I have a question that maybe can be answered here. My gma had to be put in a ltc facility about a year ago. She has always had mental issues (severe panic attacks, agorophobia, "imaginary" symptoms, etc.) and once her husband died she basically laid down and didn't get out of bed. This caused her muscles to atrophy, etc. and now she really can't get up out of bed. She had a "helper" but the helper ended up stealing from her, threatening her , slapping her, etc.
so off to LTC she went. (no one else in the family could physically or emotionally take care of her, she is about 170 lbs. of dead weight. She did not even attempt to get up, walk around, leave the house, or even watch TV She also had a habit of calling 911 sometimes several times a night for things like turning down the a/c, help to go to the bathroom , etc.)
Since being in the facility she still refuses to get out of bed and is having panic attacks. She was on valium for 35 years (!!) but had to be taken off of it cold turkey because it was damaging her intestines.
The nurses have suggested she listen to relaxing music, etc. but she just doesn't seem interested. I don't think the ltc facility is necessarily a bad one. I do think she is severely depressed, has OCD, and horrible panic attacks. She has been having these attacks for probably 60 years. It is just so sad. Are mental issues so severe common in ltc, or is it mostly your "run of the mill" depression and dementia ??
She is still very sharp and very kind (not combative at all, if anytying she is passive) but the anxiety is just like something I have never seen.
perhaps she would be a good candidate for some type of pet therapy,if her facility has that available.you might be surprised
oh honey , i wish :( she is horrified of animals , particularly cats (more like has a phobia of them !!) Growing up, she always "tolerated" my animals but never cared for them much. Acutally the nursing home she lives in has several cats and she has complained about them peeking in her room. :) She has so many irrational fears and anxieties. It's like she cannot enjoy ANYTHING AT ALL. no pleasure in life, whatsoever.
well,it was just a thought.we are getting ready for this hurricane.we are expecting a direct hit or at least a lot of wind damage.pray i will still have a house standing after the hurricane.wish you the best of luck in your situation.i had a homecare pt a year ago that sounds very similar.nothing we could do would help.and i mean nothing.
Is there a Gerio Psysh Unit near you (also called Senior Care Unit)? We have one in our hospital for short term admissions (2-3 weeks max) and they do a wonderful job getting these patients functioning to their best ability. Also, gets patient in with a psychiatrist who treats them inpatient and sees them on an OP basis as well.
Maybe the Social Worker at the LTC could help you.
I have a question that maybe can be answered here. My gma had to be put in a ltc facility about a year ago. She has always had mental issues (severe panic attacks, agorophobia, "imaginary" symptoms, etc.) and once her husband died she basically laid down and didn't get out of bed. This caused her muscles to atrophy, etc. and now she really can't get up out of bed. She had a "helper" but the helper ended up stealing from her, threatening her , slapping her, etc.
so off to LTC she went. (no one else in the family could physically or emotionally take care of her, she is about 170 lbs. of dead weight. She did not even attempt to get up, walk around, leave the house, or even watch TV She also had a habit of calling 911 sometimes several times a night for things like turning down the a/c, help to go to the bathroom , etc.)
Since being in the facility she still refuses to get out of bed and is having panic attacks. She was on valium for 35 years (!!) but had to be taken off of it cold turkey because it was damaging her intestines.
The nurses have suggested she listen to relaxing music, etc. but she just doesn't seem interested. I don't think the ltc facility is necessarily a bad one. I do think she is severely depressed, has OCD, and horrible panic attacks. She has been having these attacks for probably 60 years. It is just so sad. Are mental issues so severe common in ltc, or is it mostly your "run of the mill" depression and dementia ??
She is still very sharp and very kind (not combative at all, if anytying she is passive) but the anxiety is just like something I have never seen.
Specializes in LTC,Hospice/palliative care,acute care.
It can be very difficult to get consulting doctors into LTC facilities.(lots of hoops to jump through and not much compensation)..We do have a psychiatrist that rounds once a month-he does return phone calls within and hour or so....It's probable that the best you can hope for at this point is comfort but I have seen wonderful things happen with the right combo of meds.We are seeing more and more residents with psych diagnosis-and handling them in LTC is be a challenge...Maybe if her depression and her anxiety can be treated she will want to take an active part in PT.But I have also seen residents live out their last yrs lying in bed 24/7......They can be strongly encouraged to take an active role in life but if they refuse we can NOT force them-we can not forbid them from lying in bed all day-it is their right to control their own body...We have 2 local geri-psych units and they are wonderful-meds in the elderly need alot of tweaking-you'll need to keep in close touch with the nursing staff
Specializes in LTC,Hospice/palliative care,acute care.
as a nurse, i would not allow someone to stay in bed 24/7.
i contract with them and let them go in baby steps, i.e., oob for a couple of hours at first and slowly build up.
also put them in a gc where they can recline and feel comfortable.
and will put gc right outside their room so they're not overstimulated, anxious or intimidated by too many people around.
99% of the time, they do take an interest in their environment, as long as they're feeling safe.
other times, i've brought fearful residents up near me so they can always see me and feel safe that way.
but a therapeutic relationship obviously needs to first be established between nurse and patient.
gma being in bed all day is just adding to feelings of isolation.
not healthy at all.
