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By SandwichMe On 2009.09.02 10:48
I've been lurking for awhile, so not totally a newbie. I am a mother to four kids ages 5-20 and a caregiver to my FIL and MIL who live in an apartment on our property. FIL has PD now for 10+ yrs. He has been declining rapidly over the past few months. Crazy blood pressure changes, really low blood sugars (previously they'd always been high, he's diabetic) and more and more confusion. About six weeks ago he started having horrible agitation issues and the neuro admitted him to the hospital to sort out the BPs and control the agitation with some med trials.

They ended up taking him off all BP meds, and sent him home with a PRN Ativan order. He did pretty well in the hospital, walking okay with a walker and one assist at times. He hasn't been able to shave or bathe alone for a year and always needs help dressing, so that was continuing there.

He's been home for ten days. We have had Hospice involved for a week now. (He needs 24 HR supervision).

In the past ten days, he's needed Ativan every four hours to control the restlessness and agitation. He's eating if someone feeds him, but having more and more trouble swallowing each day. He's so disoriented most of the time but at other times okay.

Yesterday he fell because he forgot to ask for help getting up and he walks like a staggering drunk.

I guess I'm just looking for some ideas on how to remind him to ask for help. MIL can't be his only assist and we've got 16 hrs of home health aides, but in the evenings, she's alone with him.

Sorry so long.

By susger8 On 2009.09.02 11:06
Hi, Sandwich Me (good screen name, by the way),

People in the late stages often have problems with short-term memory. I don't think there's likely to be a way to get him to remember to ask for help. It's pretty common for PWP to forget that they have problems with getting up, walking, etc.

Wish I had a better answer. That sounds like a tough situation.

Sue

By bandido1 On 2009.09.02 12:33
SandwhichMe: Welcome to the live segment of this forum. If he does not have a life alert system or a cellphonr strung around his neck (as is mine),consider how he might be able to call for help whenver he is alone. Also, talk to your home health people. They may be able to add their emergency number to the cellphone's ICOE feature. Bob C

By SandwichMe On 2009.09.02 13:59
Thanks for the responses so far and the welcome!

He is never alone in the house but he doesn't have anyone directly next to him all the time. The problem is that he now thinks he can walk without assistance. He has used a walker for two years and a wheelchair for one.

His dementia is now in full force (worse in the last two weeks) and he's hallucinating a lot. So, he's forgetting that he can't walk safely and he just bounds up out of the chair or bed and starts to go. No one hears him. For two days he has no idea where he is either and I'm worried he'll try to get out the door and fall outside somewhere.

I'm looking for a bed/chair alarm so that MIL will at least hear him moving and get there in time.

He's in bed nearly 20 hours a day now.

I really think we're in the end stages of this fight. I just don't want him to die from a fatal head wound or suffer a break and have pain. He's on warfarin for blood thinning and that would be disastrous if he fell again.

I'm also a nurse, and have done both inpatient critical and hospice home care, so I can kind of visualize what's coming.

By susger8 On 2009.09.03 09:06
Many communities have a service that provides a bracelet with a GPS for people with dementia who might wander. If the person takes off, you call the police and they can trace it (kind of like a Lo-Jack for humans, ha ha!). In my area this is available free, through the county Office on Aging.

My dad had one of those bed/chair alarms when he was in rehab after breaking his hip. This place has them (you have to buy the pressure pad separately).
http://www.ameds.com/moreInfo.php?ProductNumber=TL-2100E&SubCategoryID=1304

My experience is that it's pretty much impossible to prevent all falls. My dad has had two serious ones.

By SandwichMe On 2009.09.03 18:36
Thanks for the link on the alarm! I checked it out last nite and I'm going to see if MIL thinks it's something she wants. He got up and out to the dining room by himself three times today and then fell into the table again before she heard him. We have to do something!

By annwood On 2009.09.03 18:54
My husband had the same problems the last few months of his life. He was unable to walk on his own but forgot and tried. You could not even leave him alone long enough to go to the bathroom. There is an alaerm pad that fits under the bed sheet and a clip that attaches to the patient. Our Hospice found this for us. I believe they also have them at medical supply stores. At the end I had to posey him into a chair. I am also a nurse so you probably know that posey belts are no longer allowed. I purchased a lift belt and clamped it in the back of my husband's wheelchair.

You won't like this but you have to accept the fact that he may fall despite all efforts. My poor husband was bruised from head to toe at the end. He fractured his ribs and his right wrist. He somehow managed to work off the fibercast cast a week after it was put on. It is a challenge.

By SandwichMe On 2009.09.03 19:05
I've seriously considered rigging some type of Posey thing at times!

The Hospice doc recommended taking him off the Warfarin today after he was here and observed him trying to get around. At least that will be a better outcome if he does fall again.


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