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I would consult with her doctors and/or a geriatric psychiatrist to get her some medication for both pain and depression. Cymbalta was a miracle drug for my loved one when she suffered multiple fractures from falls, including a spinal fracture. It really helped with her pain and lifted her mood. Discuss the options with her doctor.

When you have someone in their 80's who has declining mental and physical abilities, I don't find that tough love or ultimatums are helpful. To me, it is requiring the patient to do something they simply are not capable of doing. Why add to their pressure? Pulling yourself up by your bootstraps may be fine for middle aged people, but for injured, sick seniors, it's just not fair, IMO.

Pain can cause a lot of symptoms, but I would watch your mom after she gets her pain under control to ensure that the pain is what is causing her mental decline. It could be something else that is causing this change in her.
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She definitely needs better pain control. I have had 2 back surgeries and still have chronic pain, and am on the Butrans patch. First, the patch makes you very sleepy and isn't the greatest for pain. And if she is taking a nerve pain med like neurontin, then she is probably so zoned out that she doesn't know what is going on. My 90 year old mother just went through all of thks, and responded well to a very mild narcotic (Norco). I also added Advil PM at night to help her sleep.

She most likely can't attach the TENS leads herself, and may not know how to work it. She is 85, after all. Just because she was fine before, an injjry and pain changes a person, and especially elderly.

I agree to try to get her into pain management faster if possible. Can her regular dr or clinic get her something until she gets in?
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The pain clinic in 4 to 6 weeks -- is she on a list for cancellations? Explain how much she is suffering and beg for an earlier opening if one comes up.

Pain changes everything. If it is excruciating to take a step, all the "tough love" in the world isn't going to help. If the pain could be managed better if it weren't for the blood thinner, think long and hard about dropping the blood thinner. Who cares about preventing a possible stroke in the future if you are in debilitating pain in the present?

Do everything you possibly can to address the pain.

And then consider the depression. It sounds like this poor woman has already tried several things and they did not work. Can you blame her for being discouraged, and for not wanting to get her hopes up again? Work on trying to convince her that, "Yes, the acupuncture didn't work. But SOMETHING is going to work and we have to keep trying until we find it. Maybe the tens unit will help." No scolding or ordering, please, but some empathetic coaxing.

It sounds to me like she needs and deserves some help. Could you offer to help her get ready for the day each morning? Help find something in her closet that would be easy to put on. Maybe even buy a bright mumu that would slip easily over her head. Or at the very least help her into a nice housecoat. It may seem to her too much effort and it won't help the pain, but psychologically we feel less like invalids when we are dressed. Then settle her on the couch or a chair where she is least uncomfortable. Set up a card table next to her. Make her toast. Serve her tea or coffee in the prettiest cup in the cupboard. Fuss over her. Comforting love may be far more appropriate in this situation than tough love.

Come back up at noon and heat her a bowl of soup. Make sure she has enough water to last the afternoon. Help her to the bathroom if she needs it. If it helps the pain, have her lean against the wall as she walks. Consider getting her a walker.

Encourage her gentleman friend to come over and play cards or watch movies with her -- to help get her mind off her pain. Ask him to rent some comedies if they like watching those. Ask her golfing and bowling friends to stop by. Square dancers are the friendliest people on the planet. Let the group leader know MIL could use some cheering up.

I understand that tough love is real love. I KNOW your motives are to keep her out of a wheelchair. But your message is "We don't really believe you about your pain. We believe the doctor that you should be able to walk!" I'd much rather hear "We are so sorry about this awful pain that is no fault of yours. We'll try to help you as much as we can. We love you. I'm trying to get you into the pain center sooner, and until then I'll help you get through the day."

And, BTW, walking or moving in water is MUCH less painful than on land. See if there is a rehab center or hospital in your area that offers water therapy. She would need a lot of help, probably, getting dressed afterward, but it could be very worthwhile. I took arthritis exercise in such a pool while therapy was going on. Sometimes the person had to be wheeled down the ramp and only gotten out of the wheelchair when they were submerged, but in the water they could do what the therapists wanted them to.

And I'd be a little careful about making a wheelchair sound like a terrible things that will happen if she doesn't cooperate. With or without her cooperation she may wind up in a wheelchair, and it may be the very best thing. Try not to make it sound like a punishment or a sign of failure.

Bless you and hubby for moving into the lower suit so that MIL could remain in her home. Bless you for caring and trying to do the right thing by her now. I hope what I've said hasn't sounded like criticism. I do admire your efforts and know that your heart is in the right place.

I have seen my mother and one sister in constant pain over long periods. It is not pretty! I have not experienced anything that severe myself, but the few bouts of pain I have had convince me that I want to feel loved, accepted in spite of my inability to do what I used to be able to do, a bit pampered, reassured that no one has given up and there are other things to try. The last thing I would have wanted when the pain caused the 45-second trip to my bathroom to take 10 excruciating minutes would be for someone to tell me I had to get my own breakfast.

I sincerely hope the pain can be managed eventually. Maybe MIL can go back to some of her old activities, but start preparing yourself mentally that that may not be possible. You and your husband's roles may change.

(And, wow!, you are good on that tiny keyboard!)
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Sorry for the mistakes, I type this on my phone, small keys and cant correct errors.
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Thank you for your concern. She gets traction at physio and has had two acupuncture treatments and quit. Has not had relief from them and her acupuncturist is aldo her physical therapist says her condition isnt one that acupuncture will benefit. My husband got on her tonight, its bis mom, and told her she had to at least make the effort to do things like go to the kitchen to make toast or he was scared he would be ordering her a wheelchair. Afterward she told me tbat every step she takes is excrutiating, which I didnt know, so this thing has progressed from nothing to this severe in just 3 short months. I think its spinal stenosis although tbe doctor has not really given it an official name. Its just so sad to see what her life has become. She sits in front of the TV all day every day, in pain. It's terribly distressing.
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See if you can get her to see an acupuncturist (my personal preference is a Chinese trained acupuncturist) but check and see if the fact that she is on warfarin might contraindicate acupuncture therapy.
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Jilly, oh my gosh, it's like night and day from how your Mom-in-law was. Back pain can be very exhausting, I remember back 20 years ago when I had a disk problem which pinched on a nerve. Nothing really helped. For six months I used a cane, had something like a TENS to wear which helped somewhat. I thought I would be spending the rest of my life like this. Depressing to say the least. Thank goodness I had an SUV as that was easy to get in and out of.... sedans were torture.

Physical therapy didn't do squat for me.... finally doing "traction" worked... only two sessions and I was back to normal and since then rarely had any more back pain. Of course, each case is different, maybe traction won't work for your Mom, but it would be worth asking about it.

And if that is an option, tell Mom that the massive traction machine isn't what we saw on TV shows back in the 1970's, being in bed with weights hanging down. It's a nice small bed that you use for about 20 minutes for each session.
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Your mom is 85 and in chronic pain, I think she has just given up on life. Have you talked to her doctor about her depression? She may need meds for that as well as better pain management.
For your own sake there is nothing wrong with a little tough love. Tell her that what she is doing will result in her ending up in a nursing home because there is NO WAY you can care for her if she becomes wheelchair bound. It's hard watching our moms decline right before our eyes isn't it?
You might want to check out the thread started by dmanbro about his mother, www.agingcare.com/discussions/moms-stubbornness-is-confounding-to-me-184838.htm
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