It will be 9 days this afternoon Nov 16, since my 84 year old long time physically handicapped mom fell. The 5 days of Tramadol did not work. She is in terrible pain and lying in bed everyday. I get her in the wheelchair by sheer will between us to change her underwear and wash the wet sheets.
What we need is what we got in 2009 after the car accident, and again in 2012 after she broke her leg. We need the Visiting Nurses of NJ to come here, assess the situation, and get us set up with occupational therapist so we properly get her out of bed everyday, and do everything the correct way that wont injure her, and a physical therapist so my mom can start the process of getting better everyday.
Mom pays a lot of money for Medicare insurance and AARP health insurance as the supplemental, as she always had, that paid for the visiting nurses in the past.
Somewhere there is a glitch in the system. The ER sent her home with no meds and no plan of action.
The primary care and orthopedic surgeon doctors simply say she will recover, but give us no plan of action.
We need a plan, we need a routine, and we need to do it properly. Is all this too much to ask for in 2022?
We need to get her out of the depression, we need to get her feeling better so she eats more everyday, we need to get her moving so her previously damaged legs, before this fall 9 days ago, do not freeze up for good.
Is all this too much to ask for in 2022? It has been 9 days.
I have very little power, none actually, over my mom. Everything is her call. She makes calls and tries to get help everyday.
I can make suggestions, get her in the wheel chair, walk her to the bathroom, change her underwear, wash all the layers of sheets and towels on the bed, bring her any food she wants, which is hardly any now, i can set up her table with phones, and i give her Tylenol and Advil, and Xanax, and I can take care of the house as I have been for 14 years, with her guidance.
What I can't do is get her medical help. I do not have the legal right to call any doctor or medical group. I can't help her fix what appears to be an un-fix-able glitch in the system.
She never did anything in her life to deserve to be shunned by doctors.
She has been the perfect person her entire life.
Tramadol can vary from 50mg to 400mg per day, depending on which tablets you take, how many of them, and whether they are immediate release or slow release. I take 100mg slow release, and they aren’t very strong. If I have a bad day, I don’t take Tramadol, I stick to Codeine (as explained below).
Tylenol is the drug Acetaminophen, also known as Paracetamol. They are all basically the same thing. Most tablets have 500mg of Acetaminophen, but there is an ‘extra strength’ USA version as well – the website is a bit coy about strengths. The maximum dose per day of Acetaminophen is 3000mg, or 6 tablets of 500mg. Overdosing is dangerous. Acetaminophen is more useful for some types of pain than others, and it does nothing for my back pain. 1000mg of Tylenol at night (2 tablets) might help me sleep, that’s about all.
Pain control is a specialisation now, and as a result of legal claims and prosecutions for massive over-prescribing of fentanyl and other strong drugs, many ordinary doctors are unhappy about prescribing anything of any strength. Most hospitals have a pain clinic, and you may need to find one for your mother. My guess is that she needs stronger drugs than she is getting now, so that she can relax, sleep and get better.
I’ve been through the Pain Clinic system for over 20 years now. I have a script for unlimited Codeine (always sold in tablets combined with Acetaminophen to stop easy abuse), and I am permitted to take 6 tablets a day. I only take what I need, from 0 on good days to 4 on bad days. Interestingly, the 6 tablet limit is not for the 180mg of Codeine (which is very safe) but for the 3000mg limit for Acetaminophen.
I hope all this makes sense. The bottom line is that your mother’s pain medication needs to be checked by someone who understands pain control. At present it may be not what she needs. Very best wishes to you both, Margaret
Were you able to get homecare services set up?
I find those "post ER" calls to be quite useful if my problem hasn't resolved. I would have used that opportunity to say I was still in terrible pain, what should I do?
Hospitals have a financial interest in not having patients re-admitted or return. It's bad for their bottom line. Take advantage of that fact.
I'm glad to hear mom is feeling a bit better.
When my mom was in her 80s, she suddenly gave up driving. So I started going with her to doc appointments.
Although my mom was "sharp as a tack" in some ways, I discovered that she was a very poor advocate for her own medical care (she always wanted to be seen as a "good" and uncomplaining patient and she was not comprehending what the doctors told her. She would make up her mind beforehand what was going to be said and then not take in anything different.
Are you simply "buying" what mom is telling you?
