Archive for the 'hospital' Category

Dementia And Dehydration, The Double D’s

For months it’s been one thing or another. I have so much to tell you but I have not had the energy to sit and write. But here it goes my entries will not be in order of their occurrence they will be more of a hit and miss of what I am thinking about at the time.

For the last five years I have been living my life constantly yelling. My mother tells everyone; “I’ve never liked to eat, my mother would sit next to me and yell to get me to eat.”

My mother lives constantly on the verge of malnutrition and dehydration. In the last four years she has gone by ambulance to the hospital four times, one time last year she was so dehydrated she almost didn’t make it. So I constantly yell at her to drink.

Last August I knew my mother either had a bladder infection or was becoming dehydrated she had a horrible body odor. Every time I would try to get her to drink it would end like this;

“Mom, you need to drink more.” “I’m not thirsty.” “I know you’re not thirsty, but you need to drink.” “I don’t have to do anything I don’t want to do.” “Mom, your diapers have a strong ammonia smell.” “I don’t smell anything. You must be smelling your own dirty butt”

I took her to the doctor’s and sure enough she had a bladder infection. She also lost 7 pounds in the last for months. When they told us she had an infection I look at my mom and said,” I knew you were sick just from the odor” without skipping a beat my mom looked at the nurse and said;

“My daughter knew I was sick because she’s a witch.” “What did you say?” “You’re a witch.” “Oh witch, I thought you said something else.”

So now I’m getting to what I want to write about, the last six days.

Okay, Saturday October 15th and Sunday the 16th, mom’s diapers again had the odor of straight ammonia, she was refusing to drink more fluids. I’m thinking dehydration. When I would say something to her it would go back to the same song and dance. I made a decision to take her to the doctors on Monday or Tuesday if she was still refusing to drink.

Monday the 17th, mom got up around 9:30.

“Mom, take a bath before it gets too late.” “Why I’m not going anywhere.” “That’s not the point you’ve been in the same diaper all night and if it gets any later you’ll be getting lunch instead of breakfast.” “I’ll take a bath and eat when I’m ready just worry about your own fat butt.”

Now, she knows it bothers me when she talks about my being heavy. Heck I know I’m big but everyday for whatever reason she brings it up. She must truly have dementia because a sane person wouldn’t be making those kinds of comments to the person who makes their food.

By the time she’s ready for breakfast its lunch time so I make her a half of turkey sandwich with swiss cheese, a bowl of soup and a few pieces of cantaloupe and watermelon. She sits down and starts to complain that it was too much food. I let her know if she kept complaining I would give her the other half of the sandwich. I walked into the den to finish my crossword puzzle.

It was about two maybe three minutes and I heard my mother snoring. “Mom wake up, mom are you sleeping, wake up” Nothing so me and my fat butt get up, I touched her shoulder nothing then I notice she had thrown up and had passed out. She was breathing but making a sound between gurgling and snoring.

“911, is this a medical emergency?” “Yes my mother was eating and passed out, I need help.” “Is she breathing? How old is she? The address and number you’re calling from?”

Finally after all the questions were answered, I called my husband and kids everyone showed up the same time as the paramedics. My husband and son stayed to clean the mess and close up the house, Dana drove ahead to the hospital and I went in the ambulance with my mom.

First before I go any further let me tell you about the ambulance. Why are all emergency vehicles so high off the ground? This was my fourth time having to call for paramedics and an ambulance to my mom’s house, I now feel like I have a close enough relationship with the dispatcher that when they see my mom’s address pop up to send a truck with a bucket to help lift my big behind into the cab of the ambulance. It’s embarrassing I felt like a Weeble (you know the roly-poly characters).

We arrive at the hospital the paramedics had already cut open my mom’s favorite dress. The nurses take her torn dress and sweater all the way off and were going to hand them to me. Hell no! I wasn’t even going to touch the bag. The look on my face let them know it was trash time.

Dana came to sit with me, lab work, x-rays, a CT scan all showed how healthy my mom was, the diagnosis was dehydration. They plumped her up with fluids and we ignored her requests for a Babe Ruth bar. The hospital would have released her but her insurance Kaiser has a policy if a patients loses consciousness they stay overnight for observation.

