Alzheimer's patient with broken hip/health failing

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ToniT
Posts: 3
Joined: Tue Jan 27, 2004 11:00 pm

Alzheimer's patient with broken hip/health failing

Post by ToniT »

Hi All,

My mom had hip replacement surgery after a fall. She is also in an advanced stage of Alzheimer's. While in the hospital and in the nursing home for rehab, she was drugged to within an inch of her life. I stayed in the hospital around the clock with her because she is such a fall risk and she is impossible to contain, moving constantly, wanting to escape from the bed, becoming agitated and aggressive, impossible to restrain without constant intervention. So she was kept heavily sedated, and was also under the influence of morphine for the pain. She was in one of two states while in the hospital: 1) In a stupefying sleep so deep we could not rouse her, could not shake her awake, and, at times, so drugged, she ate (very little) and talked with her eyes completely closed, slurring her words, making no sense, or 2) In perpetual motion, insisting to get out of there and go home, calling my name repeatedly, crying, anxious, agitated, angry.

She is hallucinating, mistaking one object for another, seeing things where nothing exists. While under the influence of sedatives and painkillers, she kept reaching out to touch things in the air, and saying things that made no sense, babbling. She still tries to put sentences together that make no sense, then looks stricken when she realizes that she has not been understood.

She believes that she is doing something wrong and causing problems, that people don't like her, that bad things are happening in her assisted living facility, that she's not safe, or that something has happened to me.

She keeps saying that she is alone, even though there are people around her constantly. I tell her that the caregivers are her friends, she insists they are not.

She goes from room to room, opening all the doors, wants to go home, wants me. She requires constant company, is afraid to be alone for a moment. Sometimes, in her assisted living facility, she'll fall asleep on the couch in the common area where she is near the caregivers, but will not stay in her bed. (When she lived with me and I tried to put her to bed, she used to keep coming out, telling me she didn't want to be alone, or that there was someone in the house, or that she was afraid that I was going out at night, leaving her alone in the house, which made her angry. She wanted to know where I went and why she couldn't come with me, insisting that I was lying when I told her I didn't go anywhere. So she wouldn't stay in bed; she kept coming out to find me.)

Her face is pale, her blood pressure goes from hypertensive to hypotensive. At one point before she broke her hip, she suddenly sat staring, would not respond to verbal stimuli, and her pupils were unevenly dilated. We believe she may have suffered a mini-stroke due to the drugs. Now her pupils are constantly dilated. This, after months on an antipsychotic, which I insisted be discontinued.

She had a vasovagal while in the nursing home. While being put on the toilet, she was in pain from her hip, and suddenly she stiffened and went completely still and unresponsive with her eyes wide open and staring, her foot trembling. Shortly thereafter, she came around.

She is so sleepy, but does not sleep at night. If she does fall asleep, she wakes shortly thereafter or wakes very early and does not go back to sleep.

She is refusing to eat and has lost a lot of weight. I ask her if she is hungry, and she replies with an enthusiastic yes, but then won't eat.

She is frustrated about being stuck in a wheelchair and rocks constantly, trying to propel herself. Everything given to her she says she doesn't like. Sometimes, she spits out whatever has been put in her mouth. She is requiring hand-feeding, where before she fed herself.

Her leg on the surgical side is swollen and edematous.

She sometimes becomes combative and uncooperative, refusing assistance, becoming verbally and physically abusive. While angry in the hospital when we were caring for her, she grabbed our clothing and hair, and punched, telling us we were mean for hurting her.

Her skin is hot, but she has no fever. Normally, her hands are very cold to the touch. While in the hospital, for one day only, she sweated profusely during sleep, but with no fever, and her upper body became cold and clammy.

She is extremely anxious, wrings her hands. When she was able to walk, she paced and wandered about continuously, rarely sitting down, wanting out of her assisted living facility, asking constantly about me.

