Options for my mother

[utrecht]

My mother is only 67 but she has been drinking and smoking for 40-50 years, the last 10 years in excess. She has the body of an 87 year old. She has severe pain from arthritis and who knows what else so she also takes hydrocodone, and probably too much of it. She hardly eats and is very very weak, probably because she is full from the pills and vodka. Its hard to feel sorry for her because this is mostly self induced but she's still my mother.

She can barely do anything for herself. She literally can barely get across the room. My wife and I do all of her grocery shopping, take her to her doctor appointments, ect. She is very weak and twice has not been able to get off of the toilet. This evening she called and said she couldn't stand up and get to her walker so she crawled to the living room and laid there for 12 hours. Why she didn't call earlier is beyond me. We live less than a 1/4 mile away and my wife was off all day today.

Anyway, what options would you say we have? She is very stubborn and will refuse to go to any type of assisted living, although we haven't brought up the subject. Does medicare / medicaid pay for any type of nurse to come to the home? Does it pay for anything else that would be helpful including assisted living if it comes to that?

 

[Buckeye]

So who is buying her booze for her?

 

[W2R]

My sincerest sympathies on this situation.

My advice would be for you and your wife to have a serious talk with her doctor. I can't imagine that he would prescribe hydrocodone to the point that she cannot even stand up, if he knew it was that bad. Maybe he has some ideas for care for her.

As a 63-year-old myself, your story is pretty hair-raising. I can't imagine living like that. What an awful fate. Do you think that she would benefit from psychological help? From AA? From "drying out" at one of those rehab places?

 

[Bestwifeever]

Drag her to a new doctor and lay it all out.

 

[Moemg]

Drag her to a new doctor and lay it all out.

So sorry to hear this but i agree with Bestwifeever . She needs a more aggressive Doctor . Medicare will pay for home health but it is usually limited and after a hospital stay . Hydrocodone & Vodka are lethal combos ! Good Luck !

 

[GregLee]

She is very stubborn and will refuse to go to any type of assisted living, although we haven't brought up the subject.

I think it's time to bring up the subject. Maybe she'll be totally against assisted living or a nursing home, but maybe not. Give it a try. Her physical condition sounds similar to that of my mother when she was about 87 -- though she never smoked, she did have an alcohol problem.

Does medicare / medicaid pay for any type of nurse to come to the home?

I think Medicare will pay for treatment of specific medical conditions, including paying for home care for limited periods. I don't have experience with Medicaid.

Does it pay for anything else that would be helpful including assisted living if it comes to that?

I don't think Medicare will pay for assisted living.

 

[Ally]

Our experience was that Medicare wouldn't pay for assistance, my dad had to pay. I would suggest paying for one of those life alert things, so she press it for help. It's worn around the neck. They can call you first to go check.

I am terribly sorry that you are facing this situation. I would make an appt with her DR and lay it all out, even though he may not be able to tell you much or respond. But he can listen and perhaps take it all into consideration with her care. This is what I did when I thought my mom had Alzheimers and she wouldn't go to the DR if I was with her ( she knew I would tell the Dr what was going on.) So I went alone and he was very grateful for the info and was able to begin testing and treatment.

 

[Moscyn]

Very sorry to hear this. It's time for tough action and a very direct doctor telling her to dry out or face an even more painful road. Also, she can try out nursing home - temporarily first if she needs a lot of convincing.

 

[utrecht]

So who is buying her booze for her?

I am, because if I don't I believe she will try to get in her car and try to do it herself and she may kill herself or someone else.

Try to imagine how this makes me feel. I'm a 21 year veteran cop who doesnt drink.

I just checked my debit card records. Im buying her 4 cartons of cigarettes every 3 weeks and a case of vodka every 3 weeks. Something obviously has to change. She bought her house near me about a 1 1/2 - 2 years ago and I distinctly remember her house hunting with no problem like any other 65 years old would do so she has deteriorated to this point in less than 2 years. Up to this point Ive been telling myself that she is in so much pain that she should at least be comfortable for whatever short time she has left. Its not like quitting smoking at this point is going to make her live longer. Now Im not sure what to do about all of this.

 

[chinaco]

Sorry this is happening. Alcoholism and substance addiction takes a terrible toll on the addict and the family.


Since she has chronic pain... pain medication may be needed. But I would think she should still be able to take some amount to manage the pain and still function.

IMO - The smoking and alcohol really has to go!

See if you can get her into some sort of Detox! Maybe you can use her medicare benefit for NH care (I think it is 60 days) to dry out and get the help with the ADLs during that time. Get her to a new doctor and into a detox program (if you can). You might have to transport her to some sort of group sessions once she sobers and gains some strength.

