As for blood pressures, we need to be taught how to take your own BP and to track it over time. Making clinical decisions on one reading is ridiculous. Also, the “right” way to take a blood pressure for the elderly may be to take a standing blood pressure. Often, the standing BP is much lower than a sitting one is. If you treat the sitting BP, you risk falls on standing due to low BP.
What a mess somemom. When you hire this stuff out, you expect it to be done!
1214mom - It is tough when you just see a snapshot of how she is. Certainly COPD though is a chronic and progressive illness that is just going to get worse (usually accompanied by weight loss) over time, especially since she still smokes. The memory issues may be related.
Do you have any cites for this? Some people have “postural hypotension,” which means that their blood pressure sometimes drops when they stand up. I have this myself, so I know how it works: my blood pressure sometimes goes down when I stand up, and I feel light headed, but then it goes up again in a minute and I feel fine. I’ve not heard of cases where the blood pressure goes down when a person stands up, and it stays down, so that people have lower blood pressure at all times when standing than they have when not standing.
If someone has postural hypotension, they know it. They don’t need a blood pressure cuff to know what’s going on.
Cardinal Fang - I have only clinical experience and collaboration with a nephrology (hypertension experts) practice I work with. They recommend that elderly patients, if the BP is high sitting, to check it standing and use that blood pressure for clinical decisions. The elderly do report feeling “weak and dizzy” a lot and it’s hard to sort out what is related to postural hypotension.
Thanks, GTalum. Google brought me an article discussing just what you are talking about, elderly people who have high blood pressure when lying down (supine hypertension) and low blood pressure when standing (orthostatic hypotension = postural hypotension). They’re hard to treat, because treating one of the problems makes the other one worse.
Hi. I’m wondering if any of you have suggestions for the following. My husband is his parents’ caregiver. Both parents are pretty much confined to wheelchairs, MIL because of Alzheimer’s, FIL because of pain and weakness from arthritis and neuropathy. FIL is very unhappy. On at least a few occasions, when the topic of him and MIL moving to a long-term care facility has been broached, he has remarked that he has guns and he’ll use them to make sure he’s not moved out of his house except on his back (i.e., after he’s dead).
The guns are in the basement. FIL probably cannot get down and up the basement steps, given his difficulties walking and his frailty. But… Maybe he can.
I’ve discussed this with my husband. He thinks FIL can’t and won’t get the guns and that the guns might not even function anymore.
If it was me, I’d remove and dispose of the guns. I wouldn’t want FIL to shoot himself or MIL, and I REALLY wouldn’t want him to shoot the person who came in to discuss a move to a care facility.
I know nothing about guns or their regulation. If my husband were to take the guns out of the house (FIL and I don’t get along and I’m afraid of him), could he legally drive with them in his vehicle? How could he dispose of them?
When my BIL was possibly suicidal, a cop friend of my sister’s said, “If there are any guns in the house, get rid of them.” She found an old service revolver of her FIL’s. She gave it to the cops to get rid of. So maybe ask the cops how to dispose of unwanted guns?
I agree that FIL is depressed. Unfortunately, he does not believe in depression or at least in getting treatment for depression. There are many problems in the situation; the presence of and comments about firearms are the ones I’m most concerned about because of danger to other human beings. My husband and his family are approaching dysfunctional but I’ve discovered, to my dismay, the limits, legal and practical, to getting help for competent individuals who do not want to be helped.
Rosered- agree with others. No family member should be in a position to be in despair that they failed to accurately predict FIL’s intent and capacity for violence. Feel the same way about continuing to ignore that an unfit elder is driving. Life and death issues need to be addressed. Also, announcing that you have fire arms could put you or your property in harm’s way if the wrong person hears it. No room for denial or assumptions here.
Not every elder who has diminished cognition and trouble functioning, with low mood and depressive thinking, “knows” they are on an anti-depressant exactly. There are many ways to describe what that pill is for if it is indicated and the elder is not fully capable. Not the same equation if someone is 100%, but depression can compromise cognition at any age.
Sounds challenging across the board. All the best.
Driving with guns that aren’t registered to you in your state may vary. In my state, yes, if you are driving with guns and they aren’t registered in our state, you would be busted.
Any way to get them to leave for some reason, and then have the cops come over to help removal? What size town is it?
My father sold his old guns that were souvenirs from the war. A rationalization to get rid of them would be that you “found a buyer” and just pay him off.
@rosered55 I plan to read that later. We have been worried that the kids will be drowned in our digital stuff, there is SO much of it. But we have encrypted all the passwords (don’t forget I have 15 or so of Mom’s) and put the encryption key in the safe deposit box that we just put the kids onto. Hope that will help.
So I am in a bit of a dilemma. You might remember my Mom broke her arm in October. She healed up and was doing pretty well, so I asked that the Doctor to prescribe physical therapy for her. Partly to increase strength in her arm and partly just so she got more attention and company. (she loves attention and company even if she forgets they were there 15 minutes after they show up). It has taken a month for the orders to bounce between the AL place, the hospice and the home health care. Home health care said at first hospice people don’t need PT, but Mom is not dying in 3 days; I have hospice so that they don’t drag her to the hospital and scare her to death for a cold. Hospice RN said she would benefit from PT and be more able to use her walker.
Anyway, in the month, and especially this week, Mom has been going down a bit more and is more easily confused. It didn’t help that her private regular care giver was sick so she didn’t get the support she usually has to eat and drink.
The assessment today was, I think, a failure. Mom kept asking how to move her limbs. She couldn’t remember how to drink. (this happens periodically and the private caregiver gets her to drink, which in itself usually fixes the problem because Mom has low blood pressure when she is dehydrated.)
So the dilemma is whether or not to press on with the PT, or just forget it. I don’t expect Mom to benefit tremendously from doing exercises, but it could help. She can use her arm to an extent, she mostly has forgotten it was ever broken so didn’t lose as much muscle tone as one would have thought.
Is there any way for her to get some very mild exercise, maybe a personal trainer? Another person to pay attention for half an hour once a week or so? It does seem formal physical therapy might be overkill at this point.
It sounds like an exercise class might be something that could benefit many residents of the AL.
The advantage of the formal PT is that it is covered by medicare since it was ordered by the Dr. I am not sure a personal trainer would be and in her small town, I am not sure they have them!! But I might check and see if the local CC has kids that need hours since they do a degree in PT-like stuff. Good thought.
Her AL place does have several mild exercise things daily; she used to do them but has been too constrained lately since she couldn’t use her walker (with the arm in the sling) and so had to be wheel chaired around. She is too tippy to let walk without the walker.