I'm a little tense, today.
    Last night, after Mom awoke from her nap, she fell in the bathroom. She insisted that she was not hurt, but fought me when I attempted to pick her up off the floor (she fell into a sitting position, going backward, hitting her head against the wall). While she was fighting my attempts to get her back up on her feet (which is difficult, even without her fighting me), she complained that her left hip hurt.
    I called the paramedics, assuming that we would be transporting her to the hospital. When the paramedics arrived, they got her up and onto the toilet seat with ease, checked her thoroughly, found no problems, even monitored her and me as we transferred her, under her own steam with her walker, into the living room and her rocking chair. Throughout the evening she seemed fine, although she was a little stiff when she finally to head into bed at 0100 this morning. Other than that, her overall mobility was fine.
    When we undressed her for bed, we noticed that she'd spotted a bit of blood onto her underwear. She immediately began calculating and came to the conclusion that "it was about time for my period."
    For obvious reasons, I had to laugh. She's responded the same, in the past, when we were having trouble with recurrent UTI's of the e coli variety. I assured her, as usual, that, at 90 years of age, she wouldn't be having a period. I'm not sure she believed me, but, you know, whatever.
    At any rate, I wiped her well after we got her prepared for bed and found no other indications of bleeding. She was adamant (as usual) that she felt "fine" and resisted my renewed suggestions that perhaps we should take her to the hospital and have her checked out. She had no problems standing (other than her usual ones), no problems remaining upright while she brushed her teeth, was no more iffy on her feet than usual, so I decided that I'd allow her a good night's rest and we'd revisit the situation when she awakened from her night sleep.
    My intention this morning has been to allow her to sleep until the 12-hour-mark (as usual), 1300 today. I heard her coughing at noon, straight up. It sounded like one of her reconnaissance coughs, meaning she was ready to arise before the 12-hour-night-sleep-mark. When I checked on her (which I've been doing obsessively all morning, checking to see if she looks "normal" in bed, which she has), she immediately opened her eyes but said she wanted to remain in bed a bit longer. This also isn't unusual. I decided to let her go until 1300, which I typically do under these "not really a reconnaissance cough" circumstances, which are fairly normal. I asked several questions of the "are you feeling all right" type, conducting a full survey of all pertinent body areas. She was astonished that I was doing this, so I reminded her of her fall, last night, and the paramedic visit.
    At this point, I am anxiously awaiting 1300 so that I'll be able to perform a full inspection through her usual morning routine. I'm assuming the best, however, I'm reserving the right to take her into the local emergency room if anything seems off, including a continuance of the spotting.
    Just a few miscellaneous observations, here:

• I was surprised to discover, while talking with the paramedics (the ones connected to the fire department) that "our taxes" cover the cost of visits, whether or not they lead to an emergency room visit. I confessed to the lead paramedic that, when I have a particularly difficult time getting her up from a sitting position on the floor because she is fighting my efforts, I will "threaten" her into "compliance" by telling her that it would cost us "$1,000" to have the paramedics do this. This usually works, as she is equipped with an internal disgust for having to pay this amount of money in order to be set back on her feet. The paramedics told me that billed services don't kick in until hospital transport commences. Although I was surprised and relieved to learn this, I'm determined not to take advantage of this service, as I recall a maternal aunt who called the paramedics so often, then refused to go to the emergency room, that she was advised that from a certain point on, the city was prepared to bill her for these services if she didn't use them with a bit more wisdom and restraint.
• As is required, the senior paramedic took my mother's history from me as the others helped her out. As he was running down the sheet of possible conditions and I was responding "yes" to each, one of the guys joked that the form should have a choice for "all conditions apply", which could be checked in lieu of going down the list.
• One of the first things I did was inform the paramedics that my mother has "dementia-lite" and explained what this meant. One of the procedures they perform is an informal orientation exam which includes the questions, "Do you know where you are?" and, depending on the answer, "What city are you in?" As I stood outside the bathroom listening to this with the senior paramedic, when my mother answered the first question with an astonished, "Well of course, I'm at home," I mentioned to the senior paramedic, "I hope they don't ask her where she is geographically." Immediately, one of the paramedics asked her what city she was in. She waffled a bit, first said "Phoenix", then settled on "Mesa." I am pleased to note, here, that the senior paramedic asked me, "Is this a normal answer?" I confirmed that it is and explained that she previously lived in Mesa. What pleases me about this interaction is that either experience or protocol has suggested to them that when dealing with the demented the normality scale must be adjusted to take into account what is normal for various types of dementia.
• Why do these seemingly emergent blips always happen on or just before a weekend????

    It's 1300. Time to go "a wassailing".
    Later.
- posted by Gail Rae @ 13:00   email  this post