Mom's settled in nursing home but still wondering...

Mom moved into a nursing home Monday afternoon and shows some improvement each day.   I've called her daily and with each conversation she sounds perkier.  She is happier with the food, her table mates and the proximity of people in the hallway.  She misses her recliner, can't quite figure out the telephone and hates the view of a broken down wooden fence but overall seems content.  She's gone to physical therapy a couple of times and is very appreciative of their support to get her to the bathroom more often.

She arrived at the nursing home with a urinary tract infection so has to go often and hates to ask for their help.   Urinary tract infections seem to be common among the elderly - both my in laws had them often.   Such infections can be hard on an older body because it weakens the patient making it harder to manage other conditions like blood pressure.   I wonder which happened first the seizure or the urinary tract infection? She is responding to treatment so I'm hopeful that she'll continue to feel better.  She had a catheter for 3 days during her hospital stay so I wonder if the UI resulted from that or eased her pain and suffering?  I'm not there so I can't ask these questions - which I HATE but must deal with it. I can only trust that she is getting the good care she deserves.  My brother, sister-in-law and niece ( a nursing student) seem confident so I trust them as well.  I'm facing my inner control freak and have to let it go.

In each conversation she says "I don't know how long I'll be here or where I'll go after therapy." As she improves I hope she has no desire to return to assisted living because it will be up to me to tell her no. Upon learning she'd go to a "rehab center" (code for nursing home) she was upset and mad but realized it was necessary.  If it becomes an on-going question, I plan to blame it on her doctor.  It's not a lie; he says "absolutely NOT, she stays put."   We've moved her things from her apartment to her garage and told the ALF that she will stay at the nursing home.   I hope I'm not repeating my reply several months from now but I suspect I will.   It frustrates me to tell her the same things over and over, I'm not ashamed to admit that.   But - a frustrated me is better than an upset mom so I'll learn to deal with my frustration and try VERY VERY hard not to let that show to her.    As long as I can be loving and supportive WITH her, I figure I can be frustrated in private later.

One event changes everything... Mom must move again.

Since yesterday things have changed and I'm not sure it's for the better.  The change means that we must admit Mom's even slower, that she's declining and there's nothing we can do about it.  She's improved since her seizure but is still not 100% and arrangements are in place to move her to a nursing home on Monday morning.   We - the family - did not have to make the call to move her.  Her physician told her he wants more nursing supervision of her care and she can't get it in assisted living.  He insists she move to a nursing home.  She accepted this coming from him; it's doctors orders so she will comply.  It doesn't mean she will understand tomorrow and that she will want to comply next week or any week after.

So now we worry about the physical and the emotional. Mom's dilantin levels were way too low so they must figure out why such a dramatic drop occurred when she's been taking meds regularily.  Physically Mom's better but not 100%; she still has numbness in her left arm and leg.  Some physical therapy will help get her moving again.  We've also got to deal with the details of a move - canceling the phone and paper;  moving her clothes to her nursing home and her furniture and belongings from the apartment to the garage at her home. Luckily, I have a classmate who manages a moving company and he can squeeze it in on Tuesday.  

As for her emotional state, we are concerned and will be concerned for a few weeks until she's settled in.  My niece talked with the doctor about depression and anxiety so he will try some anti-anxiety meds in conjunction with her dilantin.  My brothers, neice and sister-in-law will see her daily while she's hospitalized and once she's moved.  I am making plans for a return visit to check on her and see that she has everything she needs.   I believe an old friend of hers is also at this nursing home so I'll ensure they are connected and can visit back and forth regularily.

While I'm feeling really stressed and have had a headache since the first call, I am feeling really grateful to my family.  They've all stepped up to help Mom; she's been their priority and they've given up sleep, work and school to be with her.   They've been good about communicating with each other and with me.   My brothers - both over 65 - were ready to step in to quickly move mom's stuff from the ALF apartment. I appreciate their willingness to work but want to spare their energies so that they can visit Mom so I called in the movers who can have it done in a couple of hours.  So - together we're helping her; from near and far, we're getting things done.  I may not feel good about what's happening with my Mom but I do feel good that we're all coming together to help and support her.

That call we dred - something's wrong with Mom and I can't get there...

My brother called this afternoon and I knew it was probably something bad.   He doesn't call unless there's something wrong or he has an important question.   Long story short, Mom was on her way to the hospital and he was going with her.  He and my niece, his daughter, had been at the ALF with Mom for a few hours and they decided to take her to the hospital.  I'm waiting now for him to call me after he speaks with the doctor.

Things began this morning when they got a call that Mom didn't feel well and she wanted him or his daughter to come stay with her.   Mom  was feeling really anxious; we're always concerned about this because it means she's prone to a grand mal seizure.  The ALF gave mom another of her anti-seizure meds but it progressed to numbness on her left side anyway.  Mom didn't experience shaking or loose consciousness but she also didn't improve so after an hour they called an ambulance and away she went. 

I am worried about Mom but know that my brothers and their family will do all they can for her.  Her physician warned me that her epilepsy would change as she aged so other hospitalizations are expected but that does not make it easy to get this call.  I WANT to be there.  I want to help comfort my Mom but I'm on vacation on the other side of the country.  I just can't get there easily and I'm worried and feeling bad.   If I hear that there's something else wrong, that it's not a seizure that will pass, then I'll get on the next available plane.   I can't be worried about the cost or the timing, I'll just GET THERE.

Too much OJ leads to crisis and hospitalization

A friends father recently had a health scare due to OJ - yes, orange juice, that healthly bright beverage that Florida citrus growers push into trees and onto grocery shelves.   The problem comes when the OJ is fortified with vitamins and minerals - it can be too much for a body to handle, especially an elderly body that already contains medications and supplements. 

Here's what happened:  My friends father, age 84, had heart surgery about three months ago and, after a three of weeks in a rehab facility, was well enough to be home alone.  He was warned about eating right and getting enough vegetables so he thought some fruit or vegetable juice would be good for him;  he'd get fluids and the benefit of the fruit (fiber, vitamins, minerals, etc.).  He drank one 16 to 20 ounce glass of OJ a day.   After 5 weeks he had trouble breathing, was retaining fluid and his potassium levels were sky  high.   His orange juice of choice was fortified with calcium, multiple vitamins and minerals plus added sugar, preservatives and flavors.  With his existing prescriptions and supplements more than a few ounces of this OJ was the LAST thing he should have.  Eating the oranges would be fine with the natural benefits.  

After more than 5 days in the hospital, he was fine and back to normal.  To help him understand what and how to eat better, his daughter in law requested a meeting with a dietician to identify drug-food interactions and what might be helpful or beneficial for him.   The lesson learned are:

• when it comes to supplements - in food or in pill form, we really need to be mindful of interactions
• after surgery and before your loved one goes home, ask to speak with a dietician about drug interactions, special foods to avoid or add to a diet, be there when they talk with your loved one and try to get the doctor to join in too
  
• Ask the dietician to WRITE IT ALL DOWN - this might be hard but tell them ahead of the appointment that your elder needs written instructions, copy these and send a copy to their regular physician
• Create a food and prescription schedule for your loved one.  This doesn't have to be a minute by minute play by play of their day and you can include a variety of things they can or should have for each meal.   
• Help your loved one shop and, if they select "banned" things, remind them of the interaction and possible consequences; if possible, get them to put it back.