question about surgery and the elderly

[Mrs. Readsalot]

My Dh and I are concerned about his mom. My FIL died 3 1/2 years ago. Within a year she moved near us. She actually lived with us for 6 month. All of her belongings also had to live with us. We also took care of everything about having her house built etc. Needless to say it was a very long 6 months. While she lived with us she never went to the doctor, although she has been on a variety of medications for years do in large part to emotional problems, although we thought it was for lupus. Shortly after she moved into her own home she started complaining about pain in her thumbs and them locking up. Dh went to doctor with his mom. He was shocked to find out she doesn't have, nor has ever been diagnosed with lupus. She had both thumbs operated on in two seperate surgeries, Shortly after the 2nd thumb surgery she started complaining about pain in her shoulder. She had shoulder surgery last September. It was a disaster. Another brother came to care for her, he couldn't handle it, she ended up in the hospital and a rehab center for 8 weeks. Now on Easter she announces that she is having the other shoulder operated on on April 17. Dh is beside himself because his brothers have already said they will not be available to help. She said medicare will not pay for her to stay in the hospital or rehab center this time. Now just 2 weeks ago she said the shot she got in her shoulder had helped some and actually her knee is feeling worse than the shoulder at the moment(yes we see knee surgery being next) I almost hate to admit this but could she be wanting to get these surgeries for the attention she gets. She loves going to the doctor, gets all dressed up to go, talks about it for days. Leaves all the get well cards out for months. We really see this as becoming a pattern. Our concern is that things can go very wrong in surgeries especially in the elderly. This past Sunday we spent Easter at her home (other brother and his family also came) MIL cooked the entire dinner, wanted no help. ran around the kitchen and never seemed in pain. We all noticed it and actually said something to one another (MIL could not hear us) Then during dinner she makes her "announcement" about the surgery. Dh is in knots over this. Has anyone ever seen this? Can you give us any advice? Please note I don't doubt that she has pain. Also she does have a heart condition and diabeties so surgery is an added concern. Also this past winter she had a broken rib(she has no idea how it happened) so breathing complications can be a concern too.

[Mrs. H.]

I don't think it's uncommon for elderly folks to look forward to going to the Dr. Many Drs. are kind and attentive to older people, asking them about their aches and pains, and listening politely to what they have to say.

 

If your dh feels that his mother is perhaps exaggerating her pain, is there a way he could schedule a private consult with her Dr.? Without her there, he could express his concern and ask if it is possible she could be treated for her pain without unnecessary surgery. I am surprised that the Drs. are doing these surgeries without extensive scans and things for damage to the areas. Are they really doing surgery based on how much pain she says she is in, without further testing?

[Mrs. Readsalot]

Really I don't want to question the judgement of the doctors. They have done scans. The thumb surgery was border line required, we know that from the doctor. He did it because of the pain factor. The one shoulder was needed and had a lot of calification etc. The other shoulder, per the doctor is considered border line needed. Again it is being done due to patient pain. Dh has gone with his mom to several appoinments. He can't go to them all, because she tends to have about 3 a week. So yes scans are done, xrays taken. I guess we are just going to have to face the fact that their are going to be a lot of surgeries. We are both just feeling emotionally drained.

[Mrs. H.]

:grouphug: So sorry you are having to go through this, but I am glad to hear that the Drs. are doing all the testing required to properly diagnose the situation, even if the deciding factor is pain.

 

I understand about feeling emotionally drained. You stated that your mil didn't see the Dr. when she was living with you. Is she too far away to come over once a week for tea, or dinner? Or (even better for her) have you and the children visit her once a week? It seems like maybe she's just craving time and attention. I know my 10 yr. old dd would love to have an elderly lady to sit and knit with for an hour a couple of times a week, but my grandmothers are all spry, and there aren't any people in our area.

 

Also, if you are giving her all the time and attention you can, but she still seems needy, would a companion be an option? My dh's grandmother lives in a nursing home, and her children pay for a full time companion. She doesn't cost much, and she comes every day and talks to Mamaw, fixes her hair, takes her outside for fresh air and sunshine, and gets her involved with the other residents in a way that Mamaw wouldn't on her own.

[Mrs. Readsalot]

Thank you so much for your replies and compassion. We or just dh go over once a week for several or more hours just to "visit" I have encourage just dh to go for the day a few times a month just to spend one on one time with his mom. He does this although it really drains him. She craves the company of her sons. She has actually told me that she doesn't get close to DIL's because they don't stick around long. Dh's older brothers have been married multiple times. Dh and I have been married 17 years so I think I am here to stay. She told me this when she was living with us (dh and I had been married 15 years at that point). I have spoken with other DILs about this and we all feel that MIL thinks of us as having taken away her sons even though we are all very nice to her. I have just accepted it. She lived in a 55+ neghborhood and has several friends. She didn't want to met people in the neighborhood but after we encouraged(we had to take her) her to go to a neighborhood picnic she has some friends She doesn't drive although has easy access to a bus and friends who she goes places with. I am going to post about the extensive number of meds she takes in response to another responder.

Thanks again for your care and concern. Dealing with aging parents is really difficult. Especially while you are trying to raise a child too.

[Laura in VA]

She is blessed to have a dil like you!

:grouphug:

[Mrs. Readsalot]

She was going to several different doctors and taking a lot of med. We noticed this when she was staying with us. We wrote down everything she was taking and after going over it found out some were for the same things and some should not be taken together etc. After working closely with her doctor several were eliminated. She is very protective of her meds, if she travels they stay in a case by her feet and never leave her possession. She lines them all up on the counter and carefully taps each bottle several times in a row each day. She annouces to everyone when it is pill time and has done this for years (it drive dh crazy) In dh opinion she wants a pill to "cure" her instead of eating correctly , exercising etc. He says she has been this way for as long as he can remember. Dh has caught her lying about taken stronger pain medication. ie she will tell him she is only taking Tylenol and then when he takes her to the doctor she asks for refills something stronger. I guess we need to keep a closer eye on her meds now that she is seeing several new local doctors. Thanks for pointing out the need to check on this to me.

[Maria from IN]

I don't know what the situation is like at hospitals near you, but I'm doing an internship on the Behavioral Health floor of one near my home. When a patient is admitted, one of the (many!) questions a nurse asks is, "Would you like to speak to a counselor about your current stress level?" and if the patient answers yes, an email shoots up to the unit and a counselor from the floor will go see them and talk to them at different times during their stay. More often, nurses will see a change in a patient's behavior or see something unusual--often like the med-seeking you describe--and will email someone in the department to come an check up on them as well.

 

We have had families of patients ask for this service, as sometimes there are things people can hear from strangers that they just can't bear to hear from anyone else. Sometimes they are going to be fine and don't believe it; sometimes they hear bad news and have to process it or come to terms with their limited mobility--one woman was even hallucinating as she came off her meds for several days, and since her family members and doctor were in her hallucinations, she didn't believe them when they told her that no one would ever ride a horse off the elevator and into her room (loooong story there)!

 

After the consultation, during which the psychologist I'm following around offers a listing of counselors and centers, a note goes into the patient's actual paper file listing the time and nature of the consultation, including the general symptoms like stress at home, addiction, depression, etc.--even med seeking. It is likely the nurses will see those notes and notify the doctors about it.

 

More often than not the issues are from home, not as a result of a stay in the hospital, and perhaps they can unearth a little of what has your MIL behaving in this way.

 

Good luck to you all--I hope this rambling helps a little.:grouphug:

 

Maria:001_smile: