Ambulance wait times

[The_Doc_Man]

Good luck with that, and good luck to your mum.

 

[Jon]

Thanks. She seemed remarkable calm when I saw her. It was alarming at first as it was like a personality change. I will get used to it.

 

[Jon]

Spoke to physiotherapist today. Looks like they need to put a hospital bed and winch in the living room. Then we need 2 carers to come in 3 times per day. My dad is a bit shocked by it all, as he tends to look at things with rose tinted glasses rather than objective reality. They are struggling to get my mum to stand up. So, it looks like she is being kicked into "care in the community." We will have to try to get her to stand up ourselves, over time.

 

[The_Doc_Man]

Best of luck with that. We have determined that my mother-in-law has stopped walking in the nursing home. She is too weak and we fear that her tumors are weighing her down. But we have known for some time now that her days are limited. When the surgeon pulled out of the gall bladder surgery because of his discovery of metastatic cancer, we expected her decline. Keep your mum walking as much as possible. The improved blood circulation is better for her than anything else. Hippocrates (he of the Hippocratic oath) was once quoted as saying, "Walking is the best medicine for Man."

 

[Jon]

Sorry to hear about your mother. I suppose when you get to a certain age, much goes wrong.

She has been in bed for 3 weeks now and so a) her legs are weaker, and b) anxiety at walking in fear of falling. We are hoping that when she is home, she will get back into the routine as she is habituated to walking at home, while in the hospital it's just laying down.

I am wondering if she can do mild exercise in the chair by lifting up her legs 10 times in a row, perhaps 10 times per day.

 

[The_Doc_Man]

Exercise is exercise, but that one doesn't use the thigh muscle, which is THE primary calorie burner of the human body.

 

[Jon]

I was thinking if she lifts her legs up, hinging at the knee, that would be using her thigh muscle?

 

[The_Doc_Man]

Leg lifts where she moves her knee towards her chest would use the thigh somewhat. But she might complain about abdominal stress near the "abs" on the belly. That gets involved when doing that type of flexing when starting horizontally. (Vertically, gravity assists and the strain is less.)

 

[Bee]

I don't know whether there's any useful information here, but the other thing to maybe think about is speaking to her GP or out of hospital team about a referral to a home physiotherapist who will do falls prevention and chair-based exercise with her.

 

[Insane_AI]

I'm curious about the name of this miracle drug they have her on. I've not found a singe drug that manages bone / muscle and nerve pain all at the same time. The three are distinctly different as I have experienced them and the drug to use is also different although opiates work for both muscle and bone, they don't work well for nerve pain as much as gabapentin or cannabis (better of the two).

 

[Insane_AI]

AS for your Mom's exercise routine...… My wife was a nurse aid for years and would do what they call 'range of motion exercises' where she would move the arms and legs of the patient to get blood moving and to stretch. This helped me after my surgeries. It's low impact, low stress and very beneficial in comparison to sedentary life in a bed.

Also, keep her moving in the bed. Shift every hour or so and check for moist areas in the bedding to help reduce the risk of bed sores. An air mattress designed for long bed stays may be worth the investment.

 

[Jon]

Doc, the exercise I had in mind is just keeping her thighs pretty much parallel to the ground and just lift her low legs up. That gets the thigh muscle.

Regarding physiotherapists, they already said they would have a team look into a program. But these are often rubbish. Over a year ago, we were told we would have a physio come to see my mum with a plan etc. She came once and never came again!

Insane, the drug is Pregabalin. It is the ONLY drug that seems to have helped her neuralgia pain. It has massively calmed her down too and also reduced the pain from the fractured pelvis. The morphine was awful. She felt nauseous all the time and ate literally nothing for days!

 

[Insane_AI]

Jon,
Pregabalin is known as Lyrica here in the USA and has efficacy reports that hit both extremes of useful and harmful. If it's working for your mum, count her in the lucky column because it sounds like it's working for her. Pay attention to her heart, please.

The personality changes may not actually be changes so much as regressing back to her normal pain free self. Constant pain re-wires the brain (my current battle) to very negative programmed responses.

As for the morphine (and any opiate) part of the problem is they relax the muscles around the digestive tract causing a backlog of sorts. I've had to deal with a full stop situation that was not fun. It's good that she's able to come off those.

 

[Jon]

She was on morphine a couple of years ago and lost about 20lbs in weight in one month. It was very dangerous for her. Apparently, about 30% of people get nausea from morphine. She cannot tolerate it.

The problem is, when you cannot get a painkiller that works well, you have to resort to drugs that can cause harm. Codeine is a morphine derivative and she can't tolerate that well either. She had a morphine patch for her back and that was one of the reasons she probably fell and hurt herself, leading to a hospital stay. One of the side effects of morphine is increased likelihood of falls.

 

[Insane_AI]

Both Morphine and Codiene are natural opiates as opposed to synthetic. I've known people who can handle one but not the other. I'm all for leaving them off the table until there are no other choices available.

I'm happy for your Mum finding medication that works.

 

[Jon]

My mother had another fall yesterday. Just been told. I make that two falls in hospital and two falls at home in the last 5 weeks. She was left sitting in the chair and must have tried to get up. She is ok, apparently.

Looks like she will be coming out of hospital next week. They will put a hospital bed in the living room together with a hoist. Carers to come in pairs, 3 or 4 times per day. Caring bill gone up massively as a result. If you have saved throughout your life in the UK, they take your savings. If you don't save, you get it for free!

 

[The_Doc_Man]

In the USA, that financial arrangement is similar. My mother-in-law is in a nursing home where she is spending her last days. (Metastatic abdominal cancer will see to the "last days" part.) She sold off her house to put money in the home, but now because she has outlived the time that the house money has paid, she is on a Medicare (Federal) / Medicaid (State) list. The rule is similar to what you quoted, Jon. If you CAN pay, you must pay. But once your finances slip below some limit, the feds and the state pick it up.

 

[Jon]

Yes, that does sound similar to the UK. The bit that gets me is that if you have been prudent with your finances, you are penalised relative to the non-prudent.

 

[Insane_AI]

The trick in the USA is transfer the funds to a trust account at least 7 years before you need it for elder care. Give control of the trust to the kids and your inheritance is no longer an issue.
(Disclaimer:See an attorney for details, I'm not giving legal advice, just spouting an opinion based on a friends experience)

 

[Jon]

We have a similar 7 years thing too. It gets all very complicated with the various allowances, what you can do with this and that. Only found out all this when it was happening.