My mom is here at my home in AZ for 6 month "visit" which I believe should be permanent due to her need of care. She's 91 and has been in MN living on her own until about a year ago when my nephew moved in with her to help out but due to working isn't there often. Some how some way she got a hold of an opiate pain medicine and started using it to help with her sleep (I'm pretty sure how she got it but I won't go there for now.) Insanely her friggin' doctor kept refilling it based on my mom's "promise" she wouldn't take it during the day. I suspected over the phone this summer she was indeed taking it during the day. Now she's in my home under my care and on her "last" bottle. I'm certain her doctor in MN won't refill it Long distance (I'll turn her into the law if she does) and there is no way my doctor here for her would. My mom when clean DOES want to get off of it, she realizes she has no choice. But she's hidden the bottle (I think I know where it is) and I can always tell when she breaks down and takes it. So I have two questions: first I believe she won't voluntarily give me the bottle, should I take it from her as I do have the opportunity when she's sleeping. There are only a few pills left if my estimates are correct. Second, and this may sound cold, but I can't STAND her when she's high. She's demanding in a rude and "be my slave" manner. If I don't bend to her exacting will she purposely pees on her bedroom floor. I'm so angry right now. I should be compassionate, I know, and I usually am but I just can't take this high ninny in my midsts. She hates going to the doctor, we've discussed her withdrawal symptoms and while clean she sincerely wants to battle it but I'm certain she's going to lie to me this next time. She actually seems to think I don't know when she's high but it's as clear as water. I'm at a loss of what to do just because of the simple fact she WILL run out soon and will have no choice but to get off them. I'm prepared for the compassion she'll need as she goes through withdrawal but dealing with this current druggie is driving me mad. Do I confront her, what do I do if (and she will, I know my mom) she lies about it? Say to her, you're not peeing on my floor anymore or stop acting like a victim when I KNOW you're more capable than that? Geeze I'm stuck. . . She's a wonderful lady that I adore when she's clean. I don't ever get stern with her and I don't really know how to approach this.
I'd also get some video of her while she's high and share it with her when she's clean. She'll probably be appalled based on her normal behavior.
I'd be concerned about the physical withdrawal she might experience. She needs medical help to get her through that. If she's going to be with you for a while, offer your loving support to get her off the pills. I would also look to see if there are Narcanon groups in your area to get some education from them.
I wouldn't take her pills while she's sleeping. She needs to trust you in order to work with you to get her through her addiction.
Video taping her is BRILLIANT! I know she'd be mortified by her behavior and cannot be aware of it, I'm certain of that. I agree, I do believe I need to get her into the doctor. My husband and I have come up with this plan of action and I hope you don't mind me running it by you: I'll get her positioned out of her room to sleep in her favorite chair in the living room. Then we'll find and check the pill bottle to see if indeed she is taking them or is this more a case of mental deteriation. If she is taking them, then beg her to go to my doctor to work out a plan for getting off of them (I'm certain she'll fight this idea). If its something medical then I can insist she go to the doctor because something serious is going on (as if this isn't serious enough, I'm terrified for her.) Now I ask, do I wait first for another episode (having a video of her would go a long way to convince her how serious an issue this is) or do I confront this head on?
When I've really had issues with my mom, I've cried. When I cry (because I'm usually so in control) it really tips her in favor of doing what I need her to do because it makes her understand I'm serious and at the end of my rope. I'm not doing it on purpose, I just get so frustrated that I break down in tears. I'm not suggesting that you fake it, but you gotta do what you gotta do to get her to get help. Good luck and keep us posted.
We were thinking when the next episode occurs (which terrifies me to wait because our research says this drug can be very dangerous if she tries to get off of it and has a relapse) to confront her at that point and compassionately yet directly ask her if she has taken anything and if she hasn't explain to her what we're seeing, why we're so worried and can we please take her immediately to the doctor. Absolutely if I video tape her I will ask her permission first for I agree 100% humiliation will not get me any where. Now if I may: here are the symptoms.
