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Elderly parents

Where do we go from here?

510 replies

GnomeDePlume · 16/10/2024 23:25

Up until 4 weeks ago DM(85) was doing fine. Lived alone in a bungalow with family member close by calling in regularly (most days) for general chit chat.

Then she took a fall and broke her leg requiring surgery.

In these 4 weeks DM has declined so much. Her short-term memory is shot. She has stopped eating, she still chooses food but then just pushes it around a bit without managing more than a mouthful. She still drinks water but isn't interested in any other drink (she used to be a big tea drinker).

DM is now in a ward waiting for discharge to another hospital where she will do some physiotherapy.

It all seems too little, too late. She isn't getting out of bed. Her world has shrunk from bungalow, well tended garden, clubs, to the tray over her bed.

Is there any coming back?

I'm not sure what answers I'm looking for. It all feels a bit miserable at the moment.

OP posts:
WinterFrog · 03/12/2024 08:11

Morning @GnomeDePlume Family dynamics really show up in these circumstances don't they?
My mother still tells me how marvellous my brothers are when they do the smallest thing, yet as the daughter there is a lot of being taken for granted. I am handling it by issuing the men with jobs to do and making them feel important 🙄 It's important to me to know she's being taken care of, but I've become clear within myself about what responsibilities I'm willing to carry, and what I'm not.
I know exactly what you mean with the use of the capitals! Solidarity, fellow little sister 💐
So sorry things are not improving for your mum, and very much hoping the meeting tomorrow is useful!

GnomeDePlume · 03/12/2024 07:13

@WinterFrog I'm glad your DM is settling in. That must be a relief. The decline is terrifying isn't it.

DM seems to be starting yet another UTI. She has only just finished a course of ABs and will be starting another.

The constant ABs must be impacting DM's gut biome. But then again she isn't eating much at all so it doesn't have a lot to work on anyway. DM is looking quite gaunt. She is refusing most food and also supplement drinks. DM has no interest in food plus she hates being told what to do.

Tomorrow we have a meeting with DM's care team. My hopes for this is that we get an honest assessment of what we can expect. What I will also be asking for is a proper assessment of DM's capacity to make decisions. IMO DM is no longer able to make decisions for herself but I would like to get this formalised.

DB and I are DM's attorneys. However up until now we have been kicking the financial can down the road. DB has been doing DM's financial work for a few years. DB likes being able to control DM's money and I think doesn't want me to be involved. He does see himself as Head of The Family (yes, with capital letters) and I am little sister (I'm an accountant in my 50s).

Don't worry, this isn't an abuse or fraud situation. Families are complicated. DB is very caring of DM but he is quite (very) bossy!

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WinterFrog · 02/12/2024 12:40

How are things today @GnomeDePlume? Mum's settling in to her 'new normal' but it's very clear how her cognitive processing skills have declined. She went through a stage of seeing things that weren't there but that has thankfully stopped now. She seems quite content, for which I am grateful!

GnomeDePlume · 26/11/2024 21:51

@Anjo2011 thinking of you, such a shocking thing to happen in such a short space of time. 💐

@WinterFrog I'm glad your DM is settling in to her new home. It is horrible seeing the decline and the speed with which it occurs.

DM was quite calm today and a lot more 'with it' than when I saw her on Sunday.

The worrying thing is that DM is seeing various things which aren't there or don't make sense. Some of this is that her eyesight has deteriorated quite markedly but the concerning thing is that she doesn't question these things.

@Randommother the result of the case conference is that DB and I will have a meeting at the rehab unit next week to discuss plans for what happens after the rehab unit. I am expecting that they will want to know DM's living situation.

I'm hoping that we will get some sense of what level of rehabilitation is expected to be achieved.

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WinterFrog · 26/11/2024 19:00

@Anjo2011 💐

Anjo2011 · 26/11/2024 18:41

@GnomeDePlume sending good wishes to you all, I hope you now begin to see some progress.
We say a final farewell to my DM this week, six weeks after being admitted to hospital it will be her funeral. Still can’t quite believe it.
I echo others in sending good thoughts to all of you in these tricky situations. Take a moment for yourselves, you are doing your best for your loved ones.

WinterFrog · 26/11/2024 18:22

Love to you and yours @GnomeDePlume Mine's settling in to her residential home now. She still believes she'll get better and go home, but thankfully she understands why she can't at the moment. She really needs quite a lot of care and it's highly unlikely that she'll improve by much.
The rehabilitation unit believed that she'd reached a plateau so they didn't apply for an extension.
Mum was fed through a tube for a while because she had swallowing difficulties so they had no option, but I'm sure that it made a big difference. Three months and several wards here, and when she left the last one she assured them she'd be popping back to visit 😔 There's still so much she doesn't really understand but she can cope with simple conversations. Nothing like the feisty and fiercely independent woman she was before.
Heartbreaking seeing the decline, isn't it? We've been very fortunate compared to some of you but it's still a rollercoaster. I think we're probably all very tired and I send my best wishes to all 💐

Randommother · 26/11/2024 17:46

@GnomeDePlume, I’m glad she’s responding to the antibiotics and a trip to A&E is off the cards, at least for now. Have you had the results from the case conference today yet, or will you find that out tomorrow?

My mums ward is still on lockdown so I haven’t seen her, but according to the nurse she’s doing ok, I’m hoping they’ll lift the visiting restrictions soon.

Hugs to all going through this xx

GnomeDePlume · 26/11/2024 09:22

💐 to everyone who is going or has gone through this most bewildering and stressful stage in life.

Many thanks for all the helpful comments and support.

Sit Rep re DM is that she has responded well to IV ABs. The threat of being turned straight back round to the main hospital has been removed for now. The issue still remains that DM eats very little.

DM's mental state is not good. She is very confused or perhaps more accurately she now resides in an alternate and kaleidoscopic reality.

The rehab unit are having a case conference about DM today. I guess the question is now the same as when I first started this thread where do we go from here.

I started this thread 6 weeks ago and I feel that we have just slowly spiralled downwards.

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GnomeDePlume · 25/11/2024 19:05

@PotterHead1985 that is frightening especially when the cause isn't known.

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PotterHead1985 · 25/11/2024 16:22

Hugs to all.

Mam has had 2 mild versions of her 'funny turns' the last two days which isn't great. She hadn't had one in a couple months. The thing is they have no idea what they are, what causes them, how to treat them etc, which makes life so much harder. And makes me terrified to not be here as if I wasn't and she had one when upright shed collapse.

GnomeDePlume · 24/11/2024 17:04

@Randommother my fingers are crossed for your DM and you. Norovirus is horrible.

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Randommother · 24/11/2024 14:02

@GnomeDePlume, that’s shocking treatment from the hospital, they should never have discharged her knowing she wasn’t medically fit!

I had a call from mums hospital this morning, they’ve locked down her ward due to a norovirus outbreak, so I can’t visit until Tuesday at the earliest. I’m just hoping she doesn’t get it, it’s the last thing she needs on top of everything else she has going on!

GnomeDePlume · 24/11/2024 07:12

Nothing is so far mentioned about kidney damage.

As I understand it, elevated potassium levels can be caused by kidney damage and then lead to heart problems.

DM shouldn't have been discharged to the rehab unit. The problem is that now a return to the hospital will mean the busy and chaotic A&E which is a horrible atmosphere for someone with delirium.

It did feel like once the decision to discharge DM from hospital was made, they weren't going to back down. The blood tests showing very elevated infection and potassium levels were ones taken by the hospital.

The GP doing check in at the rehab unit ordered the IV ABs.

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Randommother · 23/11/2024 22:11

@GnomeDePlume that doesn’t sound good, and I agree it sounds like with her medical needs she shouldn’t have been discharged from hospital. Have they mentioned anything about kidney function at all, Mums AKI developed from a UTI and was picked up on a blood test, it was similar with high potassium levels and confusion/ delirium. I hope the antibiotics start working for her, it’s so hard to watch someone you love so ill xx

Anjo2011 · 23/11/2024 22:04

@GnomeDePlume theres just no end is there, I feel for all of you. It seems she should never have been discharged from hospital, she has too many medical needs. Waiting for the phone to ring is just awful, I felt the same for the last week of my DMs life. Her Dr said you know when I call it’s not good. Again so many similarities, IV AB’s, catheter and never ending confusion. Thinking of you.

GnomeDePlume · 23/11/2024 21:04

@Randommother that sounds positive. The waiting is so frustrating. Which is kind of where I came in - where do we go from here?

