My Mom is 73 and currently in the hospital due to a fall. Her fall took place at home where her and my dad live this past Sunday 8/21/22. She had to be transported to the ER by ambulance. My dad is 75 years old, small framed man and mama is a 250 lbs., larger framed woman therefore my dad couldn’t assist with getting her up. I wished I could say this was the first time, but it’s not. She has fallen allot however, this time she broke 4 ribs. My mom has a lot of health issues which requires her to be on several medications. She has COPD, Chronic Fatigue Immune Dysfunction Syndrome, A-Fib, both of knees to be replaced but the doctors refuse to do surgery because of their fear with the anesthesia medicines and she uses her walker daily. However, when she fell it was early in the morning and it was dark, she got confused thought she was at the bed and she wasn’t. She went back like she was going to sit on the bed but she fell to the floor instead. They did a cat-scan, MRI and x-rays and the doctor said everything looked good but she did have 4 broken ribs. Because mama is on so many medications they felt she needed to be admitted due to the possibility of getting pneumonia and the fact she is on blood thinners. She is still there and when I went to visit her yesterday she stayed asleep almost the whole time and I was there for several hours. I do know she is on pain meds however, she takes pain medication daily for her back and has for over 30 years. Yesterday was just different. She wasn’t speaking clearly, in and out of it while trying to talk to me, her hand was jerking like she had tick, spasm or nerve issues, she couldn’t even focus or think clearly. Now, I know none of you know me or my mom, but my mom has always been the one on top of everything. Paying bills, raising us kids, laundry, working you name it. Over the past several years she has fallen several times and had a horrific car accident she never has quite recovered from that happened 3 years ago. My dad has been her rock every step of the way and I see it starting to wear on him. They will celebrate 50 years of marriage next February and I guess I say all of this because I’m greatly concerned with her well being from here and her current state she is in. She has mentioned several times prior to her fall she has been suffering from depression and anxiety as well. My mom is not physically active because she is always in pain due to her mobility and her knees so she literally lays in bed all day all night. She hardly eats and has no appetite either. My question is has anyone else experienced this type of behavior after a fall with an elderly loved one? My dad visited her today for 6 plus hours and he said she woke up once and he tried to get her to eat and he told me when he got back home he doesn’t even think she remembers or knows he was even there. She also mentioned before her fall she thinks she is suffering from some slight dementia. She can’t seem to remember things that she used to. Well thank you all for your time in reading my long post and any advice is welcomed.
Thank you,
Shannon
This article may be useful. There is also a podcast if you prefer audio to text.
https://betterhealthwhileaging.net/hospital-delirium-what-to-do/
Just take one day at a time.
Build repport with Mom's medical team. Then you can leave & feel more secure.
Ensure you & Dad keep up healthy meals & sleep.
Regardless, it sounds like she will likely need faciliity care (AL or LTC) and you may wish to take this opportunity to go with your Dad to visit places and educate yourselves, and also figure out the financing for this. Your Dad may need to help her apply for Medicaid, and he can consult with a Medicaid Planner for Texas.
Make sure during all this your Dad is taking care of his own self and needs -- you don't need 2 people in crisis.
You will not be able to provide in-home care yourself for very long, even with your Dad's help. There's a lot going on all of a sudden, so just eat the elephant one bite at a time. This fall will probably mean a 20-day stint in Medicare-paid rehab. use the time to figure things out. Your Dad will be overwhelmed and emotional and may be in denial or uncooperative, but you must insist that they will now need a permanent type of care in place -- it can't be you alone.
Finally, I'm hoping your parents have all their legal ducks in a row and that your Mom has a PoA assigned. The PoA should now be active since your mom is currently physically and cognitively incapacitated. I wish you much clarity and wisdom, and peace in your heart as your work towards solutions.
I would either have dad, or if he's reluctant, yourself, start talking to the hospital discharge planner about whether or not mom would be a candidate for post hospital rehab. My mom went several times after stays in the hospital, and I can tell you, if the patient is willing to work with the therapists (my mom was) they can really work wonders. The sticking point will be if mom goes to rehab and does well, if she will continue the work once she's home.
I get not wanting to exercise when you're in pain, I have back issues and when they flare up the only thing I want to do is stay in bed, but I also know that's about the worst thing I can do for it, so I get up and force myself to move. I have found aquasize is an awesome workout for me, there are programs at my local Y that incorporate both cardio and weights into the workout with little stress on my joints. It might be something to look into for both of your parents is you think they would be agreeable. Your parents aren't, in the greater scheme of things, that old, and an exercise program they can do together might be helpful for both of them.
Good luck!
Ask for a care conference and enough time to ask questions and get answers.
At present, focus on her hospital progress. This looks like it will be a long roller coaster ride. One thing you might want to help them both and take some burdon for dad is to see if you can help him keeping their bills in order. Geaton777 offers some great proactive tips. (Little bites are easier to chew when done before there is not time to do them at discharge)
She should be given a cognition exam as well, at some point, to test for dementia/Alzheimer's. Memory loss can come from her dependence on pain killers/opioids for all these years, it should be noted.
If your mom has 'hardly no appetite and hardly eats' she should not weigh in excess of 250 lbs but should be at a healthy weight for her height. Something is wrong with that math, and she's getting calories somewhere that you're unaware of. Laying in bed all day & night also means that her NEED for calories is very low, too. An active person needs at least 11 calories per pound to maintain their weight, while a person who's bedridden may only need 9, or even less if she's seriously overweight. But still, that would compute to her needing 2200 calories per day just to maintain her weight where it's at right now.
If your mom is jerking and having spasms of some kind, that could be a movement disorder called Tardive Dyskinesia or TD for short, which comes from the use or overuse of certain drugs. Here's a link from the Mayo Clinic on movement disorders:
https://www.mayoclinic.org/diseases-conditions/movement-disorders/symptoms-causes/syc-20363893
It's likely your mother will need rehab after her hospital stay; speak to her doctors about that and see what they have to say. Also mention TD and see what they have to say about that; ask why she's suddenly jerking like she is!!!
Wishing you the best of luck with everything you have on your plate, Shannon. I certainly hope your mom makes a full recovery here.