She is interested in nothing, will not watch television, occasionally participates in activities. The speech therapist said that her major obstacle is that she will not apply herself to anything for any length of time. I told the therapist that she is that way with everything: Before one thing can be completed, like a meal, she is asking what's next, saying let's go or what are we doing now, ready to rise and get going. She is always ready to move on to something else. This, I believe, comes from the lifestyle she had with my dad when he was alive, relocating constantly, never staying at home, but always out and about.

She cannot focus her eyes on anything, make out what she is looking at, even if placed directly in front of her face.

At times, she is smiling and friendly, sweet, generous and grateful.

She seems to have a thirst, though I am not with her all the time.

She is still continent.

I have a physical therapist scheduled to visit her, and I exercise her each time I am there. I am also trying to hire companions to watch her, alternating with my bringing her home with me on occasion. I am not equipped at home, however, to safeguard her properly. At the assisting living facility, there is a hospital bed lowered to the ground, a fall mat, bed alarms, raised commode, and an overnight staff member, so I will bring her back there to sleep.

I'm hoping to get her to eat while home with me. Right now, she'll take a bite of something and then want nothing more.

I need a remedy(ies) to help pull her through this. She is clearly suffering not only from the surgery and dementia, but the effects of all the drugs. Plus, she is not getting proper sleep: She sleeps on and off throughout the day, and then is up all night. Her circadian rhythm is reversed. And she is not getting proper nutrition. Please, can anyone offer a suggestion?

Thank you,
A very worried daughter,
Toni


Jean Doherty
Posts: 1576
Joined: Fri Apr 12, 2002 10:00 pm

Re: Alzheimer's patient with broken hip/health failing

Post by Jean Doherty »

Just some thoughts to start with until others comment. Would wonder about Hyocyamus. You are a wonderful daughter!
Babbling (32): 3Hyos., 2stram., alum., anac., apis, ars., aur., bar-c., cact., calc., carb-f., cupr., gall-ac., glech., helo., ichth., lach., lampr-s., laur., lsd, lyc., morph-s., nux-v., op., ph-ac., plb., sac-alb., sil., stann., tung., vacu., verat.
Needing company (19): 3Corv-c., 3Lat-h., 3Nat-i., 2cor-r., 2crot-c., ars., bani-c., biti-a., clad-r., eryth., graph., grat., kali-c., puls., sep., sil., stram., ther., thuj.
Desire to escape (66): 3Bell., 3Stram., 2coloc., 2crot-h., 2hyos., acon., agar., all-s., apis, aq-tun., ars., ars-h., ars-met., arum-t., asc-co., bar-c., bry., camph., caras., caust., chel., chin., chlor., cic., cocc., crot-c., cupr., cupr-s., dig., germ., glon., hell., ign., iod., ip., kali-br., lac-eq., lac-f., lach., lap-c-b., lav-v., lil-t., loxo-r., lyc., lyss., med., meli., merc., merc-c., mez., nat-m., nux-v., op., palo., phos., plb., puls., rhus-t., sep., succ., sul-ac., sulph., tab-fum., valer., verat., zinc.
Refuses food (35): 3Bar-c., 2arum-t., ant-t., arg-n., ars., aur., bell., bry., carc., cimic., coca, dig., dulc., glon., hyos., iod., ip., kali-bi., kali-c., kali-m., kali-p., lach., latex, laur., morbill., oena., phos., phyt., ratt-r., rhus-t., sars., thuj., verat., viol-o., zinc-m.
Jean


Jean Doherty
Posts: 1576
Joined: Fri Apr 12, 2002 10:00 pm

Re: Alzheimer's patient with broken hip/health failing

Post by Jean Doherty »

Interested to hear input as this is not an uncommon situation and possibly worthy of some of our energy, Jean


Joy Lucas
Posts: 3350
Joined: Wed Apr 01, 2020 10:00 pm

Re: Alzheimer's patient with broken hip/health failing

Post by Joy Lucas »

I agree Jean, worthy indeed. if possible it would be good to see the case without the obvious or not so obvious imposition of the drugs - I realise they are causing their own problems and might need to be addressed but unless they can be removed from her situation it is a bit difficult seeing the wood from the tress so to speak. Would it be too much to ask if you can illustrate her sx that exist without the reaction of the drugs. If on the other hand you think that the drug imposition has actually caused a state that needs treating in itself then that needs to be addressed first - Opium, Arnica, Nux vom, Avena?

