My mother has been in a nursing home due to Alzheimer's for over a 1 and a half. She is only 74, but doesn't remember me or her grandchildren, and it's difficult for me to see her failing as she is, but as we all know that is the norm for this type of disease. Reason for my question.....I kept two of my mother's outside doctors, one for Hypertension (which is being controlled at Nursing home) and her Cardiologist. These Dr's are more of a followup, rather than her needing them because her has not condition changed or gotten worse. The nurses at the Home are telling me to discontinue them because she is being monitored there, and she is stable and no need to drag her out and subject her to trying to follow directions (which is hard) and not understanding why she is at the Doctors office.
I feel guilty,and I know I shouldn't but please give me an opinion. Stop extra outside visits or go?
Just a personal opinion, but I would think you probably could eliminate the separate doctor for hypertension.
If she has some sort of heart condition the cardiologist feels she should be monitored for (they can also take her blood pressure there and look at what she is taking for that) and if there is a good rapport between you and that specialist, you might want to continue with him/her, being sure to accompany your mom to the cardiologist appointments, if they are on a limited monitoring basis and also if a special need arises.
If it gives you an extra sense of comfort that she is getting the best treatment for these conditions by going outside the nursing home to a specialist you really like and respect, that's important. Cutting down to just the cardiologist would make it easier on your mom, I think.
I would see if you can be there when the doctors come to visit the other patients and meet the doctors yourself that come to the home. If you are satisfied that they are pleasant and qualified, then feel free to switch in good conscience. You can usually research them in advance, most of the homes list affiliated doctors on their sites so you can research their license with the state medical board as well as look at ratings, as well read them as some people can put silly things on line.
Having dealt with my MIL with dementia and now my FIL, having to make trips outside gets to be quite an ordeal, and as it progresses, they also can become quite frail and they get disoriented with a change in schedule. With a doctor at the home, it can fit in a bit better and not be as disorienting - but make sure that you are happy with the choices that you make.
If the inside doctors can give the same care - then stay inside - but do the research to make sure the care is equivalent. I am sure the doctors will not mind a few questions.
Hi Rumpled, and Thank you for your answer. The primary care Dr. that sees my mother in the nursing home has a practice, that even I can belong to. He is a Dr. in the community that is well liked and conservative in his treatment approaches. He is well liked by many. Since my mother had hypertension problems previously I just kept her Dr., but the Nursing home physician is quite capable of care. As for her Heart, the only reason why she went back to the cardiologist was when she had a new primary care Dr. (before the nursing home) had a EKG and had a false positive for Bundle Branch Block. This was confirmed by Cardiologist even though mom had a mild heart attack 20 years earlier, and she has had a stress test and a current echo which shows a normal sized normal functioning heart. She does not show signs of heart trouble.
Basically I feel guilty all the time about everything. Putting her in a nursing home, having to do this only in part of my house not being big enough, not having the resources to take care of her, and being a parent of a severely autistic young adult, had me over extended, nervous and overwhelmed ALL THE TIME!
You make valid points and I appreciate you taking the time to read and make a thoughtful response to my question.
Thank you LivingInHope, for taking the time to answer my question and giving me a thoughtful answer.
I will drop the Hypertension Dr., even though mom has had him for well over 20 years, whom I admire, because it really does seem redundant in having two Dr.s doing the same care.
As far as mom's heart, like I told the poster below, mom's heart is doing well, and she has not been showing any ill effects. I like this Dr. as well, and this Dr. will be the one I will have a hard time terminating, though the Hypertension Dr. is also a top notch Dr that I trust as well.
The Primary Care Dr. for the nursing home is also a physician in the community who is known and is trusted and well liked.
I have a parent who has had a bundle blockage for years now which has continued to show up (so not a false positive). My understanding is as long as one of the bundles of HISS is still firing to cause the heart to beat, it's not considered a problem, so that's a comfort to me.
If you speak to the cardiologist about your mom, and he/she feels it would be fine to have just a primary care doctor at this point, given her currently showing no signs of heart trouble.... what about this idea (since you're kind of loathe to terminate the heart specialist's being involved in your mom's care it sounds like)? What about asking the cardiologist if your mom ever starts exhibiting signs of heart trouble again, would they still be willing to keep your mom as a patient on an 'as needed' basis?
Thanks for your reply! I guess as far as giving up my mom's doctors, part of it is I'm afraid to break ties with them. Guilty I guess. She is monitored, and is checked daily, so I don't know why I'm so worked up about this. Another part is I hate to make decisions all the time, and am afraid I'll make a mistake and said...I should have done this or that.
I'm an only child, my father passed in 2005, and I'm the BIG GO TO person. I am also the parent of a severely austistic daughter (age 23) and with my husband of course, have to decide what's best for her as well. She lives with us. I guess I'm tired. Doing this all these years, and am human and will make mistakes. Just filled with guilt about everything. Eventually my daughter will be in a group home. So that is depressing to me.
I feel like nothing positive is in our lives. So I am rather despondent.
I will ask the Cardio, if they will take mom on "if needed" case, I'm sure they will.
Let me know if it works out with the cardiologist?
I can't say I understand the pressure you must feel with an ailing mother as an only daughter and a disabled daughter at the same time. I'm thankful with the stressors I do have in life that I have the Lord to lean on, because I don't believe I could go on without Him. He is the lifter of my head, my Comforter when I get depressed.
It seems to me you are doing the best you know how to do and are a caring daughter and mother. I have a second cousin who eventually had to put her son with cerebral palsey in a group home because as an elderly person, it was getting to be way too hard on her back to lift him. I believe it was a difficult step for her to take and and she delayed it for probably longer than she should have physically. It took a long time and I think more than one home, but it seems their son is now pretty well adjusted to being away from family and living in a group home. You need to consider your own health too. I hope you get many wise counselors to help you with this decision.
I took mom to the Cardiologist, and she did well physically...though didn't respond well to directions. The Dr. realized this and when I mentioned about terminating the Hypertension Dr. she agreed with me and said he would understand, as such situations happen in her practice as well. She also revealed to me that her mother was also diagnosed recently with Alzheimer's and was placed in a Assisted Living facility. She was very compassionate and understanding.
I called the Hypertension Dr.s office, told them what the Cardio said, and there was NO PROBLEM. So, I probably made mountains out of mole hills but that is my personality anyway.
It is always gratifying to me when I get compassion from a doctor and I'm so glad her cardiologist was that way during your visit! Empathy is a kind of balm, I think, so the fact she knows firsthand a little of what you are going through from her own experience probably really helped make the visit that much more special. Thank you for the update! Did she say she'd see your mom on an as/if needed basis?
Yes, she did....she made a 6 month visit...but with mom's mental capabilities failing, I believe she would be also understanding if I cancel and just leave it up to her primary care physician. I am fortunate my mom had such good Dr's, who were always on top of her condition, but are undertanding and compassionate. It is truly a blessing.
You could even just cancel and mention the doctor your mom could come see her on an as needed basis, in case you decide later you really want that caring specialist to examine her because something's gone wrong that you feel a cardiologist would be better trained for than the primary care doctor. Sounds like she left the option open for you, just in case, which was nice of her.
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