My Mother is 86 years old. (Biologcal Grandma) As the topic says she suffered a fall and injured her shoulder and arm, she was in Hospital for a few days but is now back at home and has a scheduled appointment for surgery but it's nearly a week away.
For context the only people here to take care of her is her daughter (my Aunt) and me although I live far away I came back to try to help - I am a very small woman, not very strong, and my Aunt has a hernia and struggles to lift more than 30 lbs. My Mother is on the heavier side.
Here's where things get really difficult. Despite the fact that my Mother only suffered a shoulder injury she is acting as though she is nearly completely unable to move or stand. We can not get her to walk, stand, roll over, or even sit up. Logically she should be able to do these things so I don't know if it's fear or the concoction of medications she is on, but she just completely limp fishes or yells out in pain, she does not work with us at all. Because of this we are struggling immensely to change her soiled diapers.
Please understand this is completely new to me, it's a horrible experience to have to change your parents soiled diapers especially at 25 years old. I'm supposed to be working, but I've had to take time off for this. I need some kind of advice or reassurance because I'm in over my head and the other older adults around me are flaking on me, not showing up when they say they will etc. I don't even know where to begin. I can not afford to pay for a nurse, I'm self employed and barely make enough for rent. Please any advice is appreciated. Thank you.
Another issue is her having surgery at her advanced age and the danger of the anesthesia having a permanent impact on her cognition. I would talk to the doctor about this very real concern. My aunt has advanced dementia and at 98 years old fell and broke her shoulder. Her long-time doctor said to just allow it to heal on it's own. I don't know if she had any rotator cuff issues...she didn't do a lot of moving around with her arms prior. Then the next year she fell and broke her knee cap. Same thing: just let it heal. Now she's not in pain but of course her mobility is greatly impacted. She can shuffle if we hold her up with a belt so we're not transferring dead weight.
Usually after a fall that lands one in the hospital, Medicare has you in the hospital for 3 days then you are transferred to a rehab center for 21 days. After that I'm not sure because I'm not old enough to be on Medicare (65) but my in-laws both had stints in and out of rehab from falls. Other forum sages have good knowledge about Medicare coverage.
This caregiving is out of your league because even after a "successful" surgery it will be a full-time effort and she still most likely will never go back to her pre-injury level of movement. If your Mother has all (or most) of her reasoning and comprehension abilities, she gets to make decisions for herself but you ARE NOT obligated to be part of her care plan. You should not be. If she insists on being home but there's no one there to care for her then you should do what Alva suggested (in her post next to this one) and make sure the ER knows she is an unsafe discharge. Make sure they understand you live out of state and there's no one committed to caring for her full-time. If your Mother has an assigned PoA this person needs to step in to now make decisions in her best interests. If she doesn't have an assigned PoA the social services will work towards gaining guardianship for her and they will manage all her care and affairs. Do not let anyone pressure you into thinking you must be the caregiver. You cannot. The best thing you can do for her is find out if she has a PoA and if not then talk to social services about what to do in this situation. I wish you much wisdom and peace in your heart.
Call the [several rude words ending with idiotic] hospital and ask for the discharge team, discharge planner or equivalent term. When you get hold of this person, explain that your mother has been discharged home with no support in place and urgently requires help with mobilising and personal care. Neither your aunt, who is medically unfit, nor you, who do not live there, is able to assist her so she has essentially been sent home with no care. This is an unsafe discharge. They need to rethink their assessment stat.
I question your mom being sent home without the surgery or going to rehab. She should not have come home. How did she get home?
Have you talked to her doctor to explain what her condition is and to ask for help? A fall, a broken bone, even a bruised arm could render someone 86 year olds pretty helpless. As you say, it could be her meds, her pain, her fear, mental decline, a UTI, any number of issues. Is your aunt her primary caregiver? Does she have POA? Why didn’t she go to rehab? I’m sorry to pepper you with questions but it’s difficult to understand how or why this is happening.
Did your mom have a follow up visit to her doctor after being released from the hospital? How long ago did this happen? Read the discharge paperwork to see exactly what the instructions were. I would call the number listed and let them know what is going on.
Often a senior will want to go home instead of rehab. It’s just not possible in the situation you describe as she needs more help than you or aunt can manage. I am sorry this has happened. Give us more information and hopefully we can help you sort this out.
Thank you for explaining how the shoulder injury can effect other areas. I wasn't here when she was at the Hospital so I wasn't able to personally talk with any nurses. She hasn't had a follow-up yet, but has one tomorrow including more x-rays. We are going to have a serious talk with the doctors and explain how things aren't working well. I'm honestly not sure how we're going to handle costs but I guess we'll have to figure something out.
As for why she's back home and not still in Hospital/rehab, the Hospital she was in was not a good Hospital- we live in a secluded area with not many options and the conditions were not great, to the point of negligence whenever family wasn't around, so I suppose my other family thought it best she be back home. I have another cousin who is SUPPOSED to be helping us. (She is the one who told the Hospital that we have things covered at home) She actually does have experience in elder care, but she has been completely flakey and difficult to contact, making excuses etc.
It's a very difficult situation but I appreciate your response. We are taking her to a different Hospital/Doctors next time, still figuring out transportation but hopefully they will help us figure out a better solution.
So now you know that your Mother/Grandma has EXCELLENT reason to be in pain, whether from a tear in rotator cuff of actual impairment in bones, we can concentrate on the future.
I think that you and your Aunt need to speak with the doctors to make it clear that your Mom/Grandma should go into rehab to learn how to handle pain and activities of daily living for the likely 8 weeks that she will be dealing with the severity of this injury. They will want to avoid this, of course; cost factors. So if they insist you take her home you will need to assess frequently whether you can do this care without rehab. If she is not doing at least somewhat well at home then you may need to consider EMS call on 911, transport to the hospital where you will have to tell Social Workers ON ADMIT that she cannot return home as she requires either rehab or SNF; that you are not capable of caring for her at home. I sure do wish you the best and hope for her speedy recovery.
I am going off of the words of my older family members so I can't say with 100% confidence how correct all of this is. Still figuring things out, but I appreciate your reply a lot. Have a good day!
Edit:
We are all about the same “age” as caregivers when we first tackle Medicare and other elder issues. In fact with your young smart mind, good energy and willingness to help, you might be ahead of the pack. You need to understand the insurance, moms finances and her condition before being willing to leave your work for prolonged time periods. Someone needs to see an attorney for mom. She needs a POA for finances and medical and to help her determine the best way to liquidate her property to pay for her care.