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Topic Mom in ICU Go to previous topic Go to next topic Go to higher level

By kwannberg On 2009.01.15 07:23
I'm sorry I haven't posted in a while. My name is Kristine, and I'm one of the newbies on the forum.

Yesterday was one of the worst days ever. Mom tried to commit suicide yesterday. We found her and she's now in the ICU. She's stable now, but they have her on a breathing machine.

I called my Mom's place in her retirement residence a couple of times yesterday morning, and didn't get an answer. I thought this was weird, so I had a staff member from the resident check in on her. They checked and said she was sleeping. I thought that was probably o.k., since she doesn't get much sleep anyway, and she can use all she can get. I called again a couple of times in the afternoon, but she still didn't answer, and I got a bad feeling. My husband and I got off work, and she had overdosed. The medics came, and she had all of her store of fentanyl patches all over, and she may have taken some other meds.

I know she's in good hands right now, but I'm not sure what type of care she'll need. Do you know if most hospitals have social workers? I thought I'd call the retirement residence, and talk to their Director of Health Services. If she makes it out, we'll have to have someone monitor/administer her meds. I'm not sure if she's to the point of needing skillled nursing care or not -- before she did this, she could barely move and she's been in so much pain.

Mom's not out of money yet, but the bills are pilling up. I've checked into Medicaid (just started reading information on Oregon's state websites, but I have't made a call to the Human Services Department). It the eligibility stays rules stay as they are currently, she could qualify when her 401 money runs out, but the Governor's proposed budget for the next fiscal year recommends reducing the eligibility amount, and she would make too much (by $100) to recieve Medicaid.

I feel so sad and frustrated and confused as to what to do! I know she doesn't want to continue and there isn't a lot of hope, and I feel so guilty -- part of me wishes that God would just take her so that she's not in all the pain anymore. I feel so bad for even thinking that.

By susger8 On 2009.01.15 08:15
Oh, that's rough. I completely understand feeling that it wouldn't be a bad thing for her to move on from this world. I feel that way about my father sometimes.

The hospital should have a social worker who should help you figure out the next steps. I would also suggest talking to the people at the retirement residence.

By Pick On 2009.01.15 08:20
I don't really have any helpful comments except that yes, as susger8 says, the hospital should have a social worker. Please ask any nurse, doctor, etc.

Like I said, no answers from me but i just had to post to let you know my heart and prayers are with you. I know what it is like to lose a loved one to suicide. You are not alone. God bless you.

By lurkingforacure On 2009.01.15 09:13
That is so tough. It should help that she is in a good facility, though, and your mind clear that you are doing the very best that you can. Please also remember that however mean or rude she may act at any one moment, deep down she must know how much you love her. That is what really matters, and that is what really counts.

By annwood On 2009.01.15 12:06
Fortunately this is the first time to my knowledge that this has come into the forum and I am so sorry that you are going through this. I am sure that many pts with PD have consider the possibility at one time or another. This is just an awful disease, isn't it. When I worked in oncology drs and nurses were well aware that some cancer deaths were suicide. Pts would store up their meds and use them at the time of the suicide. Sometimes the pain and misery just becomes too much and this is an attempt to take control of one's life if for no other reason than to end it.

Every hospital has a Social Worker that will help you when things get stabilized. I am sure Adult Protective Services will also be involved when the time comes. Right now you need to just concentrate on your Mom and be there for her.

Given the information you relayed in your post I think that I would be screaming at the retirement center's administrator or director of nursing. If you called and expressed you concern more than once someone should have been taking a closer look at you mother yesterday.

By caregivermary On 2009.01.15 14:44
Elder Care Atty will be able to help with the qualifying issue. There are some ways to resolve it based on what you stated in your post. You may even be able to get a free consult with the atty and arrange a small fee for this help.

By rajenriver On 2009.01.16 14:59
In several states, there is a program called the Miller Trust. If you are over the eligibility level, you can contribute to the trust and it will adjust your income level and allow you to qualify. I would think that the social worker at the hospital, or the management team at any nursing home would be aware of the opportunities available in your state. We first found out about it when talking to the assisted living home where we first placed my FIL. So far, he has been able to qualify, but he is very close to the limit. As stated above, it would probably be best to contact your state's aging resource for direction.

http://www.ltciacademy.com/ltcu/www/index.cfm?fuseaction=library&location=http://www.ltciacademy.com/ltcu/www/courseware/media/library/LL3_T4_4.html

By kwannberg On 2009.01.19 18:18
Hi Everyone -- I just wanted to give you a little update about Mom. It's been a wild and very emotional rollercoaster the last several days. Mom was in ICU for a couple of days after she tried to committ suicide. She was unconcious and they said she'd had a long time without getting enough oxygen to her brain. The doctors told us she really wouldn't recover long-term, and would have brain damage. She had essentially had a stroke because of the oxygen issue. My brother and I got out the living will and the health care power of attorney, and we stopped all food and hydration and said our goodbyes. I knew it was going to be pretty hard, and it was. The next day (Saturday, I think), she had improved a bit - she was concious and talking a tiny bit. Mom indicated that what my brother and I had directed at the hospital (the no food or hydration) was consistent with what she wanted. So, the hospital had us work with hospice, and she's been at her retirement residence in the respite care room since yesterday evening.