 

[MichaelB]

Drag her to a new doctor and lay it all out.

+1

 

[rescueme]

I can only suggest something that may help you and DW in this situation:

Welcome to Al-Anon Family Groups

 

[Walt34]

Drag her to a new doctor and lay it all out.

That again. And while the doc may not be able to help directly, he may be able to point you to someone who can. At the least he has to know what's going on there.

 

[utrecht]

I agree with all of the suggestions. The biggest problem is that although her body is completely broken down, her mind is sharp as a tack and shes used to being very independant. Shes not very open to suggestion. For 8 months she refused to let my wife do her laundry even though she physically cant do it.

Her entire life consists of this:

1) Wake up
2) Sit on the couch literally all day watching TV because she doesnt have the strength to do anything else
3) Take an unknown amount of prescribed hydrocodone
4) Smoke. Never opens the windows to air the place out even when the weather is perfect so she sits in a chamber of toxic fumes all day. I cant stand to be in her house more than 5 minutes at a time.
5) Nap an unnatural amount of time during the day due to having no energy and drinking
6) Eats one meal per day which is probably half of what she should eat (hence having no energy). Ive taken hydrocodone in the past for a herniated disc and I ate nothing for a week. It bloats your stomach.
7) She sleeps on the couch so she wont have to get to the bedroom
8) She has a stack of unpaid bills all over the place. Shes obviously able to pay the bills (and has the money to pay them). She just has no interest in anything.

Her husband died about 5 years ago which I believe is what caused her to just stop caring about anything. It seems to me like she is just waiting to die, although she has some type of spot on her lung and when she found out it might be cancer, she told my wife she was scared (she didnt even tell me what the doctor said).

She has many doctors.

1) A pain management doctor
2) Lung doctor
3) A new doctor shes about to see for severe swelling in her feet and ankles (to me its obvious its from lack of circulation from never moving around)
4) Some other doctor she goes to every 4 months to get some spinal tap type of cortisone injections directly into her spine

I take her to her doctor appointments but have never spoken to any of the doctors because Ive been trying not to make her feel like a child by taking over her life. Up to his point Ive only done what shes asked of me, not told her what to do. Last night was the last straw for me when i realized she laid on the floor for 10 hours without calling me because she didnt want to feel like a burden to us, although she does not hesitate to call if shes out of Vodka or cigarrettes. What would be my first step when you guys say "lay it out to her doctor"? If she needs a "new doctor", what kind of doctor? Im going to try the advice you guys are giving but remember that shes not mentally disabled or incapacitated so I have no power to make her do anything and shes VERY stubborn. She wont even admit that shes weak because she doesnt eat enough.

 

[Buckeye]

I am, because if I don't I believe she will try to get in her car and try to do it herself and she may kill herself or someone else.

Try to imagine how this makes me feel. I'm a 21 year veteran cop who doesnt drink.

I just checked my debit card records. Im buying her 4 cartons of cigarettes every 3 weeks and a case of vodka every 3 weeks. Something obviously has to change. She bought her house near me about a 1 1/2 - 2 years ago and I distinctly remember her house hunting with no problem like any other 65 years old would do so she has deteriorated to this point in less than 2 years. Up to this point Ive been telling myself that she is in so much pain that she should at least be comfortable for whatever short time she has left. Its not like quitting smoking at this point is going to make her live longer. Now Im not sure what to do about all of this.

I don't suppose she would burn down more than her own house if she passed out with a lit cigarette. I agree with you about not being concerned with cig-related health issues at this point given the other issues. Sounds like it might even be dangerous to stop the booze cold turkey without medical assistance. I personally wouldn't hesitate to put a Club on her steering wheel to ensure she couldn't drive the car.

 

[utrecht]

I could take her keys and stop buying alcohol but my guess is she would then just take more hydrocodone. Not too mention be ticked off even more at me than she probably is at the whole world for the situation shes in. I just dont see how that really helps.

 

[REWahoo]

I could take her keys and stop buying alcohol but my guess is she would then just take more hydrocodone. Not too mention be ticked off even more at me than she probably is at the whole world for the situation shes in. I just dont see how that really helps.

You need to come to grips with the fact you're gonna tick her off no matter what you do. The question you need to answer is ticking her off a fair price to pay for extending and improving the quality of her life. From where I sit in front of my computer terminal, I'd think the answer is yes, but I'm not the one who has to face her.

Good luck with whatever you decide to do.

 

[Nords]

I could take her keys and stop buying alcohol but my guess is she would then just take more hydrocodone. Not too mention be ticked off even more at me than she probably is at the whole world for the situation shes in. I just dont see how that really helps.

