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Mom was just hospitalized for extreme lethargy. Tests revealed that her hemoglobin levels were very low and a stomach lining issue was revealed to be the culprit. She was treated and almost immediately her personality returned and she looked and sounded 10x better. After a few days she was discharged and sent to a short-term rehab facility to receive some therapy.

Now, despite no medical reason for it, she is claiming that she has "lost use of her legs" and refuses to even try to sit upright, even to eat. Today she even begged me to feed her, which I refused to do because there's no reason at all that she needs to be fed by someone else. When I try to raise her bed she carries on like it's torture even though it's a mere four or five inches.

I'm at my wit's end with this, as is everyone else. Again, there's no medical reason why she cannot sit up and at least try to move around, it appears that she just doesn't feel like it or fears the pain involved. I tried to explain that this will pass after some repeated movement (she was walking rather well just a few weeks ago and she hasn't suffered any sort of injury) but she just won't do it. I think she's totally blowing a real opportunity here and it's maddening to watch. I'm even beginning to become hesitant to visit her for long as I just can't stand to see her lying there like a lump trying to eat while lying down almost flat on her back.

Her mother died shortly after breaking her hip in a fall and I believe this is why she's totally terrified of moving. I've explained this to every single healthcare person she's worked with but it hasn't helped at all. I firmly believe she needs to be forced into a sitting position for a while just to prove to her it won't kill her but they either can't or won't do it, mainly because she wails in a total panic if anyone tries. I just can't get through to her and it's miserable. Anyone ever encounter a situation similar to this?

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If she can't eat or move, ask for a Hospice evaluation. They can handle the fear and pain and of course they will be looking at medical records to see if her problem is psychological or if there is evidence of stroke or other injury. Sometimes a second opinion sheds new light on a problem.
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dmanbro, wonder if your Mom is doing this to get your attention so that she can be released from rehab to go home. She probably doesn't like doing exercises, so she's not going to sit up. Sorta like a child saying they are going to hold their breath til they turn blue, until they get their way.

What does the staff at the rehab center say about her "condition"? Guess they are just as baffled, too. It would be interesting if your Mom was placed back at the hospital to see if she gets better. And as Pam said above, get a second opinion.
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dmanbro I seem to be going through something similar with my husband, though in his case he really has no muscle left in his calves so he can't actually stand. However he is supposed to be doing exercises when lying down to strengthen and rebuild his muscles but since he has been home just seems to be getting weaker and weaker. His doc came to see him and gave him a pep talk and some anti depressants but now he feels nauseous on top of everything. Please, if your Mom can understand tell her that if she doesn't use her muscles they will waste away. And they do atrophy very quickly with bedrest, including the core muscles. Maybe put on some dance music she likes and get her to do some flexing of her legs and mini sit-ups in time to it?
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Thanks for the replies everyone. I'm going for a visit today to try & try again. It sure is exhausting though. Ideally I'd like to get her out of bed and into a wheelchair for a tour today but who knows? It's Saturday and the place will probably be packed with visiting kids and she loves children so I hope it's an impetus.
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It could be any number of things causing it. Both medical and mental. I would push the examination of her condition and even consult with a neurologist.

I will share a similar story that happened with my cousin. Back when she was running her own household, she stepped in a hole in the yard and fractured her foot. She had to wear a boot and keep weight off of it, but she was perfectly able to use her crutches or wheelchair, go to toilet, bathe, etc. The problem is that she refused. She insisted on wearing diapers and laying in bed. She resisted allowing the home assistance lady to bathe her, she resisted physical therapy, she would not allow me to change her sheets, etc. She said she was not able to get up or return to walking. She kept the boot on for way too long. I was alarmed and discussed it with her home health care team and they thought she was lazy and unmotivated. They thought tough love was in order.

Fast forward a year later and she was diagnosed with advanced dementia. That's what was causing her to have delusions about lots of things, including her ability to walk. I'm not saying that is what your mom has, but I would explore all possibilities.
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It sounds similar to what happened with my mom. I failed to notice she was gradually getting weaker and one day couldn't make it up the two steps into her home. You can't say she fell because I was right there and caught her, but I had to call all the neighbours to find help to get her back up. She seemed fine for about a week, but one day she just wouldn't/couldn't get out of bed. I was at my wits end, eventually took her to the ER where they found nothing. My diagnosis was "sometimes they just get tired". I suspect a TIA coupled with frailty and depression.
Your mom could be having some vascular issues due to her low hemoglobin as well. I told my mom I couldn't care for her unless she at least tried to help me by sitting up and walking. She has never fully recovered but she does walk with assistance, which made it possible to care for her at home. I advise you to be stern, sit her up and make her do as much to help herself as as she is able.
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Yes we had this same trouble. It was with doing physio exercises and refusing to take pills as recommended by the doctor. Find out what would motivate her like a reward she would appreciate if she does what she is "told". Everyone needs some kind of pay-off to do things they don't want to do. Leave educational pamphlets and books lying around she can pickup and hopefully see for herself in print about caregivers, other patients, and the negative consequences she faces.
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My father-in-law was frightened when he was diagnosed with multiple myeloma and had a tumor in his hip. He was told not to bear weight until they found out what was up. He was told later to walk on it, he had a small pelvic fx. The tumor shrunk but he refused to make a real attempt. He could have left the rehabilitation,nursing home if he did make an attempt. Instead he lied around and got pneumonia 6/7 times. We tried to tell him the cancer wouldn't kill him. His lack of effort to control his diabetes and refusal to do anything for himself was what led to his final bout of pneumonia. He was depressed,fearful and at times would even expect you to hold his cup while he sipped. We would say, there is nothing wrong with your hands! He just wanted a pill to make things better. Before he went to nursing home he rarely did anything and was depressed. Being sick did not motivate him. He didn't care about being healthy before, this did not give him a jolt to improve. I guess its hard for people to change even under the best of circumstances..
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Please make sure that a doctor examines your mother thoroughly. My mom had an undetected hip fracture while in rehab. You don't have to fall to fracture your hip or pelvis if you're already frail and elderly.
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Well, today was a wash. Mom had a panic attack again (which I repeatedly warned them about) and she finally had to be given a sedative to calm her down. Wasted day. I advised the staff that she shouldn't be sedated unless it's absolutely necessary for her safety. I informed them I'll be there first thing tomorrow and I will get her out of bed and into her wheelchair myself, panic attack or no.
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Get the geriatric psychiatrist who pays visits this facility to see your mom asap. Not knowing anything about her age or other medical conditions, I'm going to venture to guess that there is something undiagnosed going on, perhaps dementia or mild cognitive decline (it sounds as though her reasoning ability has gone out the window), or an underlying personality disorder that causes her to find acting helpless serves a purpose.

She may benefit enormously from antidepressants. Please don't think of these or of antianxiety meds as sedatives. Her panic is a real response to her perception of reality.

I still would urge a careful examination of her hips and pelvis.
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I've advised the staff that I want her to be evaluated by a mental health professional ASAP, as in "now". I agree with everything you posted, I'm being as proactive as possible with these folks and doing everything I can to let them know what has been and is going on here. Although I repeatedly warned them they weren't prepared for her panic reaction, now I'm concerned that she'll be labeled as a "problem patient".
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My father-in-law was the poster child for problematic patients. Was often mean and surly. I told them to give it right back. This helped, I think he enjoyed the interaction and attention. But he was by no means their first problem pt. It really does take special people to do that work. My father-in-law was at a county nursing home. It may not have been a palace but staff were so patient and kind. The main problem is staff shortage definitely not the workers attitudes. This is part of their job. They have welcomed our in put and gave us real answers. Nurses weren't able to give their advice directly, but would respond to "what would you do if it was your grandfather in this position. When I came from the hospital to let them know that he had died there wasn't a dry eye in the house, it was sincere. We still get calls from them asking @ how we are and having a memorial service for a man who had no friends or family left. If you are unsure how to procede ask an rn or even a md."what would you do if this was your mom?
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I'm beginning to wonder if the resistance to exercising and doing what's necessary to recover just might be too overwhelming for some people. They're already older, life probably isn't getting any easier, and then something happens. Is it too much? I wonder.

I've often wished I had had military service because it toughens people up. I've been wondering if I could handle caregiving easily more if I had that experience.

We all have different thresholds and it may be that for some people recovering from a devastating injury might just challenge them in ways that are more than they can handle.
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Your request to have your mother evaluated by a geriatric psychiatrist was probably what they were thinking should be done. Only the dr can order tests,but dr would listen to families requests more seriously
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When she goes into panic/resistance mode there's some real "power" there, physically speaking. Not long ago during one of her first real panic attacks she nearly took my ear off and almost ripped my shirt off my shoulder. So I know there's some muscle memory going on there. Trying to get her to channel that fight onto her rehab, though, that's a challenge. One of the nurses today told me she was astonished that such a frail tired old woman was capable of putting up the fight she did. It's just so sad to me that she's putting that energy into such counterproductive behaviors.
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dmanbro, I hope you are able to get a psychiatric consultation very quickly. Please let us know how that goes.
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Good luck with the psychiatric evaluation. Seeing a geriatric psychiatrist is best, but they are in high demand and there is often a waiting list. While you are waiting, why not discuss her situation with the team at her facility? Maybe they can come up with some ideas and strategy, in conjunction with her regular doctor. It may be that she is experiencing pain that she is not verbalizing to you or the staff. Or she may have depression or anxiety disorder.

Since you say she has a prescription for anti anxiety med, I take it that her doctor thinks she needs it. Maybe a long acting med that stays in her system around the clock would make her more comfortable. Cymbalta did that for my loved one when she was healing from multiple fractures. It did wonders for her disposition and it got rid of the anxiety.

