I have durable and medical POA for my mom. She is stubborn and fierce. A week ago fell out of bed 3x before we learned she has a compression fracture in her L1. She was more confused than usual and in agony (pain got worse very suddenly but she's had an achy low back for years). My brother, who was home with her at the time, was convinced she was - and is - dying.
She fell out of bed while he was away and before X-rays were taken and read. We got pain meds (Hydrocodone). I managed to use a home test kit (and commode top hat) that confirmed positive for UTI (3 strips), because the doctor never tested for it when she went in for the pain appointment (before her pain increased even more).
For the last week, we've had her in her second floor bedroom with bedrails, escorting her to and from the bathroom, bringing her food - provided 24/7 company. She has lived alone for the last 3 years. We have had family friend/caregiver support for years to tend to grocery shopping, helping pay bills, chores, cleaning (as Mom allows, which isn't much). She improved with antibiotics for the UTI but is still in significant overall pain.
Going to the ER was not happening over this past holiday weekend (our father died on July 4th three years ago and Mom's birthday is tomorrow). One of my brothers has been the primary caregiver for the last 4 weeks and was adamant that taking her to the emergency room over the holiday was a terrible idea, and that if she went to hospital she would never come home. He was convinced she was - and is - dying.
She's not had much motivation to do things since before Dad died. Now she speaks openly and honestly that she's depressed. She's never admitted that before. With the UTI seeming to clear up, she is back to her stubborn but repetiive and ADHD self - pillows and blankets placed just so, what's that speck of dust over there on the floor across the room, etc. But she won't agree to go to a medical facility. I desperately want to take her to urgent care, which may be better than an emergency room. She is easily startled, has bionic hearing, and we worry about the stress of a hospital stay - and what we might learn. I would rather know and try something than wait.
I've begged the doctor for in-home PT assessment at least without an office visit. No response on that. She must be seen by a doctor for us to get any medical assistance at home. How can I convince both my brother and my mom to give this a try? Her sense of humor (which is quite sharp) remains intact and she loves having an audience. So company is always good. But she doesn't want anyone fussing over her, thinks she doesn't deserve to eat because she doesn't eat all day, etc.
I have made appointments for her with new doctors and pray I can get her to go (and she stays with us this long). New Geriatric Nurse Practitioner in 9 days, and a neurologist at the end of August. I tried a neurologist before but Mom would never agree to go anywhere but to her primary care doctor. He's a kind and knowledgeable man but needed to retire years ago. We are done with him and need some real guidance. They've offered little other than "Take her to the ER if she won't come to the office." We've not been able to get, nor been offered, an appointment time.
Is there a resource out there for home visit doctors for new patients? I have asked our doctor, the local agency on aging, and some home health agencies, and no one is aware of such a physician.
Sorry for the very long post. Thank you for your insights and patience, and willingness to share.
In kindness...
My Mom had this same fracture and your Mom is in agony for no reason. It used to be people with this fracture laid on their backs in bed for 8 months before it healed. There is now a procedure where they take a needle, I think it is, and put a cement into the fracture. This procedure stops the pain. There maybe discomfort but not that pain. And, by having that pain constantly, Moms bloodpressure is probably high if not on meds to lower it. My Mom was in her early 80s when this was done. She had PT after the procedure.
I don't know why when they took Xrays this proceedure was not done immediately. I would take her to the emergency room and get a specialist involved.
That means that YOU are in the driver's seat. Not mom. Not brother.
Call 911 and get her to the ER.
My mom's has a degenerative spine. Started in January, she says she didn't fall, but I have my suspicion.
Anyways got her to doctors, X-rays all that . They did physically therapy in home. She got better, now we are at square one all over again.
They want to try more physical therapy, and for her to go to pain management, now.
Will see if it works , but if it does I think it will be just a bandaid. Time will tell.
Yes she needs to be seen by a doctor, I have a feeling once the pain gets unbearable she wont have a choice
Finally re-reading my post, I should clarify that my brother was home when she fell 3x (and doctor was away on vacation). The third time, my brother called 911 because he couldn't get her up himself and it was in the overnight/wee morning hours. Oddly enough, the repsonders actually said she seemed fine at that time and when my brother asked their professional opinion, they said "If she goes to hospital, they'll probably just send her to a facility." That's what my brother said they said. Which is infuriating.
Mom is sharp enough to speak up for herself and say when she DOESN'T want to do something. Competence is tricky, though, because for many things, she'll look at us and ask what we want her to do. But she doesn't want to do anything. She is sleeping most of the day, inconsistenly mentions pain - sometimes there's none at all anywhere, and other times it's constant.
I worry about sepsis and will use that when we call for emergency help. As it is, we need Lift Assist (at minimum) to get her safely downstairs. She is able to walk on her own, but hasn't walked anywhere, except to and from the bathroom. In the early days after her falls, we were using a wheelchair to get her to the bathroom because she was unsteady on her feet sometimes. She is better on her feet now, but often says (and has said in the past) she feels "wonky" - like she's going to pass out. Her appetite has lessened a lot today too. She usually snacks on little bites throughout the day but nothing tastes right, she says.
I'm more convinced about calling for assistance and will work it out with my brother to get on board. Mom will need to as well. Thank you all for your generosity.
As long as she stayed still, she was not in pain. But she did the therapy and it healed in a few weeks.
‘Of course, not everyone’s fracture will be the same and your mom needs to go to an ER to have it checked out.
If she is a candidate for the surgery, she will feel well right away. The pain meds could be affecting her appetite. Also the antibiotic could.
I hope she feels better soon.
B’s idea that M will never come home if she goes to hospital, is just that - ‘an idea’. M can have some health care, which may improve things for her, and change her future prospects. Perhaps the most likely ‘not come home’ scenario would be because the ‘carers’ aren’t willing to continue to provide so much care and support. But that can happen any time - now, if you want. It’s not related to going to hospital.
You clearly want the best for your M, and you are doing your best too. But M will eventually die, like all of us, and a clearer picture would help to work out the best course of action to take.
More information could give you more useful answers.