My 99 year old mother fell about a month ago and fractured her hip. She was living in Assisted Living. She has had multiple falls and injuries in the past. She had always participated willingly and fully in physical therapy she even seemed to enjoy the attention at times. With this new injury everthing has changed. She does not want to do the therapy, she does not want to get out of bed. She seems to have given up and feels there is no reason to make any effort. The therapists force her to try and stand, the goal is to allow her to at least stand and transfer so the hoyer lift (which frightens her) will no longer be necessary.
The last month since the fall has been one of non-stop physical, mental and emotional torture. All for her own good.
Her Dr. put her on anti depressants but so far they have made no difference.
So my question, is there a time we respect the wishes of the person, even if dementia and depression affect her thinking? Should we continue forcing her to do therapy in the hope that she will be more mobile eventually? There has been some improvement as she can now stand for a minute or so with support from the therapist.
WHY do we work so hard to prolong the 'life' of someone who has already lived so very long? Why the antidepressants? Why the therapy? Why not just palliative care and letting mom do whatever the heck she wants?
Just love her and let her have the last few months/weeks/ days of her life without expecting ANYTHING from her.
Such a hard decision. I really don't think a 99 yr old should be forced to do anything and especially if she is anxious and scared. She will just be in a wheelchair for the rest of her life which with numerous falls, she should have been in anyway. Why a hoyer? Is Mom a big lady?
You realize, at this point, she will not be able to go back to an AL. Her care will be too much.
When you say "force"... There is a very fine line to be drawn, here, and it can be difficult to keep to the right side of it. Encourage, support, assist, cheerlead, bribe if necessary - these are all fine. Force, actually force her, under protest? No. Not for any amount of her own good.
You're the best judge, you know her, and it sounds as though you try to be present during these therapy sessions? But, I don't know if this makes any difference - what would you think if you read about a 99 year old lady being "forced" to undergo strenuous PT and being given happy pills to make her want to get better? If you think your mother will get through this and regain some quality of life, you know best. If you don't - be your mother's advocate, and prioritise what makes her happiest.
I'm sorry I don't have a better or clearer answer for you but I get the sense from your dialogue here that you love, care and know her enough to be on firm ground following your instinct here. Tough as it is I don't get the sense you will make selfish decisions I believe you will act in her best interest over yours if that's what's needed. My thoughts are with you.
I have also tried to explain her choices, remain in bed or submit to the lift/PT routine. She says she understands but 5 minutes later she has forgotten. Part of her dementia, she has little short term memory.
I learned on this site that fractures don’t always show up right after the injury.
The location of any fracture can help show where to place the ice, lidocaine patch etc to give her relief. If it’s not a fracture then you will know. After a fall sometimes there is a fear of falling again. So there’s that to consider but I think your mom is in pain.
I am a huge fan of therapy. I’ve seen my loved ones greatly benefit from therapy and have great quality of life for many years after having a need for therapy that brought them back to enjoy life. But it’s a fine line on forcing someone. Since you can see she has improved then you are encouraged. I would be too. But I would want to know that every effort would be taken to make sure she isn't in pain.
When my mom ( without dementia) was in bed she would say nothing hurt. But when she had to get up. Severe pain. My mom was tough. She forced herself.
She knew she had to move.
She was afraid to take pain pills but got great benefit from lidocaine patches and ice and heat packs. (She did take pain meds in the very beginning).
When my aunt (92 with dementia) fell and twisted her knee, she would say it didn’t hurt.
However when PT examined her they would find the pain. Even mild pain relief measures like ice packs and extra strength Tylenol helped my aunt to do her therapy. Ice doesn’t work on everyone. Some find more comfort in heat or alternating heat and ice.
There is a great deal to know about the human body and spirit. Each person is different.
I understand you are trying to return her to a better quality of life and to get there the PT must be endured. I get that. But please make sure she gets another looksee.
My mom had follow up X-rays lying in bed at her rehab. There are traveling X-ray services. My mom didn’t have to leave the rehab for the X-rays.
Hugs to you and your mom. I hope she’s better soon. Please come back and let us know how she’s doing.
Also - it’s going to sound so simplistic, but - water. I imagine they’re making sure she’s hydrated but it’s worth checking.