96 year old aunt is in assisted living. I visited two days ago and found a bruise on her forehead, legs...every piece of clothing, bedding was urine soaked as she hasn't been diapered properly. She is itching and miserable. They charge her $75 a month on top of everything else to do two loads of laundry. HAd to pay $30 to do emergency load ...I found a urine soaked diaper in her hamper, it had to weigh 3 lbs. she has plenty of diapers. I don't know what to do. She fights her caregivers on everything from meds to showers....she is almost out of money...about 4 more months worth. Won't allow her to apply for medicaid so she can enter nursing home until she is down to $2000....then it is a 6 month wait to GET on Medicaid...where does she go for that 6 months??? I am at my wits end.....
If they're using Ativan to calm her down, it might be that she is non compliant in a physically dangerous way. Be sure to ask. You might not think a 90+ year old woman can harm you with a slap, but you'd be wrong. In TX, the care facilities have to write a report when a client hits or otherwise hurts someone so ask for that info. Be sure to warn the folks at the ER and hospital in advance. They can't refuse to take her because of it but they can take precautions.
The hospital advice seems good. If she sits in urine a lot, she probably also has pressure sores. Check for open sores but also check for ones that are just starting. Google for pictures if necessary. They can be life threatening, so you can hold your head high at the hospital.
Constant doses of Ativan will almost guarantee incontinence (in my non medical experience). She'll be so dopey, she won't know she needs to pee and will be too confused to cooperate with anyone. Ativan made my husband less compliant, not more. The only way it made him compliant was by making him too doped up and uncoordinated to move. If you haven't seen the effects of Ativan on an elderly or sick person, prepare to have your heart broken. It's not something to do for convenience.
Also. I agree about reporting the AL facility. If they can't handle her, they have a duty to make sure someone knows that.
Good luck and a big hug for you.
So, what I suggest, is to have your mother live with you at your home. You can hire a caregiver, or work with the NW Caregiver Support Program (that gives respite care to caregiver (you)--if you'd caregive your mom.
In addition, her gynecologist put a pessary (correctly sized) into her vagina and it holds all of her female parts in their anatomical position so as to help her bladder empty out of her urethra just fine---and not have retained urine which causes UTI's. It's also critical that your mother have dry pads on and change them every two hours (that is how often my mother gets into the bathroom so as to keep from getting UTI--bacterial growth started again.
Your mom needs to be on a 2-hour voiding schedule to keep her dry when using pads. And, what's really important here as well is to have your mother drink at least three 8-oz glasses of clean water per day, or more, to flush her system. Older people, especially women with incontinence don't like to drink water because they'd have to pee more frequently, or experience wet pads more often if they cannot get to the bathroom often enough.
So, long story short:
1) Drink at least three 8oz glasses of clean water per day
2) Void every two hours in the bathroom.
3) Change wet pads immediately
4) Check with gynecologist or urologist and get a pessary for your mom.
5) Get your mom into the bathroom at least once at night during sleep to keep dry---change pads because incontinence doesn't just stop while sleeping.
6) Get your mom OUT of that facility. You'd care for her better than they can 100%. I've reported a facility and their care to the State DOH because of poor caregiving and cleanliness, and abuse---you can file an anonymous complaint!)
7) Once you get your mother home, find a good female gynecologist, and female urologist, and have all issues discussed (ie, voiding, pessary, diet, have them do a ultrasound of bladder to find out how much urine she's retaining, etc.)
8) Check out your local Family Caregiver Support Program for getting help taking care of your mother in your home. They can provide 15-20 hours of help each week for free, depending on your own income, or your mom's.
9) Ask the Lord Jesus to help you with everything---He cares for you and your mother and wants you both Well.
10). Be your mom's health advocate and don't settle for any nonsense, whatsoever. Talk to her doctors, maybe change doctors, and never, ever allow anyone to abuse your mom, never, ever. If I were you, my mother would Not be in their care, but my own! Her life depends on it, on you!
11) Give your mom a cranberry capsule once per day to ward of UTI's.
12) Give your mom a D-mannous capsule once per day to ward off UTI's--both of these keep bacteria from digging into the bladder wall and causing UTI's.
13) Buy some unsweetened organic cranberry juice and give 1/3 cup per day, or every other day.
14) Get the gynecologist to Rx your mom some Estrace Cream in low dose and have your mom apply it at nighttime just inside her vagina twice per week, pea-sized amount. It helps keep the vagina in healthy condition.
15) If your mom gets the pessary, they will give her Trimosan gel to apply twice per week to keep the pH correct in her vagina.
16) If she gets the pessary, the gynecologist will have her back in a month or earlier to check to see how it's working. From there the timing to get her in may be once per month or once in 2 months just to check on erosion of the tissue walls that support the pessary.
17) Remember, give her water to drink because constipation is "old toxic poop" in her system and without water poop gets stuck (peristalsis) in the colon and it causes UTI's.
18) Feed her Activia yogurt to help keep her regular. It's wonderful and tastes great, besides it also helps with pooping, and keeps everything working great!
19) Get online on Internet, and look up what you need to know!
20) Be your mom's health advocate. Stand up for what is right! Don't settle!
Her life depends on you being her 'everything' advocate!
21) In the Bible the Lord asks us to care for the widow as family, and He asks us to Honor our Mother and Father. What a better way to do this than to take her into your home, whether you work, or not, to help her. She raised you, so the way I look at it, it's payback time! She loves you and So, Love her Back!
