rockivillemom - I feel your pain. I have come to some clarity for myself. I’ve come to accept that it is my mom’s life, not mine. She knows all the information. My sister wants to hover over her 24 hours a day, be her entertainment, fuss over making her small apartment absolutely perfect, then bitch when the rest of us aren’t into that level of micro managing.
I’m going to visit next weekend. I can hear her getting breathy again which usually is her sign of the congestive heart failure. She also has the swollen ankles. She refuses to raise her feet high enough. In fact she doesn’t even sleep in her bed that elevates the feet and head, she sleeps in her recliner. However, she seems to be reluctantly embracing her new place and joining in some parties. She is getting easier to deal with now that she’s moved and settled. Now it’s actually my sister who can’t seem to let go of the control a little.
MomofJandL- I’ll be interested to hear what others suggest. I found hospice helpful in this regard, but some issues may well surface at other times. Geriatric care centers at major/teaching hospitals are worth a call. They may have a Dr with expertise in med reviews in elders or be able to provide a lead. Perhaps ask a local hospice, AL or SNF medical staff if there is someone they have used for this and would recommend. If your relative is on psychiatric meds, see if there is a psychopharmacologist with a geriatric practice if you are concerned. The geriatric expertise would be important to me, as some meds can impact elders very differently.
Also, agree with GTalum to be pro-active with care providers re: meds and info. Sometimes issues are exacerbated due to specialists focusing only on their piece, especially if medical records aren’t linked electronically.
If relative is particularly med sensitive, on numerous meds, responds poorly to a change in meds or needs increasing pain management, consider a consult. This may not be necessary for all elders; some just are highly complex in this regard.
Anyone who is also admitted to palliative care services would receive this. People who are on palliative care services do not qualify for hospice. Palliative care was something relatively new to hospice several years ago when I quit my job, so I’m not as familiar with it as hospice, but it would be something to ask about. As we used to say, hospice always provides palliative care, but palliative care services are not necessarily hospice services.
What do you hear about the cholesterol meds? My mother takes a very expensive one, the Rx when she is in the donut hole is over $1500, because she cannot deal with the statins and the generics. She is not experiencing any dementia nor serious physical issues, so I want to maximize her length of life, but are the cholesterol drugs silly at 90? Her doctor does not seem to think so.
Somemom, I have heard some controversy at the age of 80, but age 90 for sure seems controversial. I can’t say we have any evidence to support cholesterol meds for our seniors. Does your mom have pain? Arthritis or back pain? I feel it is worth a trial off medications to see if it helps as cholesterol medications can cause pain, especially in the legs, and you might just say it is due to old age. Here’s an even-handed article on the subject http://newoldage.blogs.nytimes.com/2013/10/22/controversy-over-statins-for-older-patients/
She used to have sky high triglycerides, now her numbers are fantastic & she takes:
(colesevelam hydrochloride) a non-absorbed, polymeric, lipid-lowering and glucose-lowering agent which is a bile acid-binding molecule.
She does have a cardiac history of a single stent and minor MI (she did not even know she had it)
Actually, unless someone has a prior history of a cardiac event or stroke (like somemom’s mom), statins are being reconsidered as to whether they are worthy or not of taking. I had this conversation with my internist this last spring at my physical. He also has his certification in lipidology. Even though my mother had a silent heart attack in her mid 50s (my age now) and my brother had stents put in at late 50s, my internist had no problem letting me go off the statins, even if my cholesterol goes up 100 points. And I obviously have a strong family history of issues.
I think all of us who are on statins, regardless of our age, need to have the conversation with our primary care physicians about whether they’re needed or not.
It’s less a matter of Medicare than a matter of someone paying attention, and usually of someone asking to have it done. If you’re lucky enough to have a good open relationship with your mom’s primary, you could maybe go with her for her next visit and ask to go over all the meds with the doc. I wouldn’t bother doing this exercise with any of the specialists, because as travelnut says, they often see only their piece of the puzzle. You need someone to look at the big picture.
The most useful piece of paper I carried with me when my dad and stepmother were alive was a list of the meds of each of them. I kept an extra in the glove compartment of my car. Printed on 2 sides, dad on one, stepmother on the other. Also listed their doctors with their phone numbers.
Actually my mom’s medicines aren’t an issue, she keeps good track of why she is taking each one and whether she thinks the benefits are worth the potential problems. She gets a bit testy if she talks to a doctor about a problem and the doctor’s response contains the phrase “at your age,” because she believes she deserves to receive treatment that makes her feel as well as possible despite her age. She is probably going to have some outpatient surgery soon, and has authorized the orthopedist and PCP to talk to her family.
FIL is another story, as I’ve mentioned. He won’t allow his kids to accompany him to doctor’s appointments, and hasn’t authorized his PCP to talk to family, although BIL has started calling the doctor’s office and giving them data. Just from observation I feel like he is being treated medically for a collection of symptoms, but I don’t get a warm feeling that his doctor is looking at the whole picture. Part of that is probably that FIL doesn’t remember to tell him that he is having any problems, which is the part BIL is trying to fix.
Oldmom, over time, I added a section for drug allergies, as well as surgeries and major diagnoses and medical events. It got to be a crowded sheet! But doctors loved it.
I carry a folder with my aunt and mother’s : Medical history with dates, surgeries, list of MD’s and dentists along with their phone numbers, medications,(dose, amount, when it was started and why and MD who ordered it, I also note if they are compliant or capable of taking those medications and if a medication was discontinued in the past year), allergies, pharmacy address and phone number and mail order information, all insurance and medication insurance ID info, copy of their insurance card and drivers license,POA and living will, tel. numbers of points of contact. I also keep a copy of this file in a plastic folder marked with a large red EMS sticker on the refrigerator of each of their homes. When I travel, I always carry this folder with me.
I have one of these medication/doctor sheets for myself. Carry it in a little packet labeled medical Emergency Info oin my wallet. I am on so many meds (including three blood thinners) that if I’m in trouble, someone needs to know. We learned with my heart attack that DH didn’t have a good handle on my meds (TBH, not that he had ever needed to). He also has a copy of the list on his phone.
Just wanted to say that I’ve been on this thread a little but no longer - Mom passed away over the weekend. She was 89; she apparently fell getting out of bed midday Saturday and hit her head on the night table. No one knew until the senior care helper arrived this morning. Mom had a ER visit a couple of months ago due to shortness of breath where she was diagnosed with pulmonary embolisms and blood clots so was on blood thinners. Mom was fiercely independent and reluctantly agreed to have help five days a week - not weekends, however. She was wearing a button with a fall accelerator so must have slipped slowly; probably was light headed. She also had balance issues but did not keep her cane or walker next to the bed.
Mom said she wanted to die in her condo - hated all of her hospital and nursing home experiences. She recently was delighted to go off oxygen a couple of weeks ago and was satisfied establishing her daily routines (quite a history of falls and breaks over the last couple of years). She was in good spirits when I talked to her Thursday.
We just moved from our Chicago suburb which was 40 minutes from her Chicago suburb; now in San Diego. Fortunately my brother and wife live five minutes from her so are able to handle stuff until DH and I arrive. We got to our new house less than two weeks ago; our furniture arrived last Wednesday. Didn’t expect to be going back so soon. Sorry if I’m babbling but it still seems impossible.
Anyway, I got a lot of very useful information from this thread so wanted to express my appreciation.
Marilyn-condolences on your loss. Glad you were able to talk to your mother last week. The timing seems especially hard. May your memories be a comfort and take good care of yourself.