Need a little help from my friends....

[DVC~OKW~96]

Florida Physicians Medical Group: Salagubang Jason MD
maps.google.com
201 North Park Avenue
Apopka, FL 32703-4147
(407) 889-1953

This is the last info I had on him. (Pulled it from the 'net). I've been away from his assessment center and clinic for awhile now (changed positions and now I cover the east coast instead of working in just the Central FL area) but I haven't heard that he's moved elsewhere.

He's young. He's wicked sharp and he's excellent.

 

[jackskellingtonsgirl]

Maggie, you and Gabby are in my thoughts!

 

[mickeysaver]

Dr. Salagubang. Tell Gabby to make an appointment with him for her Mom. I'll try to find his contact info for you. He's in the Orlando area and is the BEST geriatrician.

Moving her Mom out of state is NOT a great idea. Disorienting someone with dementia can have very poor consequences. Moving her into an ALF in her area, an area where she will still recogize the general template of things is the approach that has been demonstrated to cause the least disruption.

I promise you, I KNOW how hard this is, but right now the focus needs to be on what is the best for Mom, not the best for the daughters (to not feel guilty).

I hope that's not offensive, but it's seen all too often. Familes, with misguided senses of "duty" or thinking that they are doing what the parent would have wanted, make decisions based on emotion and not on clinical factors.

Hugs, hugs, and more hugs to you and Gabby both. I wish this whole thing didn't include such a distance between your home and her Mom.

The houselady that Pati has now won't be around for much longer, because she is elderly and has knee surgery scheduled in June. So, they need to find someone to help during the day, so that it's just the evening and nightime hours that are left to the family.

Pati's whole house smells of cigarette smoke and there are lots of extra items stored in the house, which severely limits the accessible areas of the home. Pati used to do crafts and has lots and lots of leftover items that could be sold and lots and lots of materials to make more. There is also a ton of stuff that was stored there by the Gabby's grandma and the other two sisters. All of Gabby's stuff was cleared out of the house when we moved in together. Thankfully, there are paths that lead to most of the rooms and all of the exits at this point. The most open area of the house, now finally, is Pati's bedroom, which is huge. She has been working on clearing up the extra stuff for several years now. I would love for Clean House to come in and just do their thing, but that's not going to happen.

For now, the plan is for the good sister and Gabby to take turns watching their mom. This means that every couple of weeks Gabby will travel to FL to spend a week at her mom's. I have no idea how she thinks that she is going to tend to the demands of her job and her mother at the same time, but she seems to think that it's possible, but when the woman won't take a break to make herself lunch and waits until the last possible second to come upstairs to use the potty because her clients, projects, and employees are so demanding of her time, I really just don't see how this will work without her mom or her job suffering. Gabby typically works from the moment her feet hit the floor until her head hits the pillow. The internet connection at her mom's house is pretty darn slow and with her job, she needs a really fast connection or else she just can't get much done.

When it's the good sister's week, she is planning to temporarily move into her mom's house. She will sleep on the chaise in her mom's room and her hubby will sleep upstairs. First, they have to clean out a room for her hubby. The good sister goes over to her mom's house everyday, but doesn't always see her mom. She is primarily there to take care of the alpachas, which usually requires about an hour or so in the morning and another hour or so in the evening.

If she were to be put into an assisted living facility, it would be in FL, not in GA. Gabby would love to move her mom up here to live with us, but her mom is allergic to cats and we have three of them, so that will not be happening. Plus, her mom still smokes and we both have asthma, so it's sort of anti-beneficial on both sides.

It has come to light that the problem may well be the drug Topamax. She has been taking it for about 3 to 4 years and we understand that many of the side effects of the drug are being experienced by Pati, so they have taken her off of it. We can hope that she emerges out of the altered state once her body is rid of the drug. She will still be altered by the sleeping pills and pain pills that she uses for the fibromyalgia though. It's like a neverending loop of either she is in pain or she has mental clarity.

Her heart bundle conduction issue has been there for awhile. The cardiologist says that she is not a candidate for invasive procedures, so it will just have to remain as it is.

Hopefully, Pati will be discharged from the hospital next week. They will not let her go home until they know that there is 24 hour care lined up for her.

I take no offense to anything that you said. I appreciate the help. Thank you!

 

[mickeysaver]

So the neurologist believes now that her mental deficiencies are all due to the drugs that she is taking. They are trying to put in a new IV line tonight, if they are unsuccessful, they will put in a PIC line because they are starting her on the renal dose of Dopamine, due to her edema, and the cardiac & renal insuffiencies. They took out the foley, so they won't give her a sleeping pill unless one of the sisters stays with her overnight to help her to the potty. Gabby is staying overnight again, because the good sister stayed all day and the other sister, the druggie, has found God or something and has to go to church in the morning.

Personally very tired and ready for bed. Working 6 days in a row and the drama of the week has taken it's toll on me too. Sweet dreams to all.

 

[DVC~OKW~96]

The Older Americans Act (OAA) provides funding for several in home services. One of those services is CHORE. A team comes and does the really heavy stuff, like cleaning out rooms, ect. If Gabby's Mom is willing to sell or donate some of the stuff, they will help her with that (not the selling, but the donating).

There are services that will come in the home too. Personal care, housekeeping, respite (for the caregivers) those sorts of things. Meals on Wheels too, of course.

Gabby will most likely find out that she won't be able to care for her Mother and work at the same time. I tried something similar and it was a dismal failure. I'll wish her well though!

Take care and if I think of anything else I'll let you know.

I think Gabby's Mom is in Volusia county? Services differ between counties, that's why I ask.

If you can tell me the county I can tell you which Area Agency on Aging covers it, and get you the number.

 

[Kennywife]

to you and Gabby and her mom.

Anna (also known as Gabbie)

 

[mickeysaver]

Thanks to everyone here. I can't tell you how much your thoughts & prayers are appreciated.

Gabby is having a rough time with her mom due Pati's persistant belief that the ambulance brought her to the hospital to so that she could be cremated. She has mentioned it everyday so far, except for today. Pati seems a little more together today, so we are hoping that that trend continues as the Topamax leaves her system.

This morning they are putting in a PIC line. The phlebotomists have the worst time trying to find a vein on her for IV lines. Having had a PIC line in the past myself, I know that it's not much fun to care for after the fact. The procedure itself is relatively painless though.

The other not so good news is that Pati's dog, Puckie, has been ill for some time with a respiratory ailment. She sounded aweful when we were there in December. The bad sister took Puckie to her house and didn't take the dog's medicine with her. She doesn't have a key to her mom's house, so she can't get in unless one of the sisters is free to let her in. The good sister is on the way to take care of her grandmother today and Gabby is stuck at the hospital until the bad sister arrives after church to relieve her. So poor little Puckie is having a really bad day today and is totally out of it and may need to be put to sleep, if nature doesn't end up taking it's course very soon. This will not help Pati's recovery a bit if Puckie dies without her being able to say goodbye to her first.

I swear, I am so glad that I am an only child right now.

Oh and I found the myeldersource.org website last night and it seems to be the resource site that we will potentially need.

 

[mickeysaver]

Roughly 90% of the mental fog has cleared, so they kicked her out of the hospital yesterday night. Basically, she is a mess and was in as good of shape as she is ever going to be in so they discharged her. She has doctor appointments all week, starting with one today. Gabby got only about 2.75 hours of sleep last night taking care of her mom at home. The cigarettes and ashtrays are all gone from the house and Pati is ticked off, but she has no business smoking, so tough stuff. Pati still needs help showering and using the toilet, so she is in definate need of 24 hour care, even if the mental fog has lifted. I don't know how much more of a sign that the sisters need that Pati needs to be in an assisted living facility, but I can't imagine that they are going to be able to keep up with her demanding needs for too long without major burnout. Time will tell.....

 

[hematite153]

I'm glad the mental fog is lifting, but, I'm sorry for the decisions that Gabby and her sisters are going to need to make. I know that they are tough decisions, but, I hope they figure it out before everyone collapses.

 

[jackskellingtonsgirl]

Maggie, not sure if this is an option in FL, but in TX there are state licensed adult "foster" homes that provide elder care. That's where we ultimately had FIL, but it was a rough road beforehand.

When MIL passed away we put him in a nursing home, but he didn't like it there and it was really expensive. We moved him into an apartment near us and we tried to look after him, but with both of us working full time that was a fiasco! He had medical issues, mild dementia, and he was quite hard of hearing. One of FIL's neighbors called Adult Protective Services on us because she thought FIL was being neglected. They told us about the foster homes, which are private homes where the caregivers look after several elderly folks - almost exactly like a foster home for kids. It turned out to be a perfect arrangement, and FIL lived there until he passed away a couple of years later.

Hugs to you and Gabby!

 

[soulmates]

Maggie, just now reading all of this...my heart is so sad for you all. I haven't had to experience taking care of an elderly or sickly parent yet. I really haven't even considered it. Your Gabby is one tough cookie. My thoughts are with you all.

Chris

 

[Mathfailure]

It is such a tough situation.

As a daughter who has lost both parents, I can only offer prayers and empathy. This is a situation that will take so many twists and turns, and the end result is always loss. It is sad and relentless, so try and be as patient as you can for each other.

Long distance sucks, my parents were below Naples, and I lived in Maine when I lost my Dad. Ft. Myers airport is tainted with bad memories for me as I kept going down to the inevitable more bad news.

 

[mickeysaver]

Sadly, it does seem like the fog lift was only temporary. She has very decreased short term memory, but can tell you all about stuff that happened 10 or 20 years ago. We all know what this means.

Gabby is coming home tonight. She didn't leave as early as she had hoped because the good sister is suffering the effects of no sleep and Gabby stayed later to allow her time to attempt to recover from her migraine. I am so worried about these hard headed women that just won't see that they can't do this without harming themselves. I have no idea how this is going to work. I have voiced my opinion about moving her to an assisted living facility and Gabby just refuses to accept that it's a viable option, but then again, she also sees how exhausting and impossible the situation is. I have a feeling that the good sister is going to become exhausted pretty darn quick when Pati's care is 100% on her over the next week. The other sister was asked to come help tomorrow to allow the good sister to rest, but she refused because she has "appointments and she can't miss church on Sunday".

Please pray with me for the sisters to either develop super human strength and endurance or for them to come to the rather inevitable conclusion that Pati really needs to be in an assisted living facility. Thanks.

 

[cm8]

sending much good thoughts your way!

 

[DVC~OKW~96]

Sadly, it does seem like the fog lift was only temporary. She has very decreased short term memory, but can tell you all about stuff that happened 10 or 20 years ago. We all know what this means.

Gabby is coming home tonight. She didn't leave as early as she had hoped because the good sister is suffering the effects of no sleep and Gabby stayed later to allow her time to attempt to recover from her migraine. I am so worried about these hard headed women that just won't see that they can't do this without harming themselves. I have no idea how this is going to work. I have voiced my opinion about moving her to an assisted living facility and Gabby just refuses to accept that it's a viable option, but then again, she also sees how exhausting and impossible the situation is. I have a feeling that the good sister is going to become exhausted pretty darn quick when Pati's care is 100% on her over the next week. The other sister was asked to come help tomorrow to allow the good sister to rest, but she refused because she has "appointments and she can't miss church on Sunday".

Please pray with me for the sisters to either develop super human strength and endurance or for them to come to the rather inevitable conclusion that Pati really needs to be in an assisted living facility. Thanks.

Has to go to church on Sunday? Reallllly... now don't that just beat all.

 

[mickeysaver]

Yeah, the lying druggie worthless sister has found God or something. She has been claiming to be going to church on Sundays. I have no idea what that's about. I can assume that if it's for real that it's some effort to attempt to gain custody of Baby M. Little does she know that F won't give the baby to her and that we are first in line now. I can tell you this, we could definitely provide every other member of the family, save the grandmother, to witness to the woman's lack of character. I was talking with Gabby's Dad tonight and he can't stand the fact that she has any of his DNA. I think that most judges would take the character assessment of the bad sister from the baby's great grand daddy, step great grand mom, great grand mother, great aunt, great uncle, mother, and uncle over any preacher that she just met. But whatever.....

 

[DVC~OKW~96]

Well here is a tough suggestion, but it might be best for Gabby and her "good sister."

The other one? Stop even considering that she's any sort of resource to them. She's clearly not and thinking she should be is only making their lives more stressful.

Also, clearly she's not competent to assist with the Mom, so who'd really want to leave Mom in her care anyway.

Write her off the "help" list and that might reduce the stress of thinkning she could be there.

Not a pleasant thing to do with "family" but just because you do share DNA doesn't mean you have suffer from it for all eternity.

 

[mickeysaver]

Yeah, they are finding this out in spades right this moment. Pati's blood sugar is really dropping low, like to 45 off and on. Last night it happened and she wet the bed, but the good sister was there. The other sister decided to come watch her mom tonight. The first thing that I said was, I hope all of the drugs are going to be locked up except what your mom has to have for tonight. Gabby then called the good sister who agreed and she followed through on it too.