God Bless Everyone Who is Taking Great Care of Their Mother, Father, or Anyone Else!
22) Please take good care of yourself and find some caregiver support. Plan it out and see what good can come from all of this information. I hope this helps someone out there! May God Bless All of You!
So, what I suggest, is to have your mother live with you at your home. You can hire a caregiver, or work with the NW Caregiver Support Program (that gives respite care to caregiver (you)--if you'd caregive your mom.
In addition, her gynecologist put a pessary (correctly sized) into her vagina and it holds all of her female parts in their anatomical position so as to help her bladder empty out of her urethra just fine---and not have retained urine which causes UTI's. It's also critical that your mother have dry pads on and change them every two hours (that is how often my mother gets into the bathroom so as to keep from getting UTI--bacterial growth started again.
Your mom needs to be on a 2-hour voiding schedule to keep her dry when using pads. And, what's really important here as well is to have your mother drink at least three 8-oz glasses of clean water per day, or more, to flush her system. Older people, especially women with incontinence don't like to drink water because they'd have to pee more frequently, or experience wet pads more often if they cannot get to the bathroom often enough.
So, long story short:
1) Drink at least three 8oz glasses of clean water per day
2) Void every two hours in the bathroom.
3) Change wet pads immediately
4) Check with gynecologist or urologist and get a pessary for your mom.
5) Get your mom into the bathroom at least once at night during sleep to keep dry---change pads because incontinence doesn't just stop while sleeping.
6) Get your mom OUT of that facility. You'd care for her better than they can 100%. I've reported a facility and their care to the State DOH because of poor caregiving and cleanliness, and abuse---you can file an anonymous complaint!)
7) Once you get your mother home, find a good female gynecologist, and female urologist, and have all issues discussed (ie, voiding, pessary, diet, have them do a ultrasound of bladder to find out how much urine she's retaining, etc.)
8) Check out your local Family Caregiver Support Program for getting help taking care of your mother in your home. They can provide 15-20 hours of help each week for free, depending on your own income, or your mom's.
9) Ask the Lord Jesus to help you with everything---He cares for you and your mother and wants you both Well.
10). Be your mom's health advocate and don't settle for any nonsense, whatsoever. Talk to her doctors, maybe change doctors, and never, ever allow anyone to abuse your mom, never, ever. If I were you, my mother would Not be in their care, but my own! Her life depends on it, on you!
And I agree with an above suggestion about getting her admitted to a hospital so she can be discharged to a NH. It's not difficult to get an elderly person admitted to the hospital. Take her to an emergency room. I don't know her ailments but use of her ailments to get her to an ER. Then you can talk to the RN or the Dr. about getting her admitted. If your aunt is confused and living in an unsanitary environment tell the RN or the Dr. that. I wanted my mom admitted to the hospital because she refused to get out of bed. I took the RN aside and explained my situation and they admitted my mom. It can be done. Then you can start working on the NH.
I don't remember if you said you had POA. If not, can you get POA? A lot of people say you have to see an elder care attorney to get POA. I got POA over my dad by downloading the paperwork from legalzoom.com. Had it notarized and we signed it and I never had a problem with it. Once you have POA get to the Medicaid office and begin that process. It's not always as daunting as some might thing. When I applied for Medicaid for my dad, who was in a NH, it was a fairly simple process. It took 3 months to get him approved and he had died by then but I was told by our Medicaid caseworker that it's rare for someone to be denied "vendor Medicaid" which is what NH Medicaid is called here in MO.
I stress out easily. I get my britches in a knot and freak out over everything. But even I was able to get my dad to the ER, to the NH, and get him Medicaid. And if I can do it anyone can. You can start the Medicaid process as soon as you have a NH for your aunt to go to. And my one suggestion would be to keep in touch with your Medicaid caseworker. I practically befriended the gal who took my dad's application and called her weekly. It didn't get the stupid thing done quicker but I don't think I was just a case number to her either. And when I went to the Medicaid office I had all this paperwork with me. The NH had given me a booklet telling me what I'd need to apply and most of it was bogus. I was terrified because I didn't have my dad's birth certificate but they didn't even ask about it. I knew his social but didn't have his social security card, again no problem. It was a lot less of a mess than I thought it was going to be.
Good luck!
Now what is your level of tolerance can you stand up to being bullied? The hospital may be sweetly co operative or fight you every step of the way. Can you stand your ground and look them in the eye and quietly but firmly say NO. Do you have a husband or adult child to assist. start off alone but call for re enforcements if needed. probably the best time to start this would be Sunday morning when all the heavy weights at the hospital are enjoying Sunday brunch and nothing will get done till Monday morning. You can sign permission for treatment but be very careful not to take financial responsibility. read the fine print even when they are standing there with a pen and directing you to sign where the X is.
As someone suggested buy aunty some new clothes for the N/H but don't provide them till she is actually admitted. Actually go to a thrift store because the N/h will loose them
I am sorry Gayle this is going to be very rough on you standing up to a whole brigade of white coats so pull up your big girl panties and go into battle. I really hate that expression it sounds so condescending. but as long as you behave reasonably there is nothing they can do to you. While I am not advocating using these methods I have seen them used by others and they did work. We are all behind you ready to hand you the ammunition