When the ambulance came to transport my mom to Kaiser, Dana drove me home so I could pick up my car. Now I haven’t eaten anything all day. I down a banana and three cookies and then Paul drove me to the hospital.

When I walked into the room my mom was stuffing her face with Fig Newton’s, she feeling good and wanted to know who came with me to see her and who I called. I let her know everyone knew she was in the hospital and no one came because she wasn’t ill, she was there because she was to stubborn to drink water. I told her I’ve had it. I explained the paramedics, the ambulance, doctors and nurses had more seriously ill patients that they needed to tend to, also her taking space in the hospital is one less bed available for someone else more seriously ill. I was so upset and exhausted I left.

Late that night and early the next morning I received a call from the attending doctor at Kaiser, he wanted to let me know my mom was doing well and would be released around noon.

I got there at twelve thirty. When I walked into her room my mom immediately started asking me if anyone came with me to see her in the hospital. I said no because she wasn’t sick just too lazy to drink fluids. I started to get her ready to go when the nurse came in. She was letting me know my mom didn’t want to eat breakfast but she managed to get her to eat some cereal. Lunch was delivered and she needed to try and eat something. My mom flatly refused saying she would eat at home. Knowing that I would have to continue the battle at home I let my mom know if she didn’t eat she wouldn’t be going home. She began eating.

When I pulled the car up to the hospital patient loading zone, the young man who was helping my mom into the car said; “Have a wonderful day” my mom replied “I’m on the way out.” The young man didn’t know what to say, my mom made it seem like she was going home to die.

I stepped on the gas and looked at her and said;

“So where are we going? Dancing? Lunch? On a trip? Where?” “Aren’t we were going home?” “I thought we were until you told that young man you were on the way out. You’re not dying I know this because the doctors in two hospitals just examined you, the only thing wrong with you is your need for attention.”

When we got home;

“Mom, you need to take a shower you had thrown up and haven’t had a shower in two days.” “Don’t worry about me, worry about yourself.” “Mom take a shower.” “Shut up fat ass!”

Okay this time I picked up the phone, should I call the county morgue or my brother? I ended up calling my brother because I knew his number. I put the call on speaker and asked my mother to repeat what she called me and she did. Well, my brother let her know he wasn’t happy and was coming over.

Intervention (this entry is so long maybe it should be an Intermission).

Since I have tried in the past with the Scared Straight approach having only two bad cops wasn’t working. But now were doing Beyond Scared Straight, oh yeah everyone is on board.

The next day my brother came over, he had my back; even without a script he was remarkable. (Now remember in my last entry I had placed my mom in a really nice assisted living facility for a week, so I had to change it up).

I started to explain that I could not afford to put mom into the nice facility. The cost was $150.00 a day when I placed her in for a week of respite care. Placement for long term would be a little more as she needs assistance bathing, medications and walking to and from the dining room. Now keep in mind this conversation is in front of my mom. Without a dress rehearsal this is how it went down between my brother and me in front of my mom.

“I’m going to be honest with you I can’t ask my husband to do any more than what we’ve done its going to cost two thousand more a month to put mom into a home. Can you pay it?” “Two thousand no way, I’m retired.” “Well, if I can come up with half and I don’t think I can would you be able to pitch in one thousand?” “No, right now it would be tough.” “I know that’s how it is with everyone, I do know that there’s facilities that take only SSI and pensions that don’t have the extra frills but it’s doable.” “Sounds good.”

I told my mom I could no longer take care of her, I was done until I sold the house she was going to the cheaper home, the one where she would have to share a room with one to four other woman, the one where the meals would be simple, like bologna or ham sandwiches for lunch and casserole’s for dinner. Her eyes were bigger now, she understood.

My brother also confronted my mom with his disappointment with the way she talks to me. Surprise!

What a good day this was becoming. My aunt even showed up unexpectedly, without clueing her in about us taking a firm stance in Spanish she asked;

“Eva, how are you doing?” “Not good.” “No, Eva say you’re doing fine” “Fine.”

She even let my mom know she needed to do better so she could remain home. Yes today is a good day, I feel like the troops are with me.

Now on the fourth day, Kaiser sent a very nice young girl to evaluate my mother for Palliative Care. The only ailments my mother has is dementia and RA, since she was not in the final stages of life she did not qualify for assistance.

The only thing my mom understood is that this woman was from Kaiser, she asked me what she wanted. I explained she came to see if she could help, but since she didn’t have a medical condition and it was just that she’s too stubborn to eat and drink a facility might be the answer.

Well, that night no problems, this morning I woke her, gave her breakfast, she showered no problems. My brother just called, he remarked I sounded better, and I’m actually feeling better. Mom’s not sleeping she’s watching TV quietly in her room, when she heard the phone she came out to see who called; I said my brother and he asked if I found a home for you yet.

If I can keep it fresh in her mind, I do believe it will be a good day. Peace.


Hello My Name Is Dementia

I pray everyone had a wonderful Christmas, and I’m wishing everyone a Happy New Year.

Believe it or not, this Christmas was one our best. Our families traditional Christmas Eve dinner with my husband’s brothers and their families was great, It lasted almost until midnight, my kids, niece and nephews were trying to get me to take an idiot test but my son was laughing so hard when he was doing it, I got the clue I would fail right away, besides I live with my mother what more of a test do I need.

Christmas Day was relaxing, breakfast at Dana’s while watching my granddaughter open gifts, a little nap then an early dinner with just our kids, my uncle and mother. Yes finally a few good days in December, now let me explain why I haven’t written in over a month.

Hello My Name Is Dementia

Since I started writing this blog, I’ve avoided saying my mom has dementia, I would dance around by saying she has a little or slight dementia well folks dementia is dementia and by placing a word in front of it doesn’t change what it is. It’s taken me how many years to finally admit it.

I was recently asked if I was embarrassed to admit my mom suffers from dementia. It has nothing to do with embarrassment; its knowing that one day my mom will no longer be mentally aware of family. So it’s been easier for me to skirt around it. Don’t get me wrong my mom is a far cry from the final stages of dementia; I would venture to say she’s in the mild and entering the moderate stage. I’ll call it “she’s driving me crazy stage.”

I was asked by the medical professionals when I started to notice my mom’s mental decline, I would automatically say about three years because that’s when I became her 24/7 caregiver and when I started to notice changes, big changes. I now realize the dementia started about five years ago I was just to close and the changes to gradual to notice.

Some of are conversations we had three years ago that weren’t so gradual that should have clued me in to the dementia;

“Wasn’t it nice of Kaiser Hospital to give me and your dad a room before he died to have sex?”
“Wasn’t it good of Kaiser to give me and your dad…?”
“Mom, stop I don’t want to hear it, Kaiser did no such thing.”
“Yes they did you weren’t there.”

It took a year to get her to stop telling that story.

“It took me a few trips around the cemetery in the back of Chuck’s and Em’s car to throw dads ashes out of the box.”
“Mom, we had dad’s ashes placed in an urn and buried at the gravesite.”
“No, I threw his ashes out of the car you buried the ashes that were stuck in the cracks of the box that I couldn’t get out.

She is still sticking to that story.

“My name growing up was Patricia.”
“Mom, your name is Evangelina, Eva, and Eve not Patricia.”
“No growing up at school they knew me as Patricia.”
“Mom, your parents were from Mexico, you were born in 1924, your brothers and sister had traditional names from Mexico, why would they name you Patricia?”
“Well, that’s what they called me.”
“What ever Pat.”

“When you were younger I used to model.”
“Mom, you were a stay at home mother, you never worked.”
“I used to model.”
“Mom, your 5’1’ models are tall, dad worked nights and you never drove how did you get to the modeling jobs?”
“I modeled in stores.”
“Mom, coming out of the dressing room and showing the salesgirls and other customers how you looked while dad sat in the car isn’t modeling its showing off.”

This past month there has been other changes that have added to my stress, accusatory behavior and aggressiveness.

My aunt and uncle came over for a visit and my mom informed them;

“Nancy picked me up out of bed and threw me to the ground.”
“Mom, what are you saying, I can’t pick you up one let alone throw you to the ground you know that’s not true.”
“Well you did.”
Later that day;

“Mom, why did you say I picked you up and threw you to the ground?”
“Now I remember you picked me up and we both fell to the ground.”
“Mom, if I fell to the ground I would still be there.”

Now our family and friends know I have a dropped bladder, four herniated discs and bad knees, so lifting anything more then twenty pounds forget it. But what if someone who doesn’t know the situation hears her? Hmm, a misdemeanor maybe 6 months in lock up, or as I would call it a vacation.

“Mom, we need to get haircuts today, with your doctors appointment on Monday and with company and the holidays coming today is the only day we have to get it done.”
“Get your own hair cut, leave mine alone, I don’t need you to tell me my hairs long, in fact get out..”
“Mom, were getting our hair done today.”

Well, you thing that would have been that, but no she turned around and picked up her walker (one of those light weight aluminum ones) and threw it at me hitting my foot.

“Ouch mom what are you thinking that hurt.”
“Good, now get out.”

She has a few new names for me, they all have to do with the size of my butt, finally I couldn’t stand it any longer and said “I could lose weight to make my butt smaller, but there’s nothing you can do to change the size of your mouth,” she hasn’t called me names in a week. So here it is, while she is in the beginning stages of dementia she’s in the late stage of pure meanness.

But a few days before Christmas, we gave my mom one of her Christmas presents a new TV with an easier remote (this will be another entry later) since then she’s been trying to control her mouth and behavior. I guess the trick is to give a present every few days to keep her happy.

We have been referred to a neurologist hopefully he’ll explain what stage of dementia she’s in, if there’s medication that will help, or if it’s just her venting frustration and anger.

I think the New Year is going to be like a Roller Coaster, so fasten your seats belts the ride is about to begin….

The Day The Earth Stood Still

Monday night when darkness fell, we brought mom home.

We put mom in the backseat, she was confused because she always rides shotgun. Then I got in, right next to her, when she realized no one was sitting in the front seat with Paul, she looked like a deer caught in headlights. 

A thirty minute car ride must have been an eternity. I clearly and sternly told her what was off limits, I explained there was a new sheriff in town and all laws are to be adhered to; 

No more DUI’s; being, Discourteous Under the guise of Insanity.
No more terrorist threats of caregivers or their family. 

Black Tuesday, or the Day the Earth Stood Still, started early; 

“Mom, its eight o’clock time to get up.”
“No, I’ll get up later when I want to.”
“No more getting up at eleven, you will be getting up in the morning and exercising.”
“I’m not going to exercise; my doctor said I don’t need to exercise.”
“That was the doctor at Disneyland, your doctor at Kaiser said you need to walk for exercise, and I’m not going to discuss it anymore.”
“You’re a Gestapo.”
“Get used to it.” 
“Mom, you’ve been up for three hours, I need you to walk two or three times from your bedroom to the den.”
“I’ll walk later.”
“If you’re not up in fifteen minutes, I’m going to put your chair into the standing up position, so you’ll have to get up.” 
“Why are you being so mean?”
“It’s not that I’m being mean, you need to drink, eat and exercise, once you get your blood circulating you’ll feel better.”
“I’ll feel better when you leave.” 

Later that day; 

“Mom, its time for lunch.”
“I’m not hungry.”
“I didn’t ask if you were hungry, I said its time for lunch.”
“I’m not going to eat, I’m not going to eat, I’m not going to eat.”
“Paul, bring me the video camera.”
“What are you doing?”
“I’m going to video what we go through at every meal and show everyone how you behave.”

She ate everything.  

It didn’t go as smoothly as I wrote, I ran into a lot speed bumps, but ultimately each day got a little easier. She still tried to start arguments but instead of trying to reason with her, which would leave us both frustrated, a few times I would laugh and sing dumb songs, and believe it or not it worked; 

“Mom lets get everything ready for your shower.”
“I don’t need you to help me, Nancy go get my Depends, and a new nightgown.”
“Ok, I have everything you need.”
“Turn on the water, and regulate it, help me take off my nightgown and slippers, help me get into the shower.”
“Mom, let me help you, sometimes you miss washing areas that need to be washed.”
“I know how to shower; I don’t need your help.”
“Ok, just trying to help you out, forget  I asked.”
“Nancy, wrap a large towel around my back, get a little one for my body and feet, and then help me out.
“Ok, mom everything is done.”
“No, help me with my slippers and zip up my robe.”
“Mom, after helping you I need another shower, I’m sweating.”
“You don’t help me, you never help me, and you never do anything for me.”
“What, I do everything for you” and then I remembered this is how it starts, so I stopped and started singing.” 

“You never do anything for me, hee hee, hoo hoo.”
“You never do anything for me, hee hee, hoo hoo.”
“You never do anything for me, hee hee, hoo hoo, ha ha”
“Are you drunk?
“I don’t drink, hee hee,hoo hoo.” 

I couldn’t believe it by meeting her with laughter instead of frustration she stopped and walked away. So if all it takes is humor to avoid her constant need of arguing, I’m free, free at last. 

Hee hee, hoo hoo, ha ha. 

What’s Faster Than A Six Minute Egg?

Give Up? It’s my mother kicking me and my husband out of the hospital. 

Well, remember I’m taking the doctor’s advice, letting my mom decide what and when she’ll eat and drink, because me pressuring her isn’t working. So her diet has been sweets and she has only been drinking about ten to fourteen ounces of water a day. I did remind her daily of the little amount she was eating and drinking but told her it just to make her aware. 

When I did her catheter the week before, I knew by the color, cloudiness and smell that she was possibly getting a kidney infection. She argued said I was not a doctor and on Friday she said she didn’t want me to do another catheter. By then her diapers smelled like ammonia. 

Saturday and Sunday, were okay days, she seemed to be fine, and by Monday I knew she would let me do the catheter. 

Now I’m with my mom twenty-four seven, with the exception of forty-five minutes Monday through Friday to pick up Mac from school and for about four to five hours one day a week when I go take care of my aunt. On those days Paul stays with her until after she showers and she has eaten, once she’s back in bed he leaves. 

Well, over the weekend my husband and I were finally going to start on redoing my mom’s bathroom it will be her Christmas gift. We already had put in a high profile toilet and now needed to pick up new tile so Paul could redo her tub into a larger shower with a built in sear and safety bars. We were also looking for a new sink cabinet to update everything. 

On Monday, Paul and I decided to go pick out tile and to see a few cabinets. Mom as usual did not want to get up, so we left her Ensure and breakfast ready. She was told not to take a shower until we returned. 

Well, we returned after a few hours, when we pulled up Paul noticed the bathroom light still on. When he reached the porch my mom started yelling; 

“Nancy, Nancy.” 
“Eva, Nancy’s getting out of the car.”
“I fell.” 

I rush into the house, and there she is lying in the shower in about two inches of water, she had been unable to turn off the water and there was a steady drip. To make matters worse she pooped all over. 

“Pick me up.”
“I can’t, your dead weight and with my bad back and dropped bladder there’s no way I can do it.”
“You just don’t want to do it.”
“No, mom I can’t Paul will have to pick you up.” 

So I cover her in a towel and Paul brought in a sheet, he used the sheet not only to cover her but put to pick her up. 

I pulled out her bath chair and we sat her down, I started rinsing the shower and Paul went to get the bleach to finish cleaning so we could put her back in and rinse her off. 

“Mom, what were you thinking you know your not supposed to take a shower when no ones home?”
“I didn’t want to wait, and I don’t need anyone here when I shower.”
“Apparently you do, how long were you in there?”
“Since nine this morning.”
“No, mom you hadn’t been in that long because of the steady drip of the water and your butt covering the drain the shower would have overflowed, I figure you’ve been in there two hours.”
“Stop talking and get me dressed.”
“Mom, once Paul is done scrubbing the shower we need to rinse you off then I’ll get you dressed.”
“Well, stop talking.” 

Paul finished the shower he picked her up, so I could put the shower seat back in; 

“I can’t put weight on my leg.”
“Mom, do you think it’s broken?”
“No maybe sprained.” 

I made the decision to call 911, she has had knees, hips, shoulders and elbows replaced even though she was talking and actually very clear headed I wasn’t going to take a chance doing any damage to her replacements. 

“911, state your emergency?”
“My, mother fell in the shower, she seems fine, we got her out about thirty minutes ago but she can’t put weight on her right leg.”
“The paramedics are on the way.” 

I go back into the bathroom. 

