Q: My aunt is in a nursing home on a fluid-restricted diet. She is trying to drink other residents’ fluids, and she is trying to open the staff refrigerator to get liquids. I know she understands, but why doesn’t she comply?
Q: My aunt is in a nursing home on a fluid-restricted diet. She is trying to drink other residents’ fluids, and she is trying to open the staff refrigerator to get liquids. She understands she cannot drink too many liquids, otherwise she will end up back in the hospital. I know she understands, but why doesn’t she comply?
A: It is very frustrating and very challenging. On one level, she understands that too many liquids will have a negative effect. On the other hand, she is watching everyone around her drink liquids. In addition, activities during the day in many facilities center on food like snacks and meals. It is always difficult and challenging to stay on a diet without cheating. When there is a life-threatening outcome from any food allergy or restriction, sometimes it is easier to comply. However, if there is memory loss involved, your aunt may have moments whereby she forgets she has these restrictions.
Q: My father is in a nursing home on hospice care and very badly wants to return home. The hospice informed me my father could return home. The challenge is making it happen. My father has some wounds that require changing at least three times per day. The cost of hiring someone to change the dressings is very expensive. Are there other ideas that would allow my father the ability to return home?
A: Unfortunately, hospice cannot send a nurse to change the dressings throughout the day. The dressings could be changed by a family member if someone was capable of taking on that role. A home health aide is not able to change the dressings –– it must be done by a nurse. Some medical home care agencies have nurses who can come in on a daily basis, but the cost is very high. There are some hospice homes that feel more like a home than a medical setting. That will give your father a more homelike feel. A hospice home can provide care throughout the day and night.
Q: My mother is not paying her bills or managing the home. She’s repeating things she’s said before and just not able to do what she once did. When I went to look into her finances, she had spent a great deal of money, but there is nothing to show for it. In fact, she has been bouncing checks lately and has applied for a second mortgage. My mother was always so good at managing money. I can see the change in my mother, but my two siblings cannot. My mother needs her family to take over; she needs to see a doctor, and we need to all work together. How can I convince my siblings that we have a problem?
A: You are not alone. As children, we want to see our parents as “our parents,” not people who are getting old. Sometimes children rely upon their parents for emotional support, and if that parent is different they may not be able to give the support needed. Also, your mother may be able to talk with her children by phone and cover up what is going on inside her home. It is important to contact your mother’s physician and schedule an appointment. If your mother will not let you go to the appointment, send the physician a fax or letter with your observations. Prior to the appointment, have your mother sign a form that will allow you to talk with the physician. Ask the physician for a report of the exam. This may be enough proof for your siblings. If that plan does not work, then consider hiring a geriatric care manager to complete a home evaluation. The geriatric care manager can assess and make recommendations with a consultation report. Consider a family meeting with the geriatric care manager to discuss the evaluation. Maybe after seeing a physician’s report and meeting with a geriatric care manager, your siblings will be able to understand what is happening to your mother.
Debbie Gitner, a licensed certified social worker and certified social worker care manager, and Linda Sullivan, a registered nurse and case manager certified, are geriatric care managers and owners of ElderCare Resource Services helping families investigate, assess and choose medical and non-medical care and resources for seniors.
Send questions to firstname.lastname@example.org or ElderCare Resources, Inc., 29 Gano Road, Marlborough, MA 01752, or call them at 508-879-7008.