Am bumping the original post again.

Hi All,

My mom had hip replacement surgery after a fall. She is also in an advanced
stage of Alzheimer's. While in the hospital and in the nursing home for rehab,
she was drugged to within an inch of her life. I stayed in the hospital around
the clock with her because she is such a fall risk and she is impossible to
contain, moving constantly, wanting to escape from the bed, becoming agitated
and aggressive, impossible to restrain without constant intervention. So she
was kept heavily sedated, and was also under the influence of morphine for the
pain. She was in one of two states while in the hospital: 1) In a stupefying
sleep so deep we could not rouse her, could not shake her awake, and, at times,
so drugged, she ate (very little) and talked with her eyes completely closed,
slurring her words, making no sense, or 2) In perpetual motion, insisting to get
out of there and go home, calling my name repeatedly, crying, anxious, agitated,
angry.

She is hallucinating, mistaking one object for another, seeing things where
nothing exists. While under the influence of sedatives and painkillers, she
kept reaching out to touch things in the air, and saying things that made no
sense, babbling. She still tries to put sentences together that make no sense,
then looks stricken when she realizes that she has not been understood.

She believes that she is doing something wrong and causing problems, that people
don't like her, that bad things are happening in her assisted living facility,
that she's not safe, or that something has happened to me.

She keeps saying that she is alone, even though there are people around her
constantly. I tell her that the caregivers are her friends, she insists they
are not.

She goes from room to room, opening all the doors, wants to go home, wants me.
She requires constant company, is afraid to be alone for a moment. Sometimes,
in her assisted living facility, she'll fall asleep on the couch in the common
area where she is near the caregivers, but will not stay in her bed. (When she
lived with me and I tried to put her to bed, she used to keep coming out,
telling me she didn't want to be alone, or that there was someone in the house,
or that she was afraid that I was going out at night, leaving her alone in the
house, which made her angry. She wanted to know where I went and why she
couldn't come with me, insisting that I was lying when I told her I didn't go
anywhere. So she wouldn't stay in bed; she kept coming out to find me.)

Her face is pale, her blood pressure goes from hypertensive to hypotensive. At
one point before she broke her hip, she suddenly sat staring, would not respond
to verbal stimuli, and her pupils were unevenly dilated. We believe she may
have suffered a mini-stroke due to the drugs. Now her pupils are constantly
dilated. This, after months on an antipsychotic, which I insisted be
discontinued.

She had a vasovagal while in the nursing home. While being put on the toilet,
she was in pain from her hip, and suddenly she stiffened and went completely
still and unresponsive with her eyes wide open and staring, her foot trembling.
Shortly thereafter, she came around.

She is so sleepy, but does not sleep at night. If she does fall asleep, she
wakes shortly thereafter or wakes very early and does not go back to sleep.

She is refusing to eat and has lost a lot of weight. I ask her if she is hungry,
and she replies with an enthusiastic yes, but then won't eat.

She is frustrated about being stuck in a wheelchair and rocks constantly, trying
to propel herself. Everything given to her she says she doesn't like. Sometimes,
she spits out whatever has been put in her mouth. She is requiring hand-feeding,
where before she fed herself.

Her leg on the surgical side is swollen and edematous.

She sometimes becomes combative and uncooperative, refusing assistance, becoming
verbally and physically abusive. While angry in the hospital when we were caring
for her, she grabbed our clothing and hair, and punched, telling us we were mean
for hurting her.

Her skin is hot, but she has no fever. Normally, her hands are very cold to the
touch. While in the hospital, for one day only, she sweated profusely during
sleep, but with no fever, and her upper body became cold and clammy.

She is extremely anxious, wrings her hands. When she was able to walk, she
paced and wandered about continuously, rarely sitting down, wanting out of her
assisted living facility, asking constantly about me.

She is interested in nothing, will not watch television, occasionally
participates in activities. The speech therapist said that her major obstacle
is that she will not apply herself to anything for any length of time. I told
the therapist that she is that way with everything: Before one thing can be
completed, like a meal, she is asking what's next, saying let's go or what are
we doing now, ready to rise and get going. She is always ready to move on to
something else. This, I believe, comes from the lifestyle she had with my dad
when he was alive, relocating constantly, never staying at home, but always out
and about.

She cannot focus her eyes on anything, make out what she is looking at, even if
placed directly in front of her face.

At times, she is smiling and friendly, sweet, generous and grateful.

She seems to have a thirst, though I am not with her all the time.

She is still continent.

I have a physical therapist scheduled to visit her, and I exercise her each time
I am there. I am also trying to hire companions to watch her, alternating with
my bringing her home with me on occasion. I am not equipped at home, however,
to safeguard her properly. At the assisting living facility, there is a
hospital bed lowered to the ground, a fall mat, bed alarms, raised commode, and
an overnight staff member, so I will bring her back there to sleep.

I'm hoping to get her to eat while home with me. Right now, she'll take a bite
of something and then want nothing more.

I need a remedy(ies) to help pull her through this. She is clearly suffering
not only from the surgery and dementia, but the effects of all the drugs. Plus,
she is not getting proper sleep: She sleeps on and off throughout the day, and
then is up all night. Her circadian rhythm is reversed. And she is not getting
proper nutrition. Please, can anyone offer a suggestion?

Thank you,
A very worried daughter,
Toni

Joy
http://www.joylucashomeopathy.com
http://health.groups.yahoo.com/group/homeopathystudy/


ToniT
Posts: 3
Joined: Tue Jan 27, 2004 11:00 pm

Re: Alzheimer's patient with broken hip/health failing

Post by ToniT »

The drugs, unfortunately, cannot be removed, given the situation and the risks involved when her behavior becomes uncontrollable.

Without the influence of the drugs, there appears to be a Lach constitution: Verbal repetition, sarcasm, the desire to go home, enough energy to burst out of her skin, always wanting to be on the go, hysteria, paranoia, feelings that she has done something wrong, psychosis, struggling against all manner of restrictions.

Since the fall/surgery, there has been a dramatic decline in the mental faculties. She is frustrated at knowing that she is not selecting the right words to express herself. She then bursts into tears and calls herself stupid, asking me if I think she is stupid, bemoaning that she can't even talk right to herself anymore. She keeps saying that she is afraid that she is dying. She keeps asking me if there is something wrong with her. She is whiny, miserable, wants nothing to do with much of anything, doesn't want food, yet complains she's hungry, nothing pleases her, there is no way to placate her. She is like a child who has become overtired and cranky as a result. She complains of being extremely tired and wanting to sleep. While falling off to sleep, she starts at every noise, demanding to know what it is and who is making it. She is terrified at the thought of my not being with her. I believe she feels that my presence will protect her from dying.

I received two calls this morning: One telling me that she was sleeping so deeply, she could not be roused. That her respiration and pulse were barely perceptible and she was bradycardic. A second call about how it was believed she was not producing urine, that her output was insufficient, though her bladder was not distended. I wondered about acute renal failure and ordered the acetaminophen discontinued, along with the drinks and foods that were high in potassium. With what might be reduced kidney function from acetaminophen, or urinary retention, along with major tissue damage/surgery, and vitamin/mineral supplementation, I was thinking hyperkalemia. Worried, I went to see her, and got a totally different report from another caregiver, who said my mom is urinating just fine.

I believe that the trauma of the fall, the surgery and the drugs has pushed my mom into the next stage of her disease, about stage 6. She suddenly no longer feeds herself and doesn't object to being fed like a baby, whereas, not long ago, she was quite indignant when treated like a child. She has become urinary incontinent. She is disinhibited, lifting her dress over her head, whereas, before the trauma, she was still modest. She has no appetite at all. Put succinctly, since the fall, the surgery and the drugs, she is experiencing a failure to thrive.

toni
--- In minutus@yahoogroups.com, Joy Lucas wrote:


Joy Lucas
Posts: 3350
Joined: Wed Apr 01, 2020 10:00 pm

Re: Alzheimer's patient with broken hip/health failing

Post by Joy Lucas »

As I suggested before this has all the hallmark sx of opium
especially the anguish that evolves out of the shock of injury - with
the abuse of drugs, semi coma state, the fear, deep sleeping, loss of
bladder sensibility, starting from sleep - to what extent all these sx
are due to the drugs is difficult to see but I am imagining that that
needs to be dealt with to get back to baseline of her previous state,
i.e. before the fall or back to what you describe as a potential Lach
state.

It is a question of whether a totality can be seen, one that includes
both the dementia and the drug abuse or dealing with the latter first
as though it is a mini totality in itself.

You might want to look at the rubrics 'ailments from injuries' +
'shock from injury'

Joy

http://www.joylucashomeopathy.com
http://health.groups.yahoo.com/group/homeopathystudy/


ToniT
Posts: 3
Joined: Tue Jan 27, 2004 11:00 pm

Re: Alzheimer's patient with broken hip/health failing

Post by ToniT »

Hi Joy,

I agree with Op. I didn't have it, or anything else for that matter, while in the hospital with her, but I noticed that while hospitalized, she was in one of two states: Either she was awake, agitated and thrashing about, trying to get out of bed, or else she was in a deep coma-like sleep. That's it. One or the other, nothing in between. Plus, abuse of analgesics and narcotics. I'll begin with 30C aqueous. Thanks, Joy, and everyone for their feedback.

Toni

--- In minutus@yahoogroups.com, Joy Lucas wrote:


Robin Coventry
Posts: 22
Joined: Wed Apr 01, 2020 10:00 pm

Re: Alzheimer's patient with broken hip/health failing

Post by Robin Coventry »

Facing our mortality is disconcerting to many. My Aunt had alzheimers, the wind blew her over one day while standing outside. She was never again right and that was the beginning of the end. She became bed riddin after the fall because that was the easiest thing for her. She slept a lot but loved to have music playing in her room with a view. I put posers of colorful flowers on the ceiling in her room as she loved flowers. She loved looking up at them.
As she declined and I knew for certain she was near the end I gave her ARS; it helped her to relax not be combative and accept what was coming. It was then she had a moment of clarity and said my name after years of not knowing me and touched my cheek. Ars helped her relax which made her transition from this world to the next very easy on her and those around her.
Robin
From: minutus@yahoogroups.com [mailto:minutus@yahoogroups.com] On Behalf Of ToniT
Sent: Sunday, March 21, 2010 10:32 AM
To: minutus@yahoogroups.com
Subject: [Minutus] Re: Alzheimer's patient with broken hip/health failing
Hi Joy,

I agree with Op. I didn't have it, or anything else for that matter, while in the hospital with her, but I noticed that while hospitalized, she was in one of two states: Either she was awake, agitated and thrashing about, trying to get out of bed, or else she was in a deep coma-like sleep. That's it. One or the other, nothing in between. Plus, abuse of analgesics and narcotics. I'll begin with 30C aqueous. Thanks, Joy, and everyone for their feedback.

Toni

--- In minutus@yahoogroups.com , Joy Lucas wrote:


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