Bringing Grandma Home

[Candid]

My dad had to call an ambulance and have my mom taken to the hospital last night. She is 81 and has had an increased number of falls in the last 2 -3 week. She is up to multiple times in a day. He is 85 and can't always get her up.

 

They are here in town. Any way I suspect Grandma will be in the hospital for a couple of days, and I need to help dad prepare his house to bring her home. The good news on that front is they bought a new place several years ago that has wide doorways, etc. They've already been told (yesterday at her regular doctor's) that she'll probably need a wheelchair.

 

But I don't know exactly what kind of list of things we'll need to think about and I'm hoping some of you have been through a similar experience and could give me questions to ask, things to consider, stuff we'll need. Dad's had a by-pass and is not strong so he'll need help in terms of moving her around.

 

I'm off to the hospital for now, but I'll be checking in later.

 

Thanks in advance for your help.

 

Update here: http://forums.welltrainedmind.com/showthread.php?p=4141602#post4141602

Edited July 25, 2012 by Candid

[speedmom4]

:grouphug:

 

I have never been in that particular situation so I hope others will chime in. Is there any way your father could bring a nurse in to help with her care for the short term when she comes home? I imagine making sure she doesn't fall, helping her to the bathroom, bathing, etc. will be difficult. Also, have you all thought of a hospital bed to help her? You can have those delivered from a medical supply company. It might be easier to get her in and out and also might be safer since it has rails that you can raise and lower.

 

Hope it all goes well. Hopefully the docs and nurses can give you advice on what to have ready at home.

 

God Bless,

Elise in NC

[kroe1]

Your dad's home should be made fall safe. This means hospital bed, no rugs, handles around the toilet and in the bathtub, proper walker, etc. Ask the hospital to request a social work consult. The social worker can hook your dad up with supply lists and resources.

 

Then, ask why your grandmother has made a drastic change in the past few weeks. Is her medication too strong, does she have a head injury or swelling, is she in pain, is there times of day worse than others, is her lab work normal, are just some of the questions that your dad should ask the physician.

 

Good luck to them, both.

 

:grouphug:

[kricau]

:iagree:Great advice!!!

Your dad's home should be made fall safe. This means hospital bed, no rugs, handles around the toilet and in the bathtub, proper walker, etc. Ask the hospital to request a social work consult. The social worker can hook your dad up with supply lists and resources.

 

Then, ask why your grandmother has made a drastic change in the past few weeks. Is her medication too strong, does she have a head injury or swelling, is she in pain, is there times of day worse than others, is her lab work normal, are just some of the questions that your dad should ask the physician.

 

Good luck to them, both.

 

:grouphug:

[LostSurprise]

I don't completely understand. Can he not get her up if she falls or not get her up from sitting/bed lying positions?

 

If he can't get her up they need outside help during those parts of the day (beginning/end). Most people hire a CNA to come in and help with rising, cleaning, toilet, putting to bed, etc. If he can't help her onto the toilet and off, they need a situation with full care.

 

Possible changes:

 

ramp

chair which rises

walker(s)

wheelchair

shower seat

toilet/shower bars for gripping

respite care for your father (call social services), home evaluation, medical/legal/hospice forms prepared

medicalert

a plan if something happens to your father

[Impish]

I'd pay attention to her clothing. There are places that make clothing that's easier on and off than the typical...that have velcro and snaps, elastic waistbands, etc.

 

I don't know how steady she is on her feet, but standing to get dressed could be an issue for her. Also, her manual dexterity. They do have assistive devices for buttons, etc that you may want to look into. Talk to her Dr, and to the PT (there's usually one involved when it comes to ambulatory issues, or you could ask one to assess her, to get a very clear idea of where she's at, what she needs...and they can set up the required devices to be delivered, etc for your family)

 

:grouphug::grouphug::grouphug:

[elfgivas]

:grouphug: my mom fell at age 82. while she was in the hospital, a geriatric social worker did an evaluation to let us know what they thought should come next. they do this for all geriatric patients who are there due to a fall. (this was in a medium sized hospital). they recommend to the medical team and to the family. so my mom ended up with a new shoulder, and in home physiotherapy to help her learn how to use it, and two years later is doing really well. this was in ontario, canada, so ymmv, but i'd sure ask if they have someone there who can help you figure out what makes the most sense.