DM has taken a turn for the worse this evening. Got very confused and distressed and got out of bed - disastrous as she is on IV ABs and a catheter.

Rehab unit want to send DM back to the hospital but DB asked that she stay in rehab unit for as long as possible unless the move back becomes medically necessary. Back to hospital would mean A&E which will be noisy and chaotic.

Her potassium levels are high plus this infection. IME the delirious behaviour is infection related which makes me worry that the ABs arent working quickly.

I will be sleeping with my phone next to my head.

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Randommother · 23/11/2024 20:13

Thanks everyone, actually had quite a good visit with her today, she seemed a bit more comfortable than she has been. We don’t know if the paralysis is permanent, but they can’t do any rehab while she’s so ill, so it’s just a waiting game at the moment.

GnomeDePlume · 23/11/2024 18:56

@Randommother I'm so sorry, that is beyond awful.

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AInightingale · 23/11/2024 14:55

Sorry @Randommother, my mum also fractured her pelvis but had none of the other horrendous complications you mention. Do they think the paralysis will be permanent? The thought of living with the inevitable impact on mobility with a pelvic fracture - my dm went from full mobility to needing a walking frame at all times and it has also caused incontinence - is bad enough, but what you describe is so much worse. A life lying on a bed in a nursing home is no life and I'm not surprised she's had enough.
PS if she is on codeine for the pain, it will likely be making the constipation worse.

Anjo2011 · 23/11/2024 14:40

@Randommother sorry to read about your DM, so many complications to deal with. My DM had a very similar story , they even considered dialysis for the kidney injury but there were so many other complications that it wasn’t to be. Sending good wishes to you, it is the most difficult time.

Randommother · 23/11/2024 09:36

Sorry to hear about everything your poor mum is going through. I’m in a similar situation with mine. She had a fall 3 weeks ago, where she hit her head and fractured her wrist and pelvis, which lead to an internal abdominal bleed and a significant brain bleed, which currently is causing full left-side paralysis. She’s badly deteriorated in hospital with a pneumonia first, then a UTI which has lead to a stage 3 kidney injury and sepsis - all of that’s been treated with antibiotics which she is responding to, although we don’t know what the long-term damage will be.

However, she’s completely lost the will to live. She’s been through so much in the past 3 weeks, she just wants it to be over now. The food is crap, tasteless mush that she has no interest in eating, she hates using the bed pan as it’s so uncomfortable to get her on it with her fractured pelvis, and there’s no privacy in the ward, other than the blue curtain, so she’s constipated despite the daily dose of laxatives. She’s telling anyone who’ll listen that she wants it to be over, and I don’t blame her - she in constant pain and can’t even adjust her position to make herself more comfortable.

No advice I’m afraid, just a hand hold and some solidarity from someone going through similar xx

WinterFrog · 23/11/2024 08:53

We framed it to our mum as a convalescent move too @GnomeDePlume It did seem to help!

GnomeDePlume · 23/11/2024 08:35

@WinterFrog thank you. I have started looking.

There are a few decent looking places nearby. I started putting enquiries out a few weeks ago.

Discussed with DB, we will aim to frame this to DM as a temporary convalescent move.

I can't see anyway that DM could go home. As has been repeatedly demonstrated, any sort of minor infection and DM's already unreliable memory can kaleidoscope. She would need 24/7 care and there just isn't the room.

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WinterFrog · 22/11/2024 20:35

GnomeDePlume · 22/11/2024 16:58

@WinterFrog useful to know about the lack of support. At least I now don't expect any!

DM will be self funding also (assuming she is actually going to get out of hospital)

The nursing home liason people are helpful, but but they obviously want the custom, assuming they have vacancies. Self funders amd their families can't rely on social services to help navigate the system. The rehab unit have been much more helpful than the hospital but even so, it's been a case of assessing her home to see what could be improved to make it safe, and we were left to decide whether to bring in live in carers, live in ourselves but get carers to assist with personal care ( too much for one person) or find a nursing home.
It might be worth you casting around so you have an idea of what's out there. Assuming your mum's ailments don't get the better of her, they will want you to find her somewhere to live once they feel they can do no more for her. I wish you all the best in navigating this!
Care is eye wateringly expensive but there is quite a variation.