She can't really move her body much. She's told the hospice people she doesn't want to take her Parkinson's meds any more, but she was eating a tiny bit this morning, and she was drinking some. That really surprised me, since she's been so adamant about wanting to die. In fact, she told me this morning, she still wanted to go to the otherside. My brother and I talked with the hospice nurse (who was a super nice person), and she said that Mom's not actively dying, but strikes her more as someone who is very sick and she doesn't have much will to live any more.

Anyone know what happens if you go off the Parkinson's meds? Mom's been having some hallucinations, and I'm not sure if that's from dehydration or not being on the Parkinson's meds. At one point when I was there she asked who all the people in the room were. She said they were all people with Parkinson's Disease. I told her that I thought she was probably hallucinating, and she said that was probably right, but at least the people weren't being mean.

Thanks for the information about the elder care attorney and the trust. I did talk with the folks at both hospice and her retirement residence about Mom's eventual need to get onto Medicaid. I think that'll happen in about 6-8 months. They said they'd help us through the process.

I have to say, thank God for the hospice folks. I've only worked with them for 48 hours, but they've been so helpful. At least Mom's not in a lot of pain currently, and they've provided some good support to us too. At this point I have no clue what's happening either short or long-term. The nurse said that Mom was a 50/50 right now -- she could either rally and get better or she'll start to decline more. We'll know more after about a week. At this point nothing much would surprise me.

Thanks for listening to this long tale...
Kristine

By annwood On 2009.01.19 19:34
Hi, Kristine
This is hard, I know. In my personal experience taking a person off the PD meds at this point has very little effect and should not account for the hallucinations. Most PD pts have become refractory to the meds at this point and it really makes little difference if they take them or not. I would expect the hallucinations to be more from the oxygen deprivation or the morephine but the Hospice nurse is your best resource person at this point. I have worked with many dying pts and they tend to see things and have conversations with invisible people so perhaps that is what is going on. A dying individual often looks off into a specific area of a room and stays fixed on that spot. In my husband's case I even tried standing in front of him and he would look around me to that particular spot. I have no idea what they see. This stage can last for 2 or 3 weeks. When ther lower legs become mottled (blue & gray) death is imminent. The oxygen levels also begin to decrease. Pneumonia sets in and it depnds upon the pt's cardiac status just how long it takes. With Hospice the pt does not seem to experience any discomfort but just sleeps all of the time. They are very liberal with the morephine and at this point I believe that is ok. The idea is to make the individual comfortable. Even with no nutrition or fluid the process can take up to 2 weeks. Amazingly a pt can continue to have urinary output but once that stops death usually occurs within 24 hrs. Any food or liquid your mother takes at this point is probably just for her comfort. I would allow her to have anything she wanted and stop at any forced feedings or IVs. My husband had a strawberry milkshake (his favorite) and a few sips of wine with cheese a week before he died. He asked for the wine at 9AM on a Tues. morning and I thought what the heck. If he wants it I am going to give it to him. Make sure that they keep her mouth and lips moist since I always felt that would be very uncomfortable. They have special mouth swabs for that. As sick as they are you will be amazed at the body's will to live. It can be a slow process and painful only to those who are watching.

Talk to her and tell her anything you want her to know during the times she is awake. Even if she becomes comatose it has been proven that the patient continue to hear what is being said around them. I am fortunate in that I have a very strong faith and I trusted that my husband was going to a better place where he would not have PD and dementia. Despite that it is hard and very, very sad.

I pray that you mother responds and gets back her function. Stay with Hospice. I don't know what I would have done without them - they are wonderful people.

By susger8 On 2009.01.20 08:40
Annwood, that's a very sensitive description of the process and fits with my experience when my mother died.

I want to mention that it's common for a dying person to have a short period of appearing dramatically better shortly before death. They may suddenly become lucid, sit up, talk with their loved ones. Some people say it's when the dying person accepts that they're moving to the next phase of existence. I've seen it happen, and I've been told by a surprising number of other people that it happened to their loved one.

Hospice is an incredible service and I can't say enough good things about the people who do that work.

By kwannberg On 2009.01.21 08:01
Thanks so much for the information. Anything to help me know what to expect, is good. I know it's not going to be pretty.

That's interesting that you mention someone doing well right before they die. I was told that happens when my grandma died, and also when my step-mom died of cancer. In my grandma's case, she actually could recognize people and talk with them. She had pretty advanced stage AZ when she passed away.

-- Kristine


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