulting in a Vascular Dementia and Alzhiemers diagnose. After discharge , I got her into the very best Memory care facility in our area. She has been there a week and is adapting well. I received a phone call last weekend while on the lake from a home health company wanting to do therapy. My mom is walking and talking fine. If you didn't know her and she spoke to you, you would think she was just a little confused. She can have a great conversation for 10 to 15 minutes and then it is a conversation that happened 30 years ago, but still makes sense.

I just got a call from above home health and they want to do speech, occupational , and physical therapy. My mom is walking and talking as good as she ever has, but does get confused at times as too who is in the room. Which from what I have been told and researched is a function of Alzhiemers and dementia.

My feeling is that the poor lady has been through a month and a half of poking and proding. She has not had a chance to fully adapt to the memory care facility. Do I consent or let her enjoy her life for now and do it later. I also have the feeling the home health just wants billable hours.

Any suggestions are welcomed, I just want what is best for mom and needed to type out my thoughts.

 

[Beachbummer]

Best of luck whatever you decide. I would share your concern for the motivation of the suggested therapy, when she is doing well otherwise.

I would personally postpone and consider approving later after satisfactory conversation with provider where you feel they share your concern for her well being over the interest of the billable hours.

I'm going based on the info you provided and offering my humble feedback with the desire to help and not hinder. Best of luck however you proceed.

 

[Julian]

I would call her primary care physician (hopefully you have power of attorney and healthcare power of attorney already...if not work on that) and ask him/her what the benefits of the physical therapy would be. Stroke symptoms can be very hard to pinpoint and come in a myriad of different combinations and types. She may SEEM like she's ok, but when pressed to do certain things is unable to....and as such avoids it (especially when anyone is around). @Speedling would be a good one to chime in here on this.

So check with the doc....if nothing else, he should know what is being ordered and why.

 

[Scottintexas]

I'm sorry to hear you're having to go through this.
I would have to understand stand how immediate enrollment was going to help her long term otherwise I might wait until she settles in and is comfortable about doing it.
I would also like to know how often and intense the therapy is. Is it just 30 min. a day with somebody, it might be a good time killer or give her a goal to shoot for rather than waiting to see how Matlock is going to solve this one
(although I agree with Julian they can quickly learn to hide disfunction which can be ok as long as everybody understands and is ok with it).

 

[djetok]

I would call her primary care physician (hopefully you have power of attorney and healthcare power of attorney already...if not work on that) and ask him/her what the benefits of the physical therapy would be. Stroke symptoms can be very hard to pinpoint and come in a myriad of different combinations and types. She may SEEM like she's ok, but when pressed to do certain things is unable to....and as such avoids it (especially when anyone is around). @Speedling would be a good one to chime in here on this.

So check with the doc....if nothing else, he should know what is being ordered and why.

Thanks with this facility we put her on with their Dr. I have a call into the director of nursing to ask why home health is even involved as they are the ones that actually do her cognitive therapy. They do therapy that doesn't seem like therapy. Her stroke was a TIA (which is a blockage and then clears). Basically she was having a stroke (at my home , we called 911 immediately) by the time they got her in for the MRI it had cleared. From what they told me is that if they don't MRI before 3 hours from when the stroke occurred the MRI will not show, and its called a TIA. I just don't want to put any undue pressure on her, especially since she has been through so much in the last month and a half.

Thanks to all for the replies. I do have a suggestion for all that is dealing with their parents. DO NOT TAKE THEM OUT OF the hospital before 3 midnights if you think they might still have issues. We allowed it and they setup home health therapies. The home health person said that she needed to be in a SNIFF unit (special nursing facility) and medi care would not pay if you were not in the hospital for 3 midnights. She had to go back in the hospital the day after we got her out and that is where the journey began.

Also long term care insurance is a god send. My dad bought it for her in 2003 and it is paying 90 % of her 8000 per month Memory care bill. Hers is so old that its unlimited and they increase every year by 10%

 

[KXCam22]

In my experience with my parents, a paid friend was a better and cheaper alternative. The best therapy was talking to people and going for walks, basically staying active and current, not sitting and staring. Been down that road and it is not easy. Cam.

