I learned something new today. my mother almost 93 who managed to break her neck (it’s going to be ok with an orthotic neck collar) was initially transferred from a PA hospital with a DNR to an OH hospital with neurosurgery support with a DNR-CC. apparently OH has a law about DNRs that I never heard of. The CC means comfort care only and the CCA that I had it changed to was comfort care after arrest (not before). After about 20 phone calls and 2 faxes of POA they changed it to CCA. no one could tell me how CC got on the order and her internist in PA was not called. even the AL had just DNR in PA. they then transferred her to telemetry to check out cardiac as I requested. I am in CO but I think if I was at her bedside that could not have been handled any easier. Geesh. OK I am calm now.
Wow, things got complicated fast @rockymtnhigh - I would need some comfort care after hearing all of that several states away.
My mom is still in rehab and goes to the cardiologist on Tuesday. They called my sister to tell her they wanted a meeting after the appointment. We both think she’ll either have to get aides or be moved to their nursing floor. She does her rehab with a 100 yo woman. My mom is physically 10 + years older than her age. Sis thinks she’s had a huge decline this week.
Many anxiolytics cause cognitive impairment in the elderly. And research shows even after 6 months of discontinuation it doesn’t go away. Benzos, especially long term use, are not a good idea for the elderly.
From pharmacist web site below,
Scrol down through 'statins in older men"
To benzodiazapenes in elderly and concern about dementia/ alzheimers
https://www.pharmacist.com/geriatric-pharmacotherapy-sneak-peek-beers-update-key-research-2015
Interesting chart of conditions and meds to use with caution in elderly.
" potentially inappropriate "
http://www.americangeriatrics.org/files/documents/beers/BeersCriteriaPublicTranslation.pdf
So what are the alternatives? I mean it. This whole issue is about quality of life, theirs and ours. When we (or our children) are younger, we can try to control for things like food allergies and nutrition, that affect on mood and functioning, but that requires a level of vigilance we can’t necessarily achieve in the elderly. So where’s the balance?
Sometimes antihistamines like atarax (though typically sedating so be careful) may be used for treatment of anxiety
LF- Agree it is tough and not one size fits all. I have seen geriatricians or geriatric psycho-pharmacists be helpful in navigating side effects/med interactions and doing cost-benefit analyses.
If a relative is chronically difficult, sometimes the best one can do is to try to structure their life with as much of an alternative safety net as is possible, in an effort to minimize/anticipate crises and put others on the front lines. Of course, the elders that you need maximal buffers from are the same ones that refuse alternatives. Total Catch-22 and an all too familiar scenario here.
Cognitive impairment and statins: http://www.fda.gov/Drugs/DrugSafety/ucm293101.htm
Also anyone on statins should have bloodwork every three months to check their liver enzymes, and should go off them if they can’t comply. There are other medications to lower cholesterol that don’t cause liver damage (I am on one).
As you can see, with the ‘avoid’ list there is really very little options in the elderly. It is very frustrating. Risks and benefits have to be considered
Updated studies are not consistently finding the correlation between statins and cognitive impairment http://health.clevelandclinic.org/2013/12/statins-dont-cause-memory-loss-study-reaffirms/ In fact, some studies show a benefit to memory performance when on statins. Its a mixed bag and could be due to other factors.
A friend of mine came across the following article, it will make you smile: http://inspiremore.com/man-asked-this-retired-lady-a-simple-question-her-brilliant-response-surprised-him-a-lot/
Mom is finally improving. After 9 days of me being terrified that she was sinking, she’s back. Her appetite is improving, she’s irritated with people in a normal way, and she was reading the newspaper this morning.
He big problem is sodium. We are pushing Campbell’s chicken noodle soup for the sodium in the broth and adding salt to everything.
She had a cognitive assessment from the speech therapist last night and did very well.
Switching to a different medical team makes a difference, as well. The NP or the Dr come in every day and they wrote up detailed notes for the on-call this weekend should anything have happened.
My problem right now is work. This is taking such a toll on me and the senior manager is a jerk. I’m senior finance technical, not management, which puts a level of responsibility on me that is overwhelming (think 4 hours extra, unplanned, at the drop of a hat, because we’re understaffed and its quarterly review time). I gave up vacation for work responsibilities this summer, without so much as a thank you. While I don’t expect the guy to be my friend (as if!) I do think it’s appropriate for him to at least inquire as to how I’m doing and if my mom is any better. I was livid on Friday after a late afternoon meeting and said that my mom was dying and I needed a bit of leniency. Not a word. But we are supposed to ooh and ahh over his plans for his wife’s birthday month. Crud. I need a new job
The geriatric medication article was very interesting. My mothers psychiatrist kept prescribing Trazadone even though it is one of the meds that can wreak havoc with the brain of elderly over the long term. There are better ways to help sleep.
went to ATT to look at gophones- we think the flip phone would be hard to do with one hand for FIL 94 with a stroke. the manager gave us a wireless home phone receiver for $20 a month attached to a traditional phone-no contract- she said AL and NH residents use them because they can take it to a new room. sent it off today with preprogramed numbers and labels to a friend to turn on in his room. will let you know how it works. my mother 92 has a cell phone in AL that she uses to call us. (D1 asked me to post this to let you all know- she knows I think the world of CC.)
My mother has two prepaid phones and her issue is misplacing the charger cords. So, see what you can do about that. (She did have a landline installed because of that.) I suggested she (find the cords and) carry the phones when she’s not near the LL. No idea if she did/does.
FIL will have a corded gone to the ATT system. My mother leaves the charger base for her cell phone in the kitchenette counter. I wonder how she manages to not loose the cell phone.
Sorry about your jerky boss zeebamom. This stuff is stressful enough without having to deal with that. Makes you wonder about people sometimes.