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Questions & Answers - July 2002

Mary C. Fridley, RN,C is a registered nurse certified in gerontology with more than twenty years in the geriatric health field. She is the owner of Gero-Resources specializing in caregiver, eldercare, and successful aