Elderly mum finally in rehab again but not responding - what can I do?

Where is she now? Living at home or with you? How is her mental state? Does she have capacity to make her own decisions?

I'm afraid you may have to accept that she is near the end of her days, so I would do the best I could to make her comfortable and pain free. I don't mean to upset you in any way, but she needs the best care for her current state.

I feel very sorry for the situation but 92 is a very good age and I think you may need to realise she may not go back to her old self, every illness, fall or casualty will alter an older persons abilities You may not be able to put her back together in the way she was, you may have to accept she has moved down a notch which is normal for her age and needs accepting, we can’t go on for ever.
It’s so difficult to watch but it is a natural movement in life

Mum is in a rehabilitation unit at the moment. Had she been discharged to home care in her current state she would have been completely bed-bound and at the mercy of some poor care services in her area. I did not want that for her and mum would have hated it.

Rehab was the best chance of her possibly regaining a basic level of mobility - and there is no medical reason why she shouldn't. It seems to be mental and emotional reasons why she won't engage - and that is hardly surprising considering what she has been through the last 3 months in the hospital

I;m not expecting miracles and of course my only aim is for her to be comfortable however that turns out. I have LPA for my mum's health in the event that she cannot speak for herself - and I have to respect what would be her wishes. Only thing she ever stipulated was not to put her in a care home, not to let the state and carers into her house, and not to ever let the hospitals decide her fate.

I am caught every which way here, moreso since I am not able to provide 24-hour home care for her (and she would not want that either!!)

Can you provide stimulation with music or poetry for example.

Can you get her to do (say) arm exercises to music if she will sit in the bed?

You must be very disappointed.
Thinking of you.

My 92 year old mum died last year; a mere 6 months prior to her death she was mobile and independent.
Let nature take its course OP, with help to control your mum’s pain and discomfort of course. Of course it’s hard to see a parent diminished and at the end of their days but she’s very old.
Just spend as much time with her as you can. My mum was unable to speak towards the end but we talked to her endlessly and played her favourite music.

I went through a similar situation with my once highly active father .
He had a fall and only soft tissue injuries acc

Oops..accompanied with another chest infection .
He refused to have physiotherapy and even to get out of bed .
We really really tried with him .
He disliked having to relieve himself in bed and wearing nappies .
His appetite reduced .
His interest in life waned .
As time went on extreme depression set in .
To be honest,he'd had enough of life and wanted to let go .
And after 18 months of my providing 24 hour a day care for he finally passed .
I was distraught over his deterioration and have experienced the most appalling grief over it .
I really feel for anyone who is doing their best for a loved one .
His passing has meant that I can go to church again and it gives me some comfort .The Vicar is a very close friend .
I'll say a prayer for you .

So sorry to hear about your mum. You’re right it is very difficult to watch and life does seem cruel to let an old lady suffer so much.
We had the same with my mum, it lasted five horrible years. She broke her hip at age 87. Managed to get her home and independent, until further falls and many stays in hospital and rehabilitation took its toll.

Your mum sounds like mine in that she is strong willed. Not a bad thing, but they can’t go on forever. The last time mum was admitted to hospital after a fall she was
resisting treatment, crying and very unsettled. Even though I didn’t have POA it was agreed between my self and two Drs that mum should be put on end of life care. Mum was sent back to the care home where she passed away peacefully 8 days later.
It is what she would have wanted. So difficult to make that decision but I’m so glad we did. Ask for a meeting with her doctors. Good luck.

It was unfair of your mother to make these three stipulations, which seem to indicate she expects you to care for her full-time, and you cannot do this.
Seek the care that is best for her on medical grounds and let her life end peacefully.
You have been a very good daughter and fulfilled her wishes to the best of your ability, but now you have to make difficult decisions based on needs, which may not agree with her impractical wishes. You have cared for her assiduously so please do not succumb to unnecessary feelings of guilt when considering her future care.

Yes your mums expectations are unrealistic. You can only do so much, you can’t care full time for her, I couldn’t do that for my mum either.
You are doing your best. I know it’s difficult to not feel guilty, but don’t it’s wasted energy. Just get the best care you can for her and keep yourself sane and well.

Although this is an awful time for both you and your Mum, I think you must accept those things that you can’t change.

The rehab unit should get their doctor to examine her. If necessary ask for a second opinion too.After being in hospital and then "rehab" she could have developed a painful back or something.
Rehab is better for her than being at home with carers , unless you can afford expensive private care. I am 93 and my 'rehab' unit was a very good thing, but the carers there varied in their empathy and sympathy although well trained in such skills as preventing falls, cleanliness and such basics.

Is your mother deaf? Is her mouth clean and no toothache? Is she passing urine? Emptying her bowels? Pressure sores? I don't know whether or not your rehab unit is proficient at these checks.

Above all don't blame yourself. Not your fault your dear mother is become old and losing her autonomy.

PS, I know exactly what she means by nurses messing with her in hospital. The nurses have do a tick-box routine of blood pressure recording, drips and so forth despite the routines interrupting the patient's sleep and immediate comfort.

In hospital I was once woken up during the depths of night by a strange looking young man who put me up on a drip with no conversation or explanation whatsoever. It's hard to retain one's sense of humour!

drbledu23 Your mother, when she was fit and well, put you in a headlock. No care in the home, no care home and no hospital decisions. Many people are caught in an emotionally headlock like this, coerced into making these kind of promises to someone they love dearly.

But these are promises are often ones that they cannot possibly keep when the situation where they need to be applied arises, and promisee is then left wracked with guilt for the rest of their life when they have to break these promises.

Please do not be one of those people. Your mother wrung this promise from you when neither of you could foresee what the future would bring. You must now ignore those promises and ask yourself a simple question, which is 'What is the best way I can make sure my mother is properly looked after?'

While I have every respect for the advice Caleo has given, and she speaks from personal experience, I suspect that your mother physical and mental health is worse than hers. But even Caleo now has carers.

I hope that you can get your mother back home, supported by carers. If not she will need to go into care home. These have an undeserved bad reputation. Some are poor, but many are very good and all the ones I have had elderly relatives in have been very good indeed.

My mum died aged 92. Until a few months before she had lived independently and happily in her own home, with all her marbles. She then had six months in a care home with a new lease of life ( more company, entertainment, no housework or shopping ). When she suddenly went downhill, she went into hospital. She would not have wanted to “ recover” enough to live even longer but with no quality of life. She died three weeks later. Much as I miss her, I know she was ready to go.
Her time had come. Maybe your Mum’s time has come too?

I’m so sorry to hear this, music and talking to her is always good, but acceptance that she is very near the end of her life is also important.

Thinking of you

My mother was only in hospital for a short time before she died, though now we suspect that she'd been ill for a while. However she was in her late 80's and seemed simply to have had enough of life. She'd always made it clear that she didn't want to "linger" and had "Do Not Resuscitate" put on her notes.
Sad as it is, perhaps your mother's time has come Quotedrbledu23, she's probably realistic about not getting fit enough to go back to her own home again - and as you say you can't provide the care she needs yourself. So unless she is prepared to accept carers at home or going into a care home you are at an impasse.
I do wonder if the hospital have been discussing her next move with her, since none of their likely suggestions will be acceptable. This could explain her "dip".

My thoughts would be to gather any possible support around you. If you feel it might help find a good therapist to use as a sounding board and helper.
Talk to friends and family.
Look after your own health ,mental and physical.

It's utterly exhausting. And I'm afraid to say , your own life is also ticking by.

So, she doesn’t want to go in care home.
She doesn’t want carers coming in.
She doesn’t want to be cared for in hospital.
She can’t live with you.

So what’s the alternative.
I’m afraid you will,have to decide what’s best for her as she seems unable to do that.

Also you have POA over her affairs. So best decide and tell,her.
Kindly.

You need to discuss this unhappy situation with your mother's nurses and doctors, and if she will talk about it and can with your mother.

There comes a time for many of us, perhaps all of us, when life no longer holds any allure. If your mother is at this crossroads, you and the medical team caring for her ought to accept that at 92, she has lived a long life.

I know it is hard to lose your mother, but I found it easier to lose my 89 year old father, who like your mother may have done, had decided that enough was enough, than to lose my 67 year old husband or my 60 year old sister, but realised that life held only suffering for them if they battled on. They all died peacefully and with no pain, and honestly I do not think any of us can wish for more, when our time comes.

The time has come when sadly you must do what is right for your Mum , regardless of promises made - and never feel guilty. It is a hard road and one I have been down , look after yourself. 💐💐

I feel for you having been in a similar scenario with my Mum. After a fall and fractured hip she was in and out of hospital with infections, then transferred to rehab. When she left the rehab unit the NHS provided carers three times a day for six weeks. Mum was OK with this because it was 'prescribed' by the doctor. After a month when she was still struggling with routine life tasks and personal care, we discussed carrying on with carers privately and luckily she had got used to regime by then and agreed providing they only came twice a day. Her biggest fear was going into a care home and she accepted that help at home would make this much less likely. She too lost interest in most things, having been a very determined and lively lady, but I got the impression she had simply 'had enough'. She died age 91 after three days back in hospital with pneumonia.

“Everyone needs an escape – why not use drugs?” Making a statement like this trivializes the person's experiences with substance abuse and suggests that drug use is an acceptable coping mechanism