When I went to NH today mom was so angry and didn't want to get out of bed, which she never does..she fights and kicks and hits at either me or the aids trying to get her up. I finally said "forget it" and gave her the meds. and walked out. I get so frustrated when I'm trying to help her and she just sees how hard she can make it. Then I get to thinking if she died before I came back I would feel terrible.
She is on Hospice and takes morphine, roxindal and xanax to help with pain and nerves. Also wears a pain patch. Most of the time you can't tell any of it is doing any good.
Is anyone else having a issue of constant anger and if so how do you handle it?
Thanks for letting me vent.
Lois~

Poor Lois! If you perform a site search with the word "guilt" you would get more posts than you could read in a week. We've all been there. Lost our temper, run out of patience, or lashed out in frustration. And our LOs forgive us. If Mom is agitated, sometimes I can get her to go for a walk around the grounds and that takes care of it. Sometimes I just say, "OK, we can just visit here." And sometimes we actually just sit in silence. Eventually, Mom usually forgets that she's angry and starts talking to me. Sometimes, she will start talking about what she is upset about. Real or perceived, I agree that it must be very upsetting. If I ask her how I can help, she starts thinking about that and forgets what she was angry about. If we sit in silence for more than about 10 minutes, I just give her a kiss and tell her it's time for me to run to the store, or put gas in the car or some mundane task. And I leave. But no matter what, my parting words now are always "I love you, Momma." That takes some of the guilt away, because no matter her mood, I've done my best.

Hi Lois---if you aren't sure the meds are doing any good, it might be time to sit down with someone at the hospice and find out if there are different options for her, or even a different hospice provider. Is is possible the drugs are behind some of her behaviors?
Mom hasn't raged like that in a while for me, but I remember there was no calming her down when she did; she just had to work it off. As Memaw says, sometimes I would just sit in her presence while she did her thing. Generally she would calm down a little and we could visit, but some days she didn't. I would always tell her I loved her, no matter what the visit entailed. I know for me it has been harder to leave when our time together was stressful but part of the journey has been me redefining what visiting means. When I defined it along the lines of, We'll sit and chat, no one will yell, my feelings could be pretty hurt if things didn't go according to plan. Since I've learned to meet mom where she is at, whatever that looks like, it feels like I have a lot less guilt and hurt feelings now. And I think it is better for mom too. After all, she is in a position where she has almost no control over anything in her life anymore, so she doesn't need me coming in with my own set of expectations for her behavior. If she wants to rage, I love her. If she wants to not rage, I love her. I've learned to pare it all down to "I love her."

Best of luck to you!

We all feel guilty but if we think about iot we are trying to do our best. Or that is our intention.

Does anyone know what are the qualifications for hospice. He is still walking but sleeping much more. He babbles and need to be started in eating. Of course he is totally dependent for daily activities and requires depends.

Amen to Pearlygirl! Well stated. We all know that the only thing we can control is ourselves. Guilt comes when we don't meet our own expectations. So coming with love and dropping the expectations for the other person are the best we can do in difficult circumstances.

That said, as advocates for our LOs, we are often the best observers of changes in their behavior. Take the med list and your observational notes to several different medical professionals to assure yourself that this is the best course of treatment. Then know you've done what you can.

You reach a point, Lois, where you just tell yourself that you'll respond to all negativity with positivity. I found it's that simple. And it works with Alzheimer patients. It takes a while. But patience pays off. You get favorable results. --Jim

We all do what we can and must remember we're working with LOs who don't understand the affects of their disease on them and to their caregivers (their minds are broken). I'm trying to get mom to take her meds and well she's being tricky to hid the pills and/or just say NO to the staff.

In the end who is she hurting -- HERSELF! What can we do at his point? Fight them? Or just breathe in deep and softly walk away. The disease is talking thru our LOs and we're doing the best we can. Don't beat yourself up!!

Not an easy battle, but we can only do so much!!

