[NPInfo] Help please or suggestions for my mom in Upland, California-thanks

Fri Apr 18 13:04:26 PDT 2008

My grandmother recently returned from a two state road trip (NV and CA) with my uncle in his RV to visit family members and friends at her old Senior Day Care in San Diego (she had left San Diego and was living in NV). Upon returning from the trip, she fell in the BR, fx her pelvis, and while hospitalized had a massive stroke that put her in a coma. She died about a week later... but there were no tears-- she died 10 days before her 101 birthday and had remained active and social until the very end.  <G>

Carla Anderson <carla_rayne at yahoo.com> wrote:   But the woman down the hall from my mom, was so robust, and in her mid 80s, and when I was down there last week she stopped in to see my mom, all dressed up to go to church, and I was just remarking on her vitality, when the next day we heard she had fallen in her apartment, did not have LifeLine, and had laid there on the floor all night, fractured hip. It can happen in an instant, your life can change. 
Thank you, Carla 

jbro wrote:
Carla

I am so sorry to hear you...and your MOm are in this dilemma...and surely it is a dilemma...

Firstly I live about 35 miles from Pomona..and CAsa was the first place I interviewed for an np job...over 20 years ago...I didn't get it!!!` but it was a lovely place that has a good rep and apparently gives excellent rehab care

I am distressed that it seems your mother was discharged without adequate planning....discharge coordinators are supposed to help the family with situations like that...or maybe they did..and if their suggestion was assisted living and your mother said no..that may be the problem..tho this is a problem we see more and more as our folks get older and infirm..the cost of ANY kind of at home care is simply outrageous

as an aside...we went thru this with my MIL `4 years ago...at 92 she needed major ..and second..surgery for vulvar cancer..she is in MN and always goes to Mayo...there she got excellent care...was transferred to their "step down" unit..where she proceeded to fight tooth and nail to help herself regain what level of independence she had had (she could drive to the grocery and church...) my brother in law literally visited her twice a day...it became a huge burden...and tho she surely could have afforded 24/7 care at home..or the best "assisted living" place..she fought it tooth and nail...refused to use her walker...refused to have any safety bars etc installed in hallways and bathroom....obviously refused to leave her cute condo...bottom line...(sorry for this)...she sorta wasted away...within 2 months of being at home...alone...she fell on the front steps(she wouldn'allow hand rail)..naturally hitting her head on the cement...and tho two neighbors saw her fall and
rushed to her aide...I believe she may have sustained a brain bleed...and died peacefully 5 days later..) she was not quite 93

the moral of this story...the frail elderly do not want to leave their homes..and the cost of 24/7 
care...even 5 days a week...is prohibitive for most families...

I remember nearly arguing with my BIL in Mn that he needed to INSIST she get and pay for full time care...a companion like you need likely would have sufficed)...he just said to me..in frustration I a sure..."she is my mom..and I cannot force her to do anything...true of course)....BTW the lady left a substantial estate ...that she refused to spend

as for your mom's case...I do have a friend in Upland...a nurse married to a doctor..I will give her a call and see if she has some ideas..and in your price range...Pomona has multiple colleges...so a college student may fill the bill..for now anyway...but finding and keeping one...obviously a challenge,.....

you are a good daughter...obviously moving her to your home makes the most sense..but the older folks fight this ..keeping their independence...tooth and nail..so you have a fight on your hands...

let me call my friend and see if she has any contacts in the area...

and good luck to you both...

just curious...what will you do for weekends!!!

rosemarie brown..np..southern calif

Dena wrote:
Carla--
You can always advertise for help in the paper-- many of my SCI patients get
their attendants that way-- but I always recommend starting with local area
nursing schools to try and find a starving student for weekends, nights, and
holidays. Also, if any of her neighbors have attendants, perhaps they know
of family members or friends that might be interested as well. I know that
in the condo building where my mom lives, one woman had a Pacific islander
as an attendant several years ago... that attendant had sisters, cousins,
and friends who all ended up caring for other building residents as needed.
A family friend has been able to save up a good sum of money over the past
10 years or so as a live-in for those who only need someone in the home at
night for safety reasons, while she continued with her full-time job during
the day. Can't believe a rehab place would send your mom home without a safe
home discharge plan..... As for getting up so often during the night, be
sure she is cutting off her fluids early in the evening and avoiding
caffeine. As for the meals, if she is unable to cook, I'm surprised no one
set her up for Meals-on-Wheels or other food delivery program. If you can't
find her adequate and affordable home help and you feel she is unsafe to be
alone, be sure to let her MD and the hospital social worker/discharge
planner know-- especially if she has deteriorated since being home. 

Dena
-----Original Message-----
From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf
Of Carla Anderson
Sent: Thursday, April 17, 2008 10:56 PM
To: npinfo at nurse.net
Subject: [NPInfo] Help please or suggestions for my mom in Upland,
California

Hi List,

My mom recently had a stroke, and she has a history of chronic back pain
with neuropathy, stage 3 kidney disease, seizure disorder, and has been left
from the stroke with profound generalized weakness, and some mental
fogginess. She did get aggressive in patient rehab for 2 weeks at a place
called Casa Colina, in Pomona Calif, and was released a week ago. The issue
is, that even with a walker, she is unstable on her feet, and she is
supposed to be using a walker to strengthen her legs, that she is a high
fall risk. She lives alone, and has to get up 4 x a night to void, and
always has at least 300ccs of urine so it is more than an urge, it is a real
issue. (maybe too much info -tmi-, but it is critical, because the
caregiving she needs is for someone to be up with her each time at night so
she does not fall. She is too weak to make meals, or stand alone to wash her
hands, and she certainly cannot shower/bathe/dress alone. 

As we have all found out, some with catastrophic results, the "Assisted
Living" places are good if you do not need assistance, dont take meds, and
dont fall. Otherwise they can be very dangerous, and my mom is so hysterical
at the thought of moving out of her apartment and going into other
arrangements, and to be honest, she needs someone by her side, so I do not
think those places would work anyway. In addition, the stroke, and the
rehab, is so challenging, that a move to a strange place , in the midst of
all this would be very hard, and I do not have the financial or emotional
support of my sisters, who just want to put her in a nursing home. I am
trying to do this alone, and get my mom back into a safe stable situation
that she feels safe to thrive again. 

Do any of you have any ideas or know of someone who would be able to
live-in, with my mom, in her apartment, speak English, and drive their own
car, and just basically make sure she does not fall with all ADLs..for a
reasonable price, ie under 2200 a month? This person would not need to pay
for groceries, or rent, or utilities, just be the helper my mom needs...
They would also need to drive her to her therapy and doctor's appts. They
would have two full days off a week, and then I need someone else to do
caregiving for the other 2 days a week.. All suggestions appreciated. I
want someone honest, with a good background, and caregiving/medication
experience and someone who could help with the rehab/companionship. 

Regular agencies cost 20.00 an hour, and this kind of 24 hr care is
between 6-12,000 a month... and I cannot afford this. Any suggestions would
be appreciated. She does not want to move to Oregon, and is afraid of dogs,
(I have two large clumsy ones) and so that is out at this time, plus she has
a good rehab place where they are just starting the outpatient rehab there
for her. 
Carla/Portland, OR

Carla R. Anderson, FNP-C
Healing Presence Family Practice, PC 
carla_rayne at yahoo.com
503 819 9726
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Carla R. Anderson, FNP-C
Healing Presence Family Practice, PC 
carla_rayne at yahoo.com
503 819 9726
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