She developed disorientation and worsening depression and felt she was being abandoned. I thought her depression meds were inadequate (I'm a clinical social worker) but the psychiatrist saw her on a good day and did nothing to her medication. Two weeks later when she felt she had been "tricked" into rehab he opted to change her meds. She is now refusing medication, rehab and most nourishment. Help. There are 5 of us and we don't know what to do?
Sorry, Anna, it's just that if *you* don't know what to do - ?!
What put your mother into rehab?
How old is she?
What are her circumstances - living alone, recently widowed, anything like that? Was she doing fine until recently?
Any underlying chronic conditions?
What medical investigations have been done?
As CM asks, what put your mom in rehab. My mom was doing "fine" in Independent Living and then had a stroke. After a week of acute rehab (the got her up walking and talking again) we moved her to a lovely subacute rehab that had a really nice Assisted Living place on the same campus. Seamless transition, right? We were patting ourselves on the back for being SUCH good planners when Mom went bonkers.
There were people having sex in her bathroom. Dead bodies were being transported up and down the hallways at night. She told us she had to pay for everything that was being done for her. She announced to me, with her nurse sitting right there, having just doled out the afternoon meds "you DO realize, don't you, that I have to manage my own meds here, don't you?". When I said falteringly, "Um, Mom, didn't Nurse Nancy here just give you your meds?" My mom cocked her eyebrow at me with one of her "significant" looks and pointed her arthritic index finger and the water pitcher by her bed.
I couldn't argue with her because there was nothing rational to argue with. I followed Nurse Nancy out of the room like a beaten puppy and said "what....what...what's the matter?"
Nurse Nancy gently explained that although it MIGHT be "just" disorientation from being in a new place, it might also be Vascular Dementia brought on by the stroke. The geriatric psychiatrist confirmed that a few days later.
The next 4 years were like Mr. Toad's Wild Ride. Keep the geriatric psychiatrist involved.
Has anyone investigated why she can't walk? Sometimes, the elder falls because of a break, or an event, not the other way around. Make sure they'e checked for stroke, broken pelvis, broken hip.
My mom was "refusing" rehab at one point. The alert PT realized she wasn't bearing weight on one side. Her hip was broken, but it didn't show up in the first xray taken.
You then want to research chronic heart disease leading to vascular dementia. Your poor mother, she probably does indeed feel completely wretched, knackered and fed up. Don't despair, it may yet be you'll find there are things going on that somebody can do something about which will help; but for now, failing that, just hugs all round. This is very hard on all of you.
The choice is to work hard or give up and take to your bed. I promise it is very hard not to just sit back and accept whatever happens. Nagging or bullying does not help progress. A person needs to accept their current condition, keep doing what they can, appreciate those who are helping them and set some realistic goals which will probably be very different from your previous lifestyle.
Downsizing does not mean giving up everything it can just mean changing the focus of your life. For example if you enjoyed building furniture but can no longer safely manage the big tools change to making dolls house furniture. Having cognitive decline changes everything so it is fruitless to expect someone with cognative decline to realize the importance of trying to do what is required.
Constant encouragement, praise and sensible rewards and most important of all recognisising what your loved one can no longer manage rather than simply does not want to do. Some things may have to be enforced like finding a safe living situation and taking over finances. Don't make it a big deal. Arrange for certain mail such as bills go to a post office box . Sort things out then sit down with Mom show her the bills then present the checks for her to sign as long as she is able. present it as a time saver as there is some kind of reward waiting. '"We'll take this to the post office as I don't trust that someone won't steal them from your mailbox. After that we will go and get ice cream", or whatever would tempt her.
There is no right way of handling these situations, a lot depends on the emotions of the participants. A lot of thinking on your feet and making quick decisions is required.
I hope you can get your mother treated.