This brings to mind the thread regarding the fella's right to refuse to go to the doctor-----In PA in LTC it is against the law to FORCE or FORBID any resident....I had 1 resident today on my 22 bed unit that is alert,oriented and has not gotten out of bed for YEARS.....He was bedridden before he was admitted-this is the life he has chosen to live and he is content...We have documented well that this is HIS choice ...We have another right down the hall-a younger woman with a degenerative neuro-muscular disease....She only gets out of bed for a half a day once a week-this is HER right...It might not be the way we would choose to live but that does not make it wrong....
we have some residents who stay in bed quite a bit-- if i knew your grandma her behavior would not faze me. i would be concerned, but it would not surprise me. sometimes the more someone gets pushed to do what others want them to do to be "normal," the harder they resist. i am not saying you are doing that--just an observation. make sure she knows it is okay with you when she does things she wants to do, even if that is only stay in bed, and then maybe she will be more responsive to doing the things you want her to do. if she is in bed she needs to be on a turning schedule--is she on one? are you a nurse? i am only a CNA. i work with lots of quirky people, residents and others! has she been told she has OCD? or anxiety? just curious. definitely not recommending she be told she has OCD or anxiety. how does she tolerate showering? i am curious because showering is, technically, getting out of bed. many people who are older have issues about water-- but maybe you could help shower her? and do some range of motion exercises while she is in shower if you are concerned about keeping her moving? or is that just too personal for you? lots of residents respond really well to things that they dont want to do if their family member is there cheering them on. she couls sit on shower chair and do ROM-- you could have an aide help if needed. it is a very small idea but since she is going to need to shower anyway... don't tell her in advance you are doing ROM (too overwelming) just try a little after shower and see how it goes, maybe. i am not really as qualified as others to give advice but you could have a care plan meeting to discuss ideas with nurses and PT and everybody else. it is possible ROM in shower may be too much at once.. maybe do shower and then while she is still up find a reason to keep her up out of bed... maybe tell her yu want to change linen on bed and ask her if she'll walk with you to linen room. or roll her in w/c. be creative!
ocurred to me i should point out that as only cna i am not included on care plan meetings and anything i say should be run by nurses first. does she go to dining room to eat? is it possible to make sure she is sitting with residents she might possibly like and connect with?
Specializes in LTC,Hospice/palliative care,acute care.
ocurred to me i should point out that as only cna i am not included on care plan meetings and anything i say should be run by nurses first. does she go to dining room to eat? is it possible to make sure she is sitting with residents she might possibly like and connect with?
(off topic) You pointed out one of the biggest problems in LTC-lack of communication....Who delivers the hands on care via the care plan? The CNA's.....You should be more involved-if not at the team meetings at least the charge nurse should hold a meeting on the floor for a few minutes each week to bring everyone up to speed.....Many nurses feel care plans are a waste of time-I find them very effective especially in geriatrics-specifically in dementia care..,.
has she been told she has OCD? or anxiety? just curious. definitely not recommending she be told she has OCD or anxiety. how does she tolerate showering? i am curious because showering is, technically, getting out of bed. many people who are older have issues about water-- but maybe you could help shower her? and do some range of motion exercises while she is in shower if you are concerned about keeping her moving? or is that just too personal for you? lots of residents respond really well to things that they dont want to do if their family member is there cheering them on. she couls sit on shower chair and do ROM-- you could have an aide help if needed. it is a very small idea but since she is going to need to shower anyway... don't tell her in advance you are doing ROM (too overwelming) just try a little after shower and see how it goes, maybe. i am not really as qualified as others to give advice but you could have a care plan meeting to discuss ideas with nurses and PT and everybody else. it is possible ROM in shower may be too much at once.. maybe do shower and then while she is still up find a reason to keep her up out of bed... maybe tell her yu want to change linen on bed and ask her if she'll walk with you to linen room. or roll her in w/c. be creative!
Hi I am not a nurse or a cna, I am her granddaughter. No one in the family has pushed her to get out of bed. We have encouraged her, but not pushed her by any stretch of the imagination. We have said things like "it isn't healthy to just lay in bed all day and stare at the ceiling" but she does not respond. We have encouraged her to watch tv, go to church services, go to the salon (or whereever that is they do hair in the facility) but she refuses. Her feet are no longer useable, they have turned down (I don't know what the term for that is) You have to understand she has had "mental" problems from the time I was a very small child. I remember her going into crying fits for no reason , I remember her having to breathe in a paper bag, etc . It always scared and confused me, I didn't know what was happening, etc.
No, she has not been told she has anxiety, ocd, or anything else. I think that may be part of the problem though, that she has never sought any *quality* professional mental health services. Perhaps if she had been educated on her problems even up to 10 years ago she could have learned ways to overcome them or at least control them. It's all too late now. I am agreeing what some other poster said earlier, sometimes allyou can do is keep them comfortable.
TexasPoodleMix
232 Posts
oh honey , i wish
:( 
she is horrified of animals , particularly cats (more like has a phobia of them !!) Growing up, she always "tolerated" my animals but never cared for them much. Acutally the nursing home she lives in has several cats and she has complained about them peeking in her room. :) She has so many irrational fears and anxieties. It's like she cannot enjoy ANYTHING AT ALL. 
no pleasure in life, whatsoever.