Her eyes become "beady" partially closed and one eye squints shut. She drools. Her speech is slurred and while cognitive the topics are strange like a drunk person. She becomes very weak and can't do things she has no problem doing otherwise. She becomes narcistic, rude and will suddenly give me the "evil eye" over simplistic matters. She doesn't ask for help and seems to want me to read her mind. When I don't guess properly what it is she needs she urinates on the floor as soon as I leave the room. This is NOT my mom. Sure, my mom has bad days when she needs heavy care because of weakness, down in the dumps and even times when she has a desire for sympathy, but this is really different. It's as if a completely different personality over comes her and wavers from demanding to guilt ridden. She's always been smarter and more alert than any of us even at 91. Can mental capacity diminish so quickly, radically and infrequently like this?
I keep my care for her at a high level always, knowing she hasn't had good care in the past as my brother and nephew believe she's way more capable than she is (they are SUPER good people, she just refuses to be honest with them at how hard things are for her.) Bottomline: I do too much, they don't do enough.
Sorry for the long explanations but I'm brand new at this. We don't even have kids so caring for someone in need is a foreign realm for me. Is waiting for another episode foolish? I'm just certain she'll deny everything if I approach her without evidence.
BTW, ladee - as much as I detest addiction, I believe those that beat it and work every day to keep on track are some of the most courageous, successful people in my opinion. I respect your success SO much!
As you have described the episodes my first thought is that she may be having small strokes rather than or as well as taking pills. The next time this happens can you tell her you think she is having a stroke and must go to the ER at once. would she go under those circumstances? as you have left the room when she is mad and urinates is it possible that she is actually incontinent at that time? Is her underwear wet? does she hide it and later rinse it out herself? this is quite a puzzle and I am just having random thoughts but the weakness following an episode and at other times certainly points to something medical.
My neighbor keeps ODing himself on Xanax and gets to the drooling out-of-it state. He thinks his mom is still alive (she died a year ago). He can barely stand when he's in that state. We called the paramedics on him last time and they admitted him to the hospital. If you can get her to the ER, they can take some blood tests and determine if her problem is pharmacological or physical. Once you know what you've got going on, you can get it treated.
maybe it is mini strokes. I would get her examined at the hospital next time something like this happens. If she refuses to go and not medically necessary she does not have to agree.
Who has her medical POA? That person should be able to get information. If nobody has it do that NOW!
Also consider a geriatric psychiatrist that could help identify what is going on with her.
It was as if magic happened and the strength I gained from approaching you all here and getting your advice transpired into reality. My mom and I talked. It was honest, thorough and life altering. It started off innocent enough and soon moved into discussing the future. I've wanted her to live with me for years and now it will be a reality. She's very happy here and I'm happy to have her here. With that discussion came a point where I could let her know I had serious concerns.
Let me try to keep this as simple as I can. First, I do not believe she is taking the "hydrocodone" on the sly as I had suspected. I'm very confident of this. I do believe the withdrawal symptoms should still be addressed by a doctor even if she isn't in current danger. I am now EXTREMELY concerned that something else has been happening and it started this last summer (I even suspect a fall caused it or "it" was the cause of the fall). She had no clue anything was happening and I followed the instincts presented here and didn't scare her by describing what I'm seeing; however, I did explain as part of her staying here I no longer wanted the antedotal remedies from my well meaning brother. I asked her to allow me to set her up with a relationship with my wonderful doctor here (if it takes getting a POA as what was suggested here, I'm all for that if she is, thanks for suggesting it.) I did express at the very LEAST if another episode occurs I want to address it immediately with her and deal with it right then and there. She is in agreement and while I was careful not to frighten her I think I got my point across that "something" is happening beyond her becoming weak.
She wears the full regiment of the padded underwear and pads on top of that, which is why the sudden urinations had me thinking they were purposeful. Now, I'm changing my mind because descriptions here fit what might be happening. I did not want to embarrass her so I didn't press the point, but as we move to me being more involved in her medical history I will gently address it with her. I believe her past physicians unknowingly (or uncaringly) have tossed her into a medicine induced nightmare and I want all her meds checked. Here's why: my mother ended up on hydrocodone because my brother gave it to her to ease her itchy leg syndrome that disrupted her sleep. He had it because of a car accident he was in and I remember her specifically telling me that when she first started taking it. I told her to check with her doctor, which she did, and I assumed it was okay until I could tell she was fearful she was getting addicted. When she got here and I realized it was more serious and I expressed my concern to her and my outrage her doctor would let her have it in the first place her story changed. Then she said she was given it for a slight back injury she got when she was doing physical therapy after a serious fall she had two years ago. I don't know which story is true but my money is on my idiot but well meaning brother.
