This thread has some great suggestions for those of us with parents with sight issues! http://talk.collegeconfidential.com/parent-cafe/1826803-my-elderly-mother-is-almost-blind-advice-and-tips-please.html#latest
^walkinghome thanks for that link. Excellent !!! My mother has macular degeneration - thanks again
FIL is now in rehab after the stroke he had 8 days ago. I haven’t been able to visit the last several days because of a severe cold and sore throat - somehow I didn’t think exposing a patient who is re-learning how to swallow to this sore throat would make sense. He is able to eat pureed food. Many of you have been through this with your parents, bit it is a frustration for him not to be able to have plain tap water - everything has to be thickened. Aside from the stroke damage, they have discovered some heart problems that we didn’t know about. I’m not sure we’ll be able to do anything about his heart, but it may explain some of the symptoms he was having before the stroke.
The care team at rehab will conference with each other Thursday and then meet with the family on Friday. I have a call in to the case manager to let her know one thing we all have noticed during our visits - FIL “lies” to the staff there. Or at least answers questions incorrectly. He walks in the park? Uses his home treadmill? Has someone living with him available to help 24/7? News to all of us. His answers sound clear and responsive to the questions, they just aren’t true.
We were looking through the checkbook and bills to try to figure out what’s on auto-pay and what needs to be dealt with. Nothing drastic, but things are on the edge. Not that he is running out of money, but that he is struggling to maintain a record of his spending. Of course, how many 50 year olds are in that boat? So what’s competent? Another item of discussion for the case manager.
@MomofJandL, is your FIL putting together sentences, e.g., “I walk on the treadmill” or is he saying “yes,” when asked, “Do you walk on the treadmill?” If he’s just saying yes, I wouldn’t trust that he is actually understanding the questions. If he is putting together sentences on these topics, I’m guessing he has figured out part of what he needs to do to be sprung from the joint, and he’s hoping to convince the staff.
He makes up whole sentences and paragraphs about the walks he takes. That’s not entirely new, as he’s been telling me the same thing for months, even though the treadmill has a pile of clutter on it that has been growing for years. The point is, he knows (or thinks) he should, and he intends to.
Communication tip from alzheimers meeting today - it takes 19 seconds for person with dementia to process a statement. And, they demonstrated by counting 19 seconds after saying something.-
Wow, we need to slow down when talking to allow for processing.------ 19 seconds excrutiatingly long when counted out.
Wow- I know from hand washing guidelines how long that is, SJCM. That is good to know. Thanks.
I always refer to the pace of everything at my father’s comprehensive sr. living community as an alternate time zone, conscious of the pace of my walk to avoid having people feel blown over. I guess I only think I am talking slowly enough.
It was a dramatic role playing when the group facilatator made a statement, then counted aloud 1-1001 , 2 1001, 3- 1001… To 19, a long long time for brain to process what it heard.
Also, from NY Times - the need to have end of life conversations, which many of your have advocated repeatedly.
“Just as important as the legal document was a conversation with the patient and her family. The patient would need to understand the options — for example, that “do everything necessary to keep me alive” can mean intubation and cardiopulmonary resuscitation, which on a frail elderly person can break her ribs and sternum; those who survive it often do so with abdominal bleeding and neurological damage. And the family had to agree to support the patient’s decisions.”
http://opinionator.blogs.nytimes.com/2015/10/27/talking-early-about-how-life-should-end/?_r=1
Another end-of-life-planning topic: if a person wants to die at home, does that mean he or she does not want 911 to be called if something happens when he or she is at home?
@rosered Whether the person is at home, in Assisted Living, or in skilled nursing, they or their representative can complete a POLST indicating whatever level of care they want or don’t want, including a “Do not hospitalize” option. This means that even if 911 is called, they won’t be taken to the hospital, or subjected to any other treatment they don’t want. It can be changed or revoked at any time.