We all suspect that the other sister is trying to avoid ever being asked to show up again to watch her mom again, even though her grandmother is planning to start paying her to take care of her mother 3 days a week when the houselady leaves next month. Don't even get me started on what I think of that idea. She showed up wearing two different left shoes and was talking some crap about having a patent on an idea for some neuropathy boot simulator (trust me, she is no where smart enough to have any sort of idea like this ever rattle around her uneducated noggin). Anyway, the good sister left her there with explicit instructions on meds, food, bathing, potty stuff, emergency things to call about and so on.

So, Gabby knowing that her mom is home with the other sister tonight just called and all her mom kept saying is "there is no morning". The other sister says that her mom is fine and that her blood sugar is 45. Gabby told her to get her mom some soda asap and told me to call the good sister to get her butt back over to her mom's house to see what is going on.

I have the distinct feeling that the other sister will never be in charge of watching her mother again. Gabby is mad because she can't understand how they could have let her mom get so far off of normal so quickly and is freaking out, feeling guilty, and wishing that things were far different than they are. I wish that there was something that I could do other than hug her, support her, and love her more than freakin' words can say, as always.

Oh, and my Dad is falling apart too. He was started on Oxygen everyday all of the time as of yesterday. His COPD has progressed pretty far along now and room air is no longer enough for him. Did I mention that I freakin' hate cigarettes?

 

[mickeysaver]

The good sister, who has been dealing with all of this much longer than she has let on, obviously, took care of the situation by phone. Luckily, Pati's blood sugar rebounded to 88 after a little Coke. With the rebound, she was much more lucid again, not much, but a little more. Pati is napping now and the other sister is still watching her. The good sister had to remind Gabby that this is what is to be expected as their mother progresses further into dementia. Gabby hasn't quite fully come to terms with the fact that her mother is slipping away. She knows it's happening, but she really hasn't wrapped her brain around it.

After the call from the good sister, Gabby, complete meltdown. Bless her heart, she is such a mama's girl. She is taking all of this really hard. Her confusion over what the best thing to do for her mom, her sisters, herself, and even me just got to an overload point and she lashed out, punching her luggage that is in the kitchen waiting to be loaded in the car tomorrow for her business trip, like it was a punching bag, over and over again. She bruised the heck out of her knuckles and scrapped several of them up pretty bad. Gabby has done this sort of lashing out thing before when she gets overloaded, luckily, she has only broken a bone doing it once. Anyway, afterwards she just fell apart. After I got her sort of put back together, I iced her hands and gave her some Advil. Right now, she's taking what I assume will be her usual long hot shower. I am going to got up and go to bed and try to talk her into sleeping.

While Gabby was sitting there with the ice packs on her hands, she asked me to text the good sister to ask her to not call or text Gabby if her mother is getting really bad worse and has to go to the hospital or if she passes. The good sister is to text or call me first, so that if Gabby isn't home, I can be the one to tell her what's going on when she can deal with it away from clients or bosses. I really hope that Gabby is there before and as her mother dies, otherwise, she is never going to forgive herself. You just have no idea how close they are.

Thanks for the prayers. They are very much needed and greatly appreciated.

 

[DVC~OKW~96]

OK. I know you don't me from dirt, nor does Gabby, but this has to be resolved.

There are decent ALFs in the immediate area that specialize in caring for people with all forms of dementia.

Having her BG levels rocket up and down like that is going to contribute to the cognitive imbalance.

For the love of her mother Gabby must (and trust me, please? I rarely say 'must') look into this sort of care.

Her Mom will live longer and with a better quality of life if she is in a setting where her dementia is understood, her care needs are anticipated and treated pro-actively, and her quality of life is (improved?) at least sustained.

It's a matter of Gabby and her good sister understanding that by not making this step, they are negatively affecting their Mother's situation. That seems like a brutal thing to say but it's the only way I can put it.

Would they keep her from medical care if they thought she was having a heart attack? Keep her from her meds? Keep her from treatment for her other illnesses? Of course not! So then, why are they keeping her from comprehensive, holistic care for everything? Fear, and misunderstanding of what an ALF is, would be my guess.

Gabby needs some level of peace in her life, some relief and easing of the guilt (that will crush her).

Please, please don't be offended. It's just that my heart goes out to you both and I see this so often...

You come across and good, decent loving people who want to do the very best you can for your families.

I'm sorry about your Dad too. You surely do not have boring lives.