Lastly, I do realize I may be getting bamboozled about her getting off the medication and I'm keeping my mind open to the great advice offered here. I am absolutely blown away at how instrumental the advice given here has helped us. I'll be a frequent visitor as I am clueless about elderly care and I can use all the help I can get. I love my siblings, I love their support and advice but I like the idea of being able to freely express my fears without breaking my mom's confidence. She's a private lady and they aren't doctors, experts nor any more experienced than I. I find common sense here with a good healthy dose of "get her to a professional" and have garnished almost instantaneous results because of you fantastic caring people. Thank you SO much for the time you have given me!!
I do not believe anyone here was trying to bamboozle you about the steps that needed to be taken if she was truly an opiate addict which now sounds unlikely.
When you first posted we read the panic in your words and responded accordingly. As time went on you added further information that made it clear that there was probably a different medical explanation.
I am so glad your mother has such a trusting and loving relationship with you and I see an excellent relationship going forward.
In support of doctors everywhere (and I frequently don't agree with their views) the start of this prescribing of hydrocodone sounds as though it was perfectly reasonable. She was having pain related to her PT and it was keeping her awake at night. The Dr determined that prescribing analgesia for a 91 year old was probably safer than sedation so that was what he did. Now of course he should not have continued to mindlessly sign refills for her every month but Drs are busy people and when presented with a stack of paper to sign just do their illegible scribble. I am also guessing she never actually went back for a check up or maybe your brother just called the office and asked for a refill. What I am saying is that these things unfortunately do happen. Of course your brother was wrong to give her the medication in the first place not to mention acting illegally but I am sure he did it with the best of intentions. People do that all the time.
I hope you do not see this post as critical of you and your reactions, it is meant to be supportive both of you and other members. Those on this site have a broad range of experience and in some cases training or have taken the time to educate themselves over many years as they go along. We do not all always agree and that is very healthy and sometimes someone reacts unkindly or indifferently. Others experience your level of anxiety every single day of their caregiving lives and the gut reaction on a bad day is 'suck it up, pull up your big gIrl panties"
I have been wondering where you can buy a pair of those! Do they come in different colors or do you have to sew your own?
Rarely we have a visitor who posts a fictitious question and everyone rushes to help only to discover a few days later that some of the information just does not fit.
You are a very wise daughter and clearly inherited it from a very wise Mama.
Please keep visiting. You may not think you have any caregiving experience but frequently experience in other areas can be very helpful and insightful. For example you could know about elder tax issues or many other subjects, also your mother could contribute ideas about elder living arrangements and what works for her. Hugs for you and your Mom
When I take my mom for a doctor's visit, I have to fill the doctor in because my mom either won't remember or will downplay her problems, which is very common in seniors. When the doctor asks what is going on, my mom will say she's fine when she's not! So that's very common.
Do you have a reason or can you invent one to visit the dr alone in the near future? After the visit you can tell Mom that you mentioned that she was now staying permanently and he said he would like to meet her for meet and great or "Welcome to Medicare in Arizona " so he knows her history before she has any illnesses, get her vaccines up to date etc baseline B/P and all that good stuff. You could even push your luck and actually make an appointment while you are in the office if you think you can pull that off. I would not rush any of this, maybe take several weeks. While I would tell the Dr you wonder if she is having mini strokes I would not mention this to her. If she has another episode before Dr's visit put the frighteners on her and get her to the ER. Tell her how dangerous mini strokes can be because they can always go on to be full blown strokes leading to death, paralysis loss of speech, consciousness, inability to swallow. The actual definition of a TIA or mini stroke is one in which all symptoms resolve within 24 hours and leave no lasting effects. tell her there can't be any delay in getting medical help because there is only a short period of time in which the so called clot busting drugs can be given which can prevent serious damage to the brain. A few tears at this point may help your case. If Mom can be a tricky customer you are going have to be one step ahead of her and pull out all the stops. Just for the record if Mom does have severe pain requiring a narcotic at 91 I would not be concerned about addiction. The hydrocodone is probably not the right drug for her given her apparent reaction but there are plenty of other choices. Any drug given to the elderly can have unpleasant side effects so extreme caution is necessary is necessary in the choice and dosage. This is a very interesting thread so I hope you are successful.
Hugs