My mom is 81 and back in October ended up in the ICU due to low sodium. After leaving the ICU she spent a few more days in the hospital before going to a rehab center. Since she has gotten there, she has shut down, and is pretty much refusing all help that is offered to her, the only help she will accept is from me, but on the other hand will still exaggerate all her symptoms. She seems to me to be majorly depressed, and I don’t know how to reach her. She just keeps saying she wants to die. I would consider hospice in palliative care if that were appropriate, but she’s quite healthy, she just lost her will to live because things are a little bit harder, and she’s never been good at having an eye can do it attitude. She’s, I hate to say it, but a princess. She is running down all the money that they have by staying in this rehab place because it’s no longer covered by insurance, she’s hurting her husband and her children. Tomorrow we’re supposed to go play hardball. To try to get her understand that she can’t keep just lying in bed waiting to die and somehow must agree to get help so she can be motivated to live. It breaks my heart, and I try to be very empathetic, but I’m really struggling since I’m trying to help, and she just keeps getting in the way.
If Mom is a princess your not going to change her now. I am surprised Rehab has kept her if she is jot being cooperative. If you can take her home, see about in home care. Think about it, your in a strange place, strange smells sharing a room with a stranger. Food is lousy. I would be depressed too.
Anyway... I found a fantastic psychiatric nurse practitioner and she's been seeing her weekly. It has helped tremendously. I spent a lot of time researching the backgrounds of the practitioners to find a good fit. This woman was an rn in a nursing home and pursued the psych side later in life. Her bio said her goal was to reduce distress in her patients regardless of diagnoses. She started her on low dose of anti depressant combined with talk therapy /CBT.
Don't discard the idea of palliative care either. Mom had that as well and tho it didn't stick for long, it stuck long enough for her to ask mom what her goals were and she actually articulate some small things she wanted to do. And this presented an entry to open the door to agree to counseling. Now she looks forward to the visits. It's not a cure all but it had definitely helped.
Ultimately you can't make her do anything. Present the choices to her unemotionally as possible. You can even tell her if she has decided to die, you can bring in hospice...
Please let us know how the family meeting went....
You don't tell us much about what has been tried that has not worked or about the history. Therefore, a couple of questions:
1. Does mom have a diagnosis, or has she been seen by a neuro-psyc doc for diagnosis of dementia, depression, etc?
2. What caused this low sodium condition, and did it damage the brain? As someone with a family member who had low sodium and ended with Central Pontine Myelinolysis (look that up; you end with a sort of loss of myelin sheath on nerves, much like MS) I can tell you that low sodium can damage the brain.
Have tests been done?
Was the low sodium due to an illness that caused severe nausea, vomiting, or is there any underlying alcoholism by history?
3. What conversations have been had with rehab about moving Mom to extended care facility for more affordable care?
I think you are on this in that, if there is no dementia and there is no brain damage you may be looking at depression. But you do not mention that your mother is being examined for this or treated for this. If she is refusing there may need to be a conservatorship so she can be diagnosed and treated.
There's so little ultimately that a Forum of strangers can do but guess; as an old retired RN I always found every patient to be a mystery. So basically you are still in the diagnosis stage, it sounds like? And without a diagnosis and prognosis there can't be any treatment, really.
I will tell you that some people lose their will to live. My father did in his early 90s and that was after a long, good and happy life. He just basically said it was all exhausting and he couldn't really see a reason why. As I am 82, and while I ALWAYS understood him, I now can FEEL what he meant. At some point, why? We have done our thing; it was good; we are tired. So stick around for the next good book, the next season of Survivor? There are a lot of losses. Some people just don't have contentment genes, and would as soon leave. Fine, but not to the tune of what, about 600.00 a day in care.
You have my sympathy. I am hoping for some more information. Meanwhile, if she's fully competent, and refuses a try at something like a mild anti-depressant, she needs to be told the funds aren't there for the rehab center anymore, and arrangements need to be made for ALF.
Sure wish you the best and am hoping we hear back from you with some more information.
She was released to PT and spent 20 days there, that is when we figured out she was not taking her meds, sure enough when she got back on them she turned around and started to embrace walking and living.
She is in AL and up to that point was able to manage her meds, she is no longer able to, so the facility is.
My mother is 99, in AL a real drama queen, anytime she has a medical problem, she "Wants to die"!
I think your mother may be depressed and that some meds might be in order.
Do not become her 24/7 crutch, it is time, to play hardball and stand your ground.
Sending support your way!
Mom only accepting help from you is her plan . She wants you to be her caregiver . She wants a servant rather than to do for herself at this point . My advice is stop enabling this . Stop helping her . There is staff there to help her . Perhaps without you helping it will motivate her to try .
Good Luck