AND what is "Medicare Rewards"? Are those various Medicare Advantage plans who are calling? It's open enrollment time. I get several calls a day from various companies. I ask if they're from CMS and hang up when they say no.
Mom doesn't sound like she's a reliable reporter. Why won't she allow you to assist with this?
Why do you need her "guidance" to do basic things such as taking care of the house?
Mom thought it was a survey about the care in the ER. The lady called back today and still did not present herself as why she was actually calling. Finally my mom asked "what do you have to do with this, Centrastate has nothing to do with Hackensack Meridian Health.
The the doctors office beeped in and my mom connected to them and my mom asked the receptionist why is hackensack meridian health calling, and that is when mo found out it was about the At Home care. Jesus H Christ. If people would just learn how to speak and present themselves.
Has anything we have said to your previous posts been helpful.
This may be something that only the medical people you are dealing with person on person and face to face can help with. I don't think our input has helped you so far.
I am certain you must be desperate and frustrated and I am so sorry for it.
1) sent an occupational therapist for a couple hours to assess our setup and show us the proper way to move about.
2) sent a physical therapist 5 days a week for 2 weeks to get her walking. She has to learn how to walk properly again.
3) sent a home health aid to wash her up and "down there', something a son cannot really do.
4) sent a nurse 2 or 3 days a week for a few weeks to check on her medical condition and see how we are getting a long.
We got this in 2009
In 2012 as well except for the home health aid.
In 2012 she broke her leg, the tibia i think, and she needed to learn to walk again.
This fall was no broken bones but the injuries are much worse.
I want everyone to know she has been severely physically handicapped in her legs for the past 14 years.
Everyday has been a painful struggle for her, but for 13 years has been able to walk with a cane, cook in the kitchen with my help, get up at night put on her sneakers and walk the 10 feet to the bathroom several times a night all by herself. She has been able to push a cart through the supermarkets 2 times a week with me with her doing the shopping.
She has kept herself busy with new recipes for cooking pretty much constantly, and paying the bills, talking to her grandchildren, and my brothers who live far away. And watching TV, she loves the Mets.
We have a cleaning lady who comes once every 2 weeks for 20 years for about 5 hours, can do the whole house. My mom has become very great friends with her and her husband, they are like family to us. And they have been taking her to dinner several times a year. In the wheelchair.
We always use the wheelchair the past 13 years to go to restaurants, and most places, doctors, getting her hair done, anything, except for the supermarket where she pushes the shopping cart like a walker.
I am just worried for her based on the way she talks and everything, the lack of appetite, and the pain she describes that is causing her not to do all the things she was doing up to the moment she fell 9 days ago.
We had a good thing today. I got the walker without the wheels from the garage brought it upstairs, and she just used it to get up from the wheelchair and walk to the bathroom for the first time. She even sat on the toilet, we have the thing over it with the 2 arms on it , and instead of squatting she actually sat down on it, and went, and got back up using the walker.
Now it is 130 and she is back in bed with all fresh washed 5 layers of sheets mattress covers and towels, and the giant 2 inch foam over the mattress.
She ate a little bit of the wonton soup I got her from the Chinese restaurant.
The next steps is to get her downstairs in the morning on the chair lift, and do laps from the laundry room, through the family room , through the kitchen to the dining room and back. Start with one lap, then 2 the next day, then 3 the day after that.
As long as there is improvement everyday we are probably moving in the right direction.
The problem is we do not know if this is what we should be doing or not, no doctor has advised us as of now on what to do.
This has been my concern.
I WANT THE VISITING NURSES TO ACCESS EVERYTHING AND GIVE US A MEDICALLY APPROVED COURSE OF ACTION.
You've gotten quite a bit of good advice on your past few posts, yet none of it has been taken. It's fine to vent, but much better to take action.
Good luck to you and mom.
I find it beyond ridiculous that she expects you to carry all the responsibility without the authority to speak openly with her doctors.
As a Canadian I do not know how the US medical system works, but why can't you call and tell her doctor Mum needs the referral for PT?
Why can't you call and tell her doctor that after the 5 days of Tramadol, she is still in severe pain?
1000mg of Tylenol 2x a day is not a lot of pain killing capacity. I know it is more than the recommended daily dose, but when I have a migraine I take that much every 4 hours, plus 600 mg of ibuprofen.
Medi-care pays for it up to 3 months I believe.