“Mom, I called 911, their on the way.”
“Why did you call, just pick me up, you never do anything right.”
“Mom, I know what happened your dehydrated and to weak to take a shower you probably passed out, this is your fault not mine.” 

My mom started to lean backwards when I stopped her she went forward then I realized she passed out. 

My mother almost died her core temperature was 92. Her blood pressure was 45 over 15. She non responsive, and suffering from severe dehydration. 

The paramedics worked on her outside for at least twelve minutes; they made a decision that she had to go to the USC Hospital since it is a trauma center.  

This was an experience, when I entered into the emergency area with the paramedics a guard stopped me and opened my purse, and then he asked; 

“Do you have any guns or knives?”
“Do you have any weapons, a gun or a knife?”
“I’m an old lady from Temple City with my mother who was just brought in by the paramedics why would I have a weapon?” 

(I should have said yes my gun is next to my blush just underneath my lipstick. Now really the characters that would be carrying weapons into a trauma hospital would be handling unfinished business, does the guard really think by asking them they would answer honestly). 

Once inside, my mother was treated quickly. They asked me what happened, I updated them on her health and told them she was dehydrated with a possible kidney infection. They said she could go either way, it didn’t look good. I was escorted to a private room given a phone and two social workers came in to offer assistance. 

After an hour they escorted me back to my mom, they did all the lab work x-rays, ultra sounds but she needed a CT scan, she was so unstable the nurse refused to transport her without a doctor. By then my brother had arrived. She had dislocated her right hip, she had a major kidney infection and was completely dry as he put it so dehydrated she could go into renal failure, and they could not rule out a C2 fracture. They stabilized her with pressers popped her hip back in and transferred her to the ICU. 

The next day, she’s all plumped up, wearing a neck brace and in a hip abduction pillow; she was clearly upset that I was not taking her home. She wanted to talk about her illness and I explained she was not in the hospital due to illness, but from a fall due to dehydration. 

She was upset over her lack of care, as she put it they hadn’t even wiped her face. Well, I knew the nurse had fed her breakfast in the morning what else did she want. I explained while the nurses were settling her in I met some of the families that had relatives in the other rooms, one was a thirty-five year old man dying from a brain disease they were removing him from his ventilator in hopes that they could take him home to die. Another was a young girl in her twenties also on a ventilator from an illness, and last an accident victim. I told her all these people are ill, they’re fighting to live, they need care and I reminded her she was taking up space and the doctor’s time not because of an illness but because she didn’t drink water. She didn’t talk; I stayed for four hours and left.     

The next day, still in the brace and pillow the nurse asked if I could help her change mom’s bedding no problem while helping the nurse; 

“Mom, how do you feel?”
“Get me out of here.”
“Mom, were trying to transfer you to Kaiser, then to a rehabilitation convalescent home, to get you back on your feet.”
“I want to go home, not to Kaiser or anywhere else.”
“No, mom I can’t do this you need to be stronger,”
“Get out I don’t want to see you.”
“You told the nurse earlier you wanted me here.”
“You should be here, you’re my daughter you’re obligated.”
“No mom, I’m not obligated.”
“Then get out.”

The nurse was trying to tell my mother that I was helping her and had only her best interest in mind, but mom wanted me and Paul out. We went and talked to the doctor who explained that she would be moved from ICU to a regular room, he and the nurse were apologizing for my mother’s behavior. I explained this was normal for her and left. 

The next day I didn’t go since they were to have been transferring her to Kaiser (a process that took three days, this will be another entry later.) 

Now she’s at Kaiser Sunset, in the Neurology Unit. I went to visit her; she’s in a private room under evaluation, being the weekend we probably won’t know anything definite until Monday or Tuesday. 

When I walked into her room I could tell she angry, she wants to go home and she is coherent enough to know that I want her to go for rehabilitation, she’s promising to eat and drink fluids, but she’s done this before and I need her to realize changes need to be made. She wanted to know if people knew she was there and in a neck brace, I told her this is not a game, people are tired, she always wants to be sick that’s why no one comes to visit anymore this obsession is ruining her life, her response was that I ruined my life years ago. 

I picked up my purse and left. I don’t need anymore drama, she needs to realize that you don’t bite the hand that feeds you, and I need to realize she won’t remember any of this tomorrow.

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