I'm not sure that withholding the anxiety meds they have on hand for her is a good idea. When suffering from anxiety, she's not likely to respond to tough love or anyone insisting that she get up or do therapy. Only when she's feeling calm and comfortable are you likely to see her improve. It's not the kind of thing you can force on her, IMO.
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The problem with the anxiety meds is that they gave her xanax, which for her might as well been an anvil to the head as she's never taken so much as an OTC sleep aid in her life. Today was far better (so far), finally got her up and sitting upright for a while which was great to see. IMO if we can continue to get her up and going the anxiety might be more manageable.
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I see clearly. The wasted days, the anger and frustration, that things aren't happening quickly enough. I am sorry you all are going through so much anxiety.
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The thing to remember, imho, is that the dementia patient is not reasoning and is reacting "as if" something that we are unaware of. "As if" could mean the patient is back in a war zone, protecting her young, trying to escape a rapist, trying to flee a burning building. The brain is broken and the mind has made up a scenario to which the available adrenalin is applied. We drove my just - released from rehab mom to her lovely new AL residence. She started crying the minute we got in the car and grabbed the steering wheel from my husband on the highway. What was going on in her head? I'll never know. But it was clearly a very real threat she was facing.
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Babalou is right. I think it's important to know what is really going on with your mom. Is it regular anxiety, age related decline, dementia, etc. Toughing it out or just getting on with physical recovery isn't that applicable to some medical conditions. She might make it through an episode or seem to improve on her feet, but if she's suffering with a disorder, she will likely decline over time. If treatment is available, I would certainly get it for her. There are other medications for anxiety other than Xanax.
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This is a far reaching suggestion, I noticed that my Dad didn't like doing physical therapy, it was a struggle to get him motivated.... until one day a very attractive tall blonde appeared as his PT. Need I say more, Dad was on the road to recovery :)

Same happened with my Mom about 20 years ago.... to this day she still does her exercises on her own and says how Jason [her PT back then] recommended this or that.
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I think your diagnosis is correct, she is scared silly, and the trauma she has just been through plus fear of what happens next is immobilizing her. USUALLY, a low dose SSRI is first line for this sort of thing. OTOH...make sure her legs, bowel, and bladder actually do work OK, and that she does not in fact have a vertebral compression fracture that hurts every time she goes to sit. Stranger things have happened in people who can't quite verbalize exactly what and where a problem is. You have to wonder how she let her gastritis or ulcer get bad enough to make her anemic without complaining of reflux or abdominal pain symptoms.
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I really wish the staff would simply listen to my advice regarding her condition. Today we did some light therapy (I was present) and I was able to stave off the panic by merely being gentle and taking her mind off of the pain she felt. And she did rather well too. Looked better, felt better, sounded better, ate better, all from one easy session. So far I've accurately predicted everything that's happened yet I'm still being treated like I'm a doting annoyance. Luckily the therapists have been receptive so far, much more so than everyone else. But only when I'm actually there, which sort of defeats the purpose in a way.
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This would be sad if this could be what is happening:
Often, a patient with some type of cognitive dysfunction or dementia will focus on an issue, for example she is being attacked, people are stealing from her, etc.
Later, they pick a person who they identify as their attacker, etc. This can be an innocent family member, just saying their name in error. If she is more combative with you or someone else, change the person trying to ambulate her. Is she talking? Don't take it as personal if this is what turns out to be happening, you and the staff know it is not true. The geriatric psychiatrist can help with this.
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Ignore how you think you're being treated. I find that the minute I start caring about what the staff thinks about ME, I'm off track. This is not about who's right, it's about getting your mom's treatment on track.
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Is there a t.v. in her room that she watches? Take that out, tell her she can ambulate or wheelchair to the community room to watch t.v.
From what you posted, she may be cooperating more, a sign she is getting better, I am hoping this is the case, for both you and your mother. Stay strong, a day at a time.
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dmanbro is there an overseeing physician who is aware of exactly what drugs your mom is getting. I was convinced my husband had lost his mind until he was transferred to his last hospital where his new doctor discovered he was being given 19 different drugs prescribed by the half a dozen previous doctors who were all treating different issues he had and they were making him delirious Three days after stopping the drugs he was back to normal, in mind if not in body. At one stage they had to actually put him in restraints which was heartbreaking. .
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Shirls1945: yes, it took a little work but they're giving her the correct meds. She's only on three regular meds, not bad for 82 IMO. It seems that much of her cloudy mental state was due to being anemic, as she is showing definite signs of improvement mentally. Her current central issue is panic attacks when she's made to move around, as soon as she feels pushed out of her comfort zone she thinks she's going to fall and injure herself. Now that the staff knows this they're helping to work on the problem slowly but surely.
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