 

[djetok]

In my experience with my parents, a paid friend was a better and cheaper alternative. The best therapy was talking to people and going for walks, basically staying active and current, not sitting and staring. Been down that road and it is not easy. Cam.

Thanks. We don't spend time sitting around. We are on the lake Friday and Sundays, unless something x ok meds up with her. It's crazy though that every time we get to the lake and I relax, a nurse calls with something.

This paid friend is that for me or my mom. If for me I don't think my wife would agree.

 

[txav8r]

I feel for you. We have been through all of that with my pop first, then my mom. We lost her 2 years ago this month. BTW, my wife is a hospice nurse and has worked home health before as well. You will be approaching a place that you will need to make decisions about all the trips to the hospital, possible DNR, and how you proceed from here. As far as even a good Memory Care facility, they are still basically nursing homes. And I haven't been in a single nursing home where I didn't see lazy nurses. Now please, if you are a nurse, don't go ballistic because of my statement. In every hospital and nursing home, you will find some that are dedicated and angels, and some that aren't. In a nursing home environment, the patient to nurse ratio is tight. And some patients just take up more time than others. So it doesn't surprise me that someone has referred a home health to you, because the nursing home gets to be even lazier when home health takes up some of the slack. Same with Hospice, when their aids, social workers, chaplain, nurses, and doctors come to provide care, then the nursing home doesn't have to do it. So much for your $8 grand a month your spending for her, you should get all they do for that AND the outside agency too, not less from them...unless they want to reduce the bill! My wife works for a "non profit" hospice, and it is very different than the ones that are ambulance chasing. Down here, there have been a few in the news lately and their management is now in JAIL. But again, there are always a few rotten apples, so choose with an open eye. I wish I could tell you that your mom will get better, and I pray she does. But alzhiemers and dementia just eat away not only their mind, but also their minds abilities to control their organs and bodies. My mom went from watching my pop fail pretty quick by most standards, with Lewy Body Dementia, to her own mental decline. And, she did get better after a hospital bout, then a Mental Care Facility, and my sister felt she had to let her move out to an assisted living facility and she did...for maybe 6 to 9 months before the problems started again. All told, she was about 2 years in and out of places and the only agency that provided some quality of life and helped, was hospice. And hospice is not a death sentence, but it is an acceptance that she isn't going to recover and move out on her own again. If she qualifies, and you may have to ask that pointed question of her primary care physician, do yourself a favor and take that help for her and you, at the first opportunity to get it. Those folks are angels and they can help. My heart goes out to you because it is a tough road, and I pray you and your family can weather it, and that your mom's journey is peaceful and that she hangs onto her mind as long as possible. I second the idea that if she doesn't have to be in a facility, and her long term care will pay for a caregiver at home, that is the best of all worlds for her, and for you. I want to say too, that it doesn't sound like your at that crossroads yet for hospice. Just don't put it off when the time comes, they HELP you and her. And again, prayers for all of you.

 

[txav8r]

My wife adds that any rehab therapy is just moneymaking in her condition. But we don't know if she has weakness on any side or otherwise, so we aren't the best judge of the need. But hospitals and nursing homes will try to "skill" a patient to add to the bottom line.

 

[djetok]

My wife adds that any rehab therapy is just moneymaking in her condition. But we don't know if she has weakness on any side or otherwise, so we aren't the best judge of the need. But hospitals and nursing homes will try to "skill" a patient to add to the bottom line.

She doesn't have weakness and I agree. This facility has been great so far. I am sadly familiar with hospice as well. In my eyes hospice is more for the family than the patient. They obviously make the patient comfortable. My father passed in clarehouse in Tulsa, which is a non profit. They were great. He passed from pancreatic cancer.

My main issue is to make her as happy as she can be. I know there is no cure for her illness.

