Decline

My Mother for the last 5-1/2 weeks has been struggling with a decline in her physical health. She's been diagnosed with dementia over a year ago and we'd seen her getting more and more confused. It's taken a back seat though to her lack of balance and inability to really walk safely. She's suffered at least 5 falls while at home. The last one happened while I was at the Saluki Nationals the second week of June. She busted her head open requiring stitches and fractured her left arm below her shoulder. It's unable to be casted or operated on so she was to wear a sling and keep it immobile for 4-6 weeks. She'd also become very incontinent over the last 6 months and taking care of her became more and more difficult on my Dad. We decided it was time for her to go into a nursing home to try and heal the arm and do physical therapy in hopes she may return home.

We decided on Hawkeye Care Center and though she didn't want to go she begrudgingly agreed as long as it was temporary. Moving her there soon showed us just how much she was sundowning. The first night there she tried to bite a staff member. We knew she has always been easily agitated and continually stubborn to have things 'her' way. We tried accommodating her. We made sure she had tv, her iphone, magazines and visited daily even eating meals with her. She was there a week and a half before she was sent to the ER for 'behavioral' reasons. She'd knocked the meds out of the nurse's hand and was going over the edge my Dad was told as to why she was sent to ER. There she wasn't overly belligerent but she did refuse to go back to Hawkeye. They gave her a low dose ativan that seemed to have no affect on her whatsoever. She wasn't combative there though, only adamant about not returning to the nursing home. She just doesn't want to believe that she cannot walk nor take care of herself. We preferred to have her transferred back to Hawkeye by ambulance fearing her combativeness if we took her by car. We gave them permission to give her an injection that would knock her out so that she could be compliant. Ironically the ER docs can give injections and use bed rails or restrain patients when necessary but in nursing homes that is no allowed. Injections are but they really do not wish to have to give them by force so even though she now had an order to be able to use one if she became combative again, they weren't going to.

She was groggy the next day but compliant again at Hawkeye. The Doctor decided to put her on a new drug called Seroquel to help with her dementia and behaviors. I found out she had an old friend, Judy, who came to visit her during that time but Mother reported that no one had been there to visit her at all. This was another red flag that I'm learning that points to dementia. Lack of memory and loss of time. Unfortunately, a few days later (she had now been there 3 weeks) another visit to the ER was necessary. This time they believed she was having a reaction to the Seroquel since her behavior was overly combative, foul mouthed and violent toward staff and to family. It was midnight Friday night and Myself, My sister & Dad arrived to another new nightmare of uncertainty.

She wouldn't let the Doctor examine her. She yelled about him having lice and I literally had to hold her arms from scratching him while he looked in her ears, eyes, nose and throat. He gave her a shot of Haldol to try and calm her which didn't really do much at all. Later a small dose of ativan was given and eventually they started Zyprexa the next day. Due to it being a weekend it looked like we were stuck there in ER because Hawkeye wouldn't take her back with her behaviors (she also refused to not get up on her own and had fallen twice so non compliant). We now began to learn about where do we go from here.