I’ve seen a recommendation that the POLST be hung on the refrigerator, so that everyone is constantly reminded, and so that EMTs will see it.
This is California’s form. I’m sure it varies by state.
Note that to be valid, it must be signed by a doctor.
Thank you, @LasMa. I’ll check with my husband to see if his dad has one. His father is very insistent about not wanting to be hospitalized.
You’re welcome. My dad had a POLST during his final illness when he was in skilled nursing. Every time I went over there, I reminded staff about it, because I didn’t want him accidentally sent out to ER because someone didn’t know about it.
Another thing is that it travels with the patient, and it’ll be valid even if the person somehow ends up in ER. But it has to literally travel with the patient. Usually when 911 was called for Dad, the first thing the EMTs asked was whether there was a POLST. If it doesn’t say “do not hospitalize” they’ll take it with them for the ER people.
BTW, POLST is also valid in a hospital.
We met with FILs case manager today to talk about his recovery and path forward. His recovery from the stroke physical symptoms is amazing, it’s going very well. Much of the PT/OT he is getting is to work with balance and endurance issues, many of which he had before the stroke. Swallowing is still the big physical hurdle, but there is progress. BIL asked about whether FIL would get any prohibitions or evaluations related to driving, and the case manager said driving is prohibited for 90 days after a stroke, but I haven’t seen that written down anywhere. After that there are evaluations you can pay for, but it doesn’t sound like there is any Medicare covered OT work or evaluation. We’re hoping we can just tell him no more driving, but it may not be that easy.
After a couple more weeks in acute rehab, he will be ready to step down to less intense rehab - the choice will be either a temporary stay in a rehab-focused skilled nursing facility, or going home at that point and being driven to rehab during the day. The case manager said it would not yet be safe for him to be home alone. She suggested family members taking turns staying with him, but I can’t see that working for weeks at a time with everyone’s family and work obligations.
It shouldn’t come as a surprise, but it still grated how much her discussion of the path ahead was predicated on what Medicare will cover. In order to assure Medicare payment for the next step of skilled nursing rehab, her written evaluation will have to conclude that improvement is needed and possible and that he does not have the support to live at home during the process. She talked about locations we might consider for this stage, and pointed out some that are nice but we wouldn’t want him to be there if he had to pay for it.
THE NEW OLD AGE
Some Older Patients Are Treated Not Wisely, but Too Much
There is accumulating evidence that older adults with diabetes, hypertension and other conditions should be treated less aggressively than they commonly are.
http://www.nytimes.com/2015/11/10/health/some-older-patients-are-treated-not-wisely-but-too-much.html
That was an interesting article @oldmom4896. Thinking for yourself is not an option.
Helpful, oldmom. My mother is being tested for diabetes right now.
Very interesting article. My mom’s doctor just this week said Mom could stop testing her blood sugar. My sister took the last few weeks’ worth of readings with her to review. Dr said that her blood sugar levels were stable and it wasn’t necessary. Mom is still taking glimiperide, and that combined with the meals she’s now getting (and eating) 3 times a day, is enough. There are signs to watch for, but other than an occasional check of the A1C, the blood checks are done.
Mom is thrilled, as,are the aides at the place she’s living.
http://www.npr.org/sections/13.7/2015/11/08/455224497/on-learning-how-to-die
An article about “learning how to die.”
Update on FIL, the att modem (att store) with a regular phone (target) that is connected (with an electric outlet) at the nursing home is working very well. He initially put it in the drawer so no one would take it. Finally he got it that it needed to stay on the counter to work. He is able to answer it. He needed something that could be moved to another room if he moved. It cost $20 unlimited calls and long distance and it is billed on our att cellphone account. There is no caller ID or anything but it is good for a 95 yr old.
When to Ignore a Promise to ‘Never Put Me in a Home’
http://well.blogs.nytimes.com/2015/11/09/when-to-ignore-a-promise-to-never-put-me-in-a-home/