 

[Speedling]

I don't know how I missed this after @Julian even tagged me above!
I will say that after my stroke, the therapy IMMEDIATLY after my stroke was the most effective.
I will also say that physical stuff is EASY! You can work out, work hard, and keep practicing. That's easy really. Anyone that has lost weight may disagree with this theory, but I am telling you, that's the easy part.
The mental stuff is every day and doesn't go away. You don't get to wake up and feel normal. There were times especially earlier where nothing feels real. It's all a ghost story that you're not part of. Serious dimensia stuff. Logic has to prevail and I have been blessed all my life with strong logic. I also had my stroke on the right, leaving my left side which has logic, uneffected. Believe me, especially the first week home from the hospital, I had to logic my way through feelings, emotions and where I was etc. It's freaky.
I would recommend some sessions with a speech therapist. It has very little to do with talking. I talked just fine but saw a speech for all sorts of cognitive skills. For example, did you know the right side of your brain controls math skills? I sat down to some math problems, did all the basics, square roots, even explained to her some the derivitives etc but all the sudden I got stumped on long multiplication, like, 235 x 126. Do it on paper. Yeah, no one does. My problems were more like 13 x 28. I completely froze and couldn't do it. I also right after my stroke had lost some of my verbal filters. I still don't have them completely back. I ramble on and on. I interject. I have issues with focusing the list goes on and on and on. The Speech therapist helped with all of this.
After a stroke, you literally have deleted part of your brain. Mine was severe, not just a TIA, but her age is NOT helping her in this. I don't know what the cost is for it, but honestly, a few sessions would probably at least help her and you pinpoint issues, and find compensatory techniques around them.
I am always very very busy, but if you message me, I can always explain much more to you if you like as well.
I would ask yourself; what does she stand to gain from the therapy? I had EVERYTHING to gain. Literally.

 

[Julian]

I just spent a week with my dad after he had a severe heart attack last saturday, had 5 stents put in on Tuesday, and he's now in inpatient rehab. He's getting both physical and speech therapy. He had 3 different anethesia's this week, and it was shocking how long it took him to recover from them!

On Tuesday he didn't know who I was....I was in a black shirt...he thought I was a priest.
On Wednesday he thought I was his grandson....then guessed I was his son.
On Thursday he finally recognized me right away.

I never would have guessed it would take 2 days to remember who I am and what had happened.

 

[djetok]

I don't know how I missed this after @Julian even tagged me above!
I will say that after my stroke, the therapy IMMEDIATLY after my stroke was the most effective.
I will also say that physical stuff is EASY! You can work out, work hard, and keep practicing. That's easy really. Anyone that has lost weight may disagree with this theory, but I am telling you, that's the easy part.
The mental stuff is every day and doesn't go away. You don't get to wake up and feel normal. There were times especially earlier where nothing feels real. It's all a ghost story that you're not part of. Serious dimensia stuff. Logic has to prevail and I have been blessed all my life with strong logic. I also had my stroke on the right, leaving my left side which has logic, uneffected. Believe me, especially the first week home from the hospital, I had to logic my way through feelings, emotions and where I was etc. It's freaky.
I would recommend some sessions with a speech therapist. It has very little to do with talking. I talked just fine but saw a speech for all sorts of cognitive skills. For example, did you know the right side of your brain controls math skills? I sat down to some math problems, did all the basics, square roots, even explained to her some the derivitives etc but all the sudden I got stumped on long multiplication, like, 235 x 126. Do it on paper. Yeah, no one does. My problems were more like 13 x 28. I completely froze and couldn't do it. I also right after my stroke had lost some of my verbal filters. I still don't have them completely back. I ramble on and on. I interject. I have issues with focusing the list goes on and on and on. The Speech therapist helped with all of this.
After a stroke, you literally have deleted part of your brain. Mine was severe, not just a TIA, but her age is NOT helping her in this. I don't know what the cost is for it, but honestly, a few sessions would probably at least help her and you pinpoint issues, and find compensatory techniques around them.
I am always very very busy, but if you message me, I can always explain much more to you if you like as well.
I would ask yourself; what does she stand to gain from the therapy? I had EVERYTHING to gain. Literally.

So sorry your are going through that.