 

in ontario, they also offer a "falls course" to most folks when they turn 80. my dad took it, it was six weeks long (this was after he fell, and it was recommended). it focuses on balance, teaching exercises, tai chi, nutrition, etc. he said it was great. so if that isn't offered, i'd ask about it, too. one of the things about universal health care is that there is real incentive to find simple things that improve quality of life, and therefore reduce medical expenses.

 

i asked here in SoCal about a falls course, the doctor laughed out loud. sigh.... (my mil is here, and broke her hip falling the same year my mom did in her shoulder.)

 

fwiw,

ann

[dirty ethel rackham]

Is the falling due to neurological issues or strength? If it is strength related, can she go to a rehab facility for a short time to get her strength up? Many times, after my mom was hospitalized and greatly weakend, they put her in a rehab facility for a few days to a couple weeks where she received physical therapy to help increase her strength to reduce her fall risk. Although my mom lived alone and went back to her own place, while we were there, we saw many family members of other patients getting instructions on reducing fall risk and learning how to assist their loved one in ambulation to help reduce their own risk of injury.

 

ETA: Definitely get the social worker involved. I am surprised that this hasn't been done already. Every time my mom was discharged, we had a meeting with a social worker.

[AmyontheFarm]

Take a look at lighting issues also. As eye sight dims it is harder to actually see where you are going. Couple that with the desire to save every penny and you get an elderly person with bad eye sight and who will not turn on a light to see where they are going. It's a recipe for a fall.

 

If they have stairs, remove any carpeting, put glow in the dark anti-skid strips along the edges and add extra lights. You might also consider a lift so she can just sit and it will take her up and down. Otherwise, if you watch your dad will go up behind her to help her up the stairs and then when she falls she takes him down also.

 

You might consider putting motion detector lights in the hallway, that way if she tries to leave the room during the night, the light automatically comes on for her.

 

Get rid of those little carpets on hard surfaces that can slip and look for slippers that don't fall off easily. Statistically place chairs mid-way between destinations in the house. Ex: Between the bedroom and the bathroom, is there a place to sit down if nessecary? Between the kitchen and the livingroom is there a chair that can be used? If she gets dizzy she'll have a place to land, instead of the floor.

Edited July 25, 2012 by AmyontheFarm

[fairfarmhand]

may I add that a good baby monitor will help him out, so that he can go check the mail without worrying.

[Candid]

I'm home for a bit. Believe it or not she is still sitting in a holding room at a outlying facility close to her home waiting to be sent to another location across town. The only thing they did at this facility is do an EKG.

 

I've read everything on this thread thus far and there are a lot of good ideas. I'm going to try to clarify some of the question areas as best I can, but I may miss something.

 

Her falls are not due to any environmental conditions, but instead she looses all control of her legs at moments. At the doctor's appointment, it was made clear to them that due to this a wheelchair is a must, a walker won't work.

 

I asked about changes in her meds or big falls prior to this, but nothing. She takes few meds and has taken them forever. However, she has had increasing problems walking and mostly shuffles duck like, but except for some very few and far between trips over curbs, etc. has not had this falling problem before.

 

She's been seeing a neurologist for over two years. Well, kind of seeing him. She's had three visit all of which require at least a 3 months of waiting to get in, at the second two she only saw someone on his staff. They sent her for physical therapy which didn't really help. I can't say it that is her being old and not trying or if it was because she couldn't do what they wanted. My parents told the regular doctor yesterday they want another neurologist. Dad taught at a med school about 30 miles from our city and she insisted that they send her over there. But none of that was finalized before last night's fall.

 

Which brings me to the falls, she got to the hospital because she got up at night to go to the bathroom and her legs gave out (I know that sounds like the fall in the dark idea, but her legs give out with zero environmental factors as well, and she describes it as having her legs becoming wet noodles.). Dad cannot lift her back up off the floor. Sometimes they can both work together to get her up, sometimes not. They had called an ambulance once before that week and Dad thought they couldn't keep calling the ambulance so he let them take her to this ancillary hospital near their home.