Department of Aging for your state can help, ask for a social worker (whom are usually nurses) come out and assess your mother's needs.
Medicare will only pay for what her doctor orders.
There are a lot of programs to help her.
Wishing you and your mother well and I hope the information helps.
At least some good news, my mom just asked me to get her 2 large wonton soups from the Chinese restaurant.
ER doctors are like GPs and pediatricians -- they know a little about a lot of things, but not a lot about any one thing. I was diagnosed with an ulcer by an ER doctor last year, and it turned out to be pancreatitis and a bad gallbladder. My second trip to the ER four days later determined the actual problem, and I was admitted for surgery and was in there for a week.
Repeat visits to the ER tend to get more attention than a single one.
How your mom has been treated is how my fil was after one of his falls initially diagnosed as muscle strains and sprains. He got no pain relief for that nor did the hospital send pt or ot.
He became a temporary two person assist to try to get him out of bed. He fell again anyway and was finally diagnosed with hairline fractures, which then got him 14 days worth of Vicodin plus some pt and ot.
Youve seen multiple practitioners who won’t do for your mom what you think is the solution.
Doctors cant expect a 84 year old handicapped woman to lay i urine and atrophy handicapped legs, until she will never walk again.
WHAT IS GOING ON IS SICK.
Nothing is going to happen otherwise, the glitch will keep glitching.
is her pain better ? .. is this why docs say she will recover.? If you are not getting help from primary , call and get her an appointment with an orthopedic, or pain management Dr… I had found a good pain management Dr in Green Bay for my moms back.. he was willing to order PT…
have you asked primary to order PT evaluation?
is all of her end of life papers done, you indicated you have no rights.. if they are not done , you should work on that as well…
I've been thinking about your mom!! I don't think the VNA can make the appropriate referrals for you and as Barb mentioned unless the root cause of her pain is determined correctly all the other services will be for naught. The vna won't come unless ordered by the pcp if I am correct. And they seem to have already moved on and not even ordered home services for her for an evaluation, and may have not safely discharged her home!
Our VNA nurse took one look at my mom when she was first discharged home after surgery and immediately said we had to get her back to the hospital. He called the surgeon and said he was calling 911 which he did. Left to her own devices she would refuse to go like we begged her to, or not be in any position to push forcefully enough to her pcp and surgeon.
I really think you've got to take her back to the ER, or get the vna (you don't have these services yet is my understanding tho??? ) to insist she go back to the ER. They (vna) don't have as much power as you think with pcps and surgeons in swaying their opinions, they have already pronounced their opinion and will be hard pressed to change and you are now stuck. But at least in my situation the vna used their judgement to know the discharge was too soon and sent her back to the ER, maybe a different one I wish with my full heart I had taken my mom back to a different ER!
Then when you are there get her re-evaluated with all the advice folks chimed in with on another thread i.e. do not leave until you are satisfied with the plan. It's sucks to "start over" but I really think you have to. Otherwise nothing is going to happen.
Apologies if I misunderstood any of the situation and this is not any criticism at all just what my limited experience was.
For a younger healthy person , they can spend a month in bed and be fine afterwards.
A 84 year old with severe handicapped legs already from a car accident 14 years ago cannot afford to do that.
We need to get the legs moving or we are done.
We know where the pain is and what is causing it from the fall. She says she can't walk because of the pain. The tramadol 5 day supply did not help.
Listen, we need encouragement and forcefulness of the visiting nurse, occupational therapist, and physical therapist, JUST LIKE WE GOT IN 2009 AND 2012.
First get her out of this pain for a couple days, and get her walking.
And help me know how to get her up and do all the things i need to do 24/7 to make sure she is not hurt by getting up and all those things a person might do throughout the day.
https://www.agingcare.com/questions/begging-for-help-in-nj-any-advice-478175.htm
Have you considered (as suggested previously) taking her to a different ER for a more thorough workup? It really sounds like there is a fracture somewhere.
In order for the recovery to start and take hold, we need the real deal medical care like we got in 2009 when she came home, and again in 2012.
This waiting for help I pray ends. At this age, with the previews severe injuries that handicapped her, if we do not get rolling very soon, we are finished.
Maybe that is what the powers that be want, the elderly to be finished.
We saw what they did with the nursing homes in the start of the pandemic. The powers that be intentionally murdered hundred thousand elderly by sending covid positives into nursing homes.