I too am having issues with my mother refusing medication, refusing to eat, very agitated, etc... I lose my temper, I cry, I feel horrible about my reactions. The worst part is that she is not close to me (closer to my sister) and I am not able to go out there as often as I would like. I'm so pathetically busy that I can't give up a whole weekend day every weekend to go see her. You want to talk about guilt? Then when I see her (my mother) she is usually AWFUL!

Guilt is such a useless emotion. I wish I had answers on how to stop it. Believe me, I would pass it along.

Are her meds given under her tongue? I am assuming that since she is in the comfort care mode. Mom was on roxinol and morphine as well, given sub lingal so that we didn't have to rouse her to give her meds.

[QUOTE]Originally posted by Marjk:
I too am having issues with my mother refusing medication, refusing to eat, very agitated, etc... I lose my temper, I cry, I feel horrible about my reactions.

Oh, how well I remember that stage of things with mom. Hugs to you all.

Something that helped me was a comment by the cattle rancher I went to work for, when mom entered the adult day care program. I felt like I had a lot of my own emotional work to do, and there was plenty of room for brooding and physical exhaustion among the cows. One day I was expressing exactly what you describe, and how tough it is to help someone who totally refuses it, and he said "she doesn't have to like it."

At first I thought he was being a jerk, suggesting that I submit mom to things as we submitted the calves to castration, injections, everything else. But the more I sat with that, the more I took it to mean, I had permission to be released from seeking her approval as I moved forward in caring for her, in making decisions for her. As literally insane as mom was when I was growing up, and as *&^%$#-up as a parent as she was, she was still my mom, and I had always sought to please her in some way that was clearly going to be a thing of the past, if I was going to be able to make sound (but difficult) choices pertaining to her care.

Letting go of that approval piece of the puzzle then paved the way for me to eventually be able to meet mom where she is; it has helped me let go of expectations. Was it easy? Ohmygawd no! It's been a process. But I think, for me, it was either learn those skills, or self-destruct.

When you say your mom is awful when you do get there to see her, I'm curious: Awful because of the care she gets from your sister? That would be another can of worms. Or do you mean she is awful to you because you haven't seen her all week, in a vengeful way?

Again, best of luck to you all.

Oh no, I mean she's awful because she's so agitated. She's going through that horrible stage of the disease. Nothing will calm her down, she won't listen (because she doesn't understand), she refuses meds, she refuses to eat, she yells at me. She acts the same way with my sister. She's actually on the waiting list for a special behavioral nursing home right now because no one else will take her (she got kicked out of 2 ALF's). She is not being vengeful, I don't think. But with her refusing her meds and refusing to eat and being completely resistant to care, she is making things impossible for herself. When I see that behavior, I get annoyed with her - hence the guilt. I know it's the disease.

quote:

Originally posted by Pat818:
We all feel guilty but if we think about iot we are trying to do our best. Or that is our intention.

Does anyone know what are the qualifications for hospice. He is still walking but sleeping much more. He babbles and need to be started in eating. Of course he is totally dependent for daily activities and requires depends.

Hi Pat!

Mom has been in and out of hospice a couple of times, all of which revolved around attempts to secure quality in-home skilled nursing care for her so we didn't have to drag her out in these lovely Iowa winters.

All times mom was admitted to hospice, she was completely bedridden, unable to perform any ADLs, receiving 24/7 non-skilled care. She was already getting non-skilled care at home for bath assistance but had chronic bladder infections due to her catheter. The physicians contacted the hospice organizations, who then enrolled her. The services we got were great.

The issue we had with all the hospices was, mom is in a steady rather than declining state; the way she is now, is pretty much how she has been for years. In order to stay on the hospice books, the patient has to be measurably declining.