 

She is ready to go to a nursing home because "it's going to throw out your dad's back out" (Or my back out.) Dad isn't sure. He wants to keep her at home if possible because he knows she won't be happy in a nursing home. She likely will end up tied in her bed at night because she'll do the same thing to them that she did to Dad and try to go to the bathroom without calling for help. Even this morning, she tried to convince me to wait on calling a nurse to help her go to the bathroom.

 

Since we had nothing to do, and I brought my tablet, Dad and I looked at websites of local medical supply companies and some had lifts shown. He told me over lunch that he had no idea such a thing existed. While I think he will be able to get her from bed to wheel chair having a lift, even as an idea for now, helped him think about keeping her at home.

 

I really like the idea of the social work evaluation. I used to work with homeless people, but I never remember that social workers do work with other people as well. :001_huh: Oddly, my church is having a senior care seminar tomorrow night so I'm going to look into that depending on events (I'm hoping that grandma will still be in the hospital being tested at that point.)

[mumto2]

These evaluations are also done by occupational therapists. A good friend does them. Big help. My mom is 90. She lives on her own.

 

Has your mom been given any unusual meds? Whenever they give my mom "something to help her relax/ sleep"things go aweful for us. She does not tolerate these "mild" pills well and she falls. It took a good two to three weeks to detox her. People suggested a home for her. Fotunately I was in the US and could be with her. Her memory also went wacky. She made sense, but you really had to know her. She is clear a completely there without these meds. We are now on a new hurdle. Breast cancer. Not sure what the best solution is.

 

Anyway I completely understand. Have the home evaluated. Get rid of any and all throw rugs first per my friend. See what they can suggest. Their ideas were exactly what my friend, the OT, anticipated. She grew up with me. She knows my mom's house and told me what the report would recommend.

 

:grouphug::grouphug::grouphug:

[DawnM]

:grouphug:

 

My mom is 81 too and I just got an email from my dad that her health is declining significantly. She wasn't in good health to begin with. I really think we may be facing either assisted living or her not making it too much longer.

[AmyontheFarm]

How is it going with you Mom?

[DusksAngel]

 

She is ready to go to a nursing home because "it's going to throw out your dad's back out" (Or my back out.) Dad isn't sure. He wants to keep her at home if possible because he knows she won't be happy in a nursing home. She likely will end up tied in her bed at night because she'll do the same thing to them that she did to Dad and try to go to the bathroom without calling for help. Even this morning, she tried to convince me to wait on calling a nurse to help her go to the bathroom.

 

Nursing homes use bed alarms instead of restraints as a first resort for this. They can be purchased at a medical equipment store. One end is clipped onto the patient's clothing and is held by magnet to the alarm. When the person gets up it pulls the magnet loose and sets off the alarm. You can also get bed rails to help "remind" her to stay in bed til she has help.

 

We had to get these when my grandmother (who has Alzheimer's) has balance issues and can't be trusted up by herself.

Edited July 31, 2012 by DusksAngel
typos

[Candid]

How is it going with you Mom?

 

Thanks for asking! We hope that she is going to be moved to a rehabilitation unit at a local nursing home today. I've heard from friends that this is a good thing and that their relatives who have done this have gotten stronger.

 

Mom's still running odd interference on a couple of topics. Her dementia can come and go so one moment she seems to clear and sharp and the next not. Unfortunately this seems to be tied to specific topics. It's hard to explain; on this scale I would place her around stage four. If you notice this quote, "People have trouble completing complex tasks efficiently or accurately and may be in denial about their symptoms. They may also start withdrawing from family or friends, because socialization becomes difficult." That second part seems to effect other things. Dad and I have had to learn to not raise somethings in front of her because she just goes to her corner and won't come out. As a for instance, she won't brook hearing that no matter what she probably won't be able to drive, keeps talking about driving.

 

On the other hand 90 days should mean we have plenty of time to plan what happens next which takes some heat off.

 

Now, I'm somewhat worried about Dad. He's an stay at home person who'd rather read a book, but he is used to my mom's company. I'm trying to figure out small things to keep him from being lonely.