Here's something to consider.

When my father was (very stubbornly) living independently with Alzheimer's, his symptoms got to the point where he couldn't remember how much he'd had to drink. His 5 PM pre-prandial drink with the TV news would turn into two or three... or ten... until he [-]passed out[/-] fell asleep in front of the TV without eating. He still had breakfast & lunch supplies in his fridge, but no dinner supplies. I guess alcohol was effectively his dinner.

After a couple months of this, the alcohol on an empty stomach ate a quarter-inch hole in his duodenum and flooded his peritoneal cavity with his stomach contents. I'm told it's intensely painful.

His symptoms resembled a heart attack, so the ER spent a couple hours chasing that wild goose until they thought to move the CAT scan a little lower. The surgeon said that by the time they figured out the problem they'd almost run out of time to do the surgery.

So I guess you have to decide which approach is helping less: buying your mother the tools with which to hurt herself, or forcing her to buy her own tools.

Everyone's body is different, but if you continue your current actions then I suspect that you won't have to cope this situation for much longer.

 

[utrecht]

Based on my debit card transactions shes drinking about a bottle of Vodka every 4 days. I dont drink so Im no expert. Where would you say this ranks on the "alcoholic" scale? From 1-10 with 10 being "time for rehab".

 

[REWahoo]

Based on my debit card transactions shes drinking about a bottle of Vodka every 4 days. I dont drink so Im no expert. Where would you say this ranks on the "alcoholic" scale? From 1-10 with 10 being "time for rehab".

I don't think you can look at her alcohol consumption independent of her hydrocodone intake. Sounds line a 9 or 10 to me.

From Wikipedia:

Mixing hydrocodone with alcohol.... can have severe adverse reactions including but not limited to heart failure, heart attack, respiratory distress, pulmonary failure, liver or kidney failure, jaundice, amnesia, seizures, blackouts, and coma

 

[MichaelB]

This may not be just alcohol and could be her way of dealing with pain.

She probably needs a complete physical but you cannot force her to get one. You might consider one session with a therapist that specializes with substance abuse to ask for advice on specific things you can do to help her.

Without a HIPAA consent form her doctors are unlikely to talk with you, with one you could discuss it with them. Perhaps you can get her to sign one when she asks for a resupply. If she does, at least you can discuss this with her pain management physician.

 

[Nuiloa]

Your story is a carbon copy of my own history with our mom.

She smoked 3 to 4 packs a day and drank 15 or more beers (Canadian beer at that - much stronger than US stuff). She didn't eat - a half a bologna sandwich would last her 3 days. We enabled her - bought her the beer and cigarettes because, after all, she was our mom.

She was down to 76 pounds, had broken several major bones from falling (hips, ribs, arms, pelvis at different times) and spent 12 hours on the floor in her kitchen one winter's night, after falling and being too weak to get up or reach the phone. That's when we persuaded her to move to an assisted living residence.

Unfortunately, they turned out to be highly abusive (we sued and won). From there, she moved first to my brother's and then to my sister's place. The bad habits didn't change until her doctor finally told her that she had to go into a nursing home and wait to die, because she obviously wasn't going to listen to medical advice.

That made her so mad, she quit smoking cold turkey, quit drinking, started exercising and eating. She put on 50 pounds, which brought her to about 125 pounds. She bought herself an extra 10 years of life, we figure. It was great - a lot of damage was done - but she travelled, camped and went to concerts and the casino. She died in February at the age of 83.

My advice: TOUGH LOVE. Take her car keys away (she shouldn't be driving on drugs or booze!), stop buying her booze and tell her that her options are to either start eating or go into a nursing home. I always feel that if we had done that when mom was in her 60s instead of waiting until her 70s, her quality of life would have vastly improved and she could have kept her house instead of going to the horror of that assisted living facility.

 

[Queenie]

So sorry to hear this, both for you and your mom. I agree with everyone above, tough love is the only way to go. Perhaps she became depressed aft the death of her husband? Did she have an grief counseling at the time? Often in the elderly depression is overlooked when one of the couple dies and the other tends to let themselves go.

I know for a fact a good assisted living home will not keep her if she is drinking, they are worried about falls and such.

Also very important is that she not detox alone from either the alcohol nor the other drug. She must be monitored.

Wishing you the best of luck.

Queenie

 

[bbbamI]

I'm so sorry you're going through this.

Have you considered talking to your doctor about it? Perhaps she/he could suggest more options...

 

[utrecht]

I'm so sorry you're going through this.

Have you considered talking to your doctor about it? Perhaps she/he could suggest more options...

My wife and I are healthy as a horse so we dont really even have a family doctor.