I would direct hospice questions to the hospice itself, rather than to the doctors office. It would be impossible to count how many times mom has been refused emergency room treatment because "she should be in hospice, there's nothing I can do for her", or that I've heard "there's no point in bringing her to the office for this routine procedure, we'll get her signed up with hospice and they will do it for you in the home." Seems like there are physicians who view hospice as a general dumping ground for they elderly, rather than as a distinct organization with its own particular guidelines. Having said the latter, I will also share with you my jaded opinion that some hospices might sign your loved one up if their census is low and they need more heads in their roll call for a given month. Then your loved one will be dropped from their services once they get better-qualified folks to care for. Again, let me stress, that is simply my sour opinion based on some things I have witnessed, but by and large I think they are a fabulous organization that provides services to a population many others shrink away from.

quote:

Originally posted by Marjk:
Oh no, I mean she's awful because she's so agitated. She's going through that horrible stage of the disease. Nothing will calm her down, she won't listen (because she doesn't understand), she refuses meds, she refuses to eat, she yells at me. She acts the same way with my sister. She's actually on the waiting list for a special behavioral nursing home right now because no one else will take her (she got kicked out of 2 ALF's). She is not being vengeful, I don't think. But with her refusing her meds and refusing to eat and being completely resistant to care, she is making things impossible for herself. When I see that behavior, I get annoyed with her - hence the guilt. I know it's the disease.

This'll be quick because I've got to go get mom into her wheelchair for lunch, but.....

I totally understand the raging you are talking about, and we also had mom in one of those elderly behavioral units for a month when she was like that. They knew she would only be there until they figured out different meds, as we made it clear that we planned to take her home.

THey ended up just drugging the crap out of her! They gave us back a drooling zombie. As much as mom had raged, I raged at the psychiatrist during follow-up visits because I refused to believe there was no middle ground for her. He tweaked a thing here and there, but she remained a zombie.

The kicker was when mom finally did speak, she said "I'm losing my ability to be human." I took her off all those drugs and we found other ways to deal with her behaviors. But I know, the choices we made certainly were our own, and not something others would be inclined/willing/able to do. It might be wise to make your goals clear through, going into the program, of how alert you want your mom to be able to be as they devise med plans for her. Also, this experience with mom was about 6 years ago and I'm sure professional opinions have changed, about how to treat someone with your moms set of behaviors.

Good luck!!!

Thank you all for your suggestions and help with mom. I will try and answer the questions in the emails. My mom takes her roxinol and xanax by mouth in a liquid form that supposely goes into the skin quickly. She takes Trazadone at night crushed in pudding.

As for the qualifications for Hospice...mom has been on it twice. First time for 2 yrs. They told me the first time her diagnosis was failure to thrive..if they are loosing weight is also a red flag. The weight loss was mom's 2nd time being put on. Also they can tell in blood work if the numbers are changing they go on that. Both times the NH approached me about puting her on.

We have changed meds. many times and I think the bigger of the problem is she was so use to a much higher doseage of pain meds. at home.
Of course now she is older and might not be able to tolerate that amoount. They gave her a Haladol shot to calm her once and they informed me she would probably be knocked out for the day. She didn't even bat a eye but it didn't lower the volume of the chanting.
Mom only talks when you try to do something to her. She just wants to be left alone but that's impossible. Otherwise she either lays or sits in her wheelchair and says nothing.
Today wasn't as bad..I have decided not to take her to the dining room just for a drink of ensure. She hates it and thinks all the people laughing or smiling are making fun of her.
Then that's when it's my fault.

Again thank you for making me feel better and you are a great bunch of people. I'm so glad I found this group.
Lois~

Lois,
I know what you mean about the stress and constant anger. I had to learn howto take care of myself to reduce the stress.
My fave method of dealing with stress is getting physical. I walk or clean house while listening to my iPod.
I use a simple breathing exercise that I learned from someone at my local office of the Alz. Assn. It's quick and can be done almost anywhere, even driving.
Third, I have a prescription for Ativan. I'm taking less all the time as I get better at the others and more disciplined about doing them - but I take it when I need it. It helps put things in perspective and keep the stress from taking over my life.
One thing that I know would help more, is meditating. I don't do it regularly. It helps a lot when I take the time.
When I'm not so stressed, I can be more patient and help keep a calm atmosphere in my head, which helps me not to react so strongly.
K

I forgot to say that DH is also down to bed without low 119 pounds and 6'3" tall. I am concerned because he has fallen a couple of times and may again. There would be no way to keep him in bed without restraints at this moment.. Yet he fights getting out of bed in the morning sometimes til 1 pm.