Things with my mom have not gotten better. Therapy is not even maintain. With vascular dementia, you have huge drops in mental states. Also apparently haldol, one med that the geri pysch hospital had to resort to has done some sort of damage (hopefully sort term) the memory care facility took her off it immediately. She had another drop and she looks and acts like she aged 10 years overnight.

When I put her in the facility, I put her in the biggest and nicest room (one of the few that has it's own shower) I was in there yesterday and they had all kinds of airmovers in there. She flooded the shower. In my hopes to make her as comfortable as possible with a personal shower, I might be putting her in danger.

I am lost. My brother and I have temporary guardianship. We have a date to get permanent soon. My brother is 100 miles away, so it is basically on me.

 

[djetok]

I just spent a week with my dad after he had a severe heart attack last saturday, had 5 stents put in on Tuesday, and he's now in inpatient rehab. He's getting both physical and speech therapy. He had 3 different anethesia's this week, and it was shocking how long it took him to recover from them!

On Tuesday he didn't know who I was....I was in a black shirt...he thought I was a priest.
On Wednesday he thought I was his grandson....then guessed I was his son.
On Thursday he finally recognized me right away.

I never would have guessed it would take 2 days to remember who I am and what had happened.

Sorry to hear man. It's tough, sometimes with the elderly and hospital stays they get so disoriented. Hope he gets to feeling better. My thoughts and prayers are with @Julian and @Speedling

With my mom. They kept asking her questions. What year is it? Who was the President? Her birthday? Sometimes she would get it right, but she knew every time that it pissed her off they kept asking her though same questions.

 

[Julian]

Sorry to hear man. It's tough, sometimes with the elderly and hospital stays they get so disoriented. Hope he gets to feeling better. My thoughts and prayers are with @Julian and @Speedling

With my mom. They kept asking her questions. What year is it? Who was the President? Her birthday? Sometimes she would get it right, but she knew every time that it pissed her off they kept asking her though same questions.

My mom passed away from Alzheimers about 2 years ago....she hated getting diagnosed and was REALLY ANGRY at the neurologist for asking so many difficult questions. When I asked him later what he asked, he said there are actually very few "difficult" questions, but as speedling said, the questions are intended to test all the different parts of your brain. When mom was asked math questions like 7x7 she got them all wrong and get very agitated.

She was really scared by the diagnosis....not surprisingly. It is a horrible way to go....

 

[djetok]

My mom passed away from Alzheimers about 2 years ago....she hated getting diagnosed and was REALLY ANGRY at the neurologist for asking so many difficult questions. When I asked him later what he asked, he said there are actually very few "difficult" questions, but as speedling said, the questions are intended to test all the different parts of your brain. When mom was asked math questions like 7x7 she got them all wrong and get very agitated.

She was really scared by the diagnosis....not surprisingly. It is a horrible way to go....

Yes sir, it's tough. My grandmother (mom's mom) had Alzheimer's. I was a self absorbed teenager and now wish I would have paid more attention to how it was handled. I have spoke to my aunt (her sister in virginia) quite a bit. I was going to fly her here when she was in the hospital but it didn't work out. Now I am just following her advice and winging it.

 

[Julian]

Yes sir, it's tough. My grandmother (mom's mom) had Alzheimer's. I was a self absorbed teenager and now wish I would have paid more attention to how it was handled. I have spoke to my aunt (her sister in virginia) quite a bit. I was going to fly her here when she was in the hospital but it didn't work out. Now I am just following her advice and winging it.

My father started going to an Alzheimers support group (I attended a few meetings) and it was very helpful. You learn how the disease progresses and how to cope with changes and behaviors.

 

[djetok]

Well the vascular dementia took another big drop. She is back to not eating and not taking meds. Part of me thinks she is giving up, but part of thinks she just does not have the cognitive thought to do that. She is below 100 lbs now and is just focused on leaving the facility.

 

[itsdgm]

Sorry to hear that @djetok I'll keep you guys in my thoughts and prayers.

 

[djetok]

Mom is back in the hospital again. Another stroke and tonight she barely knew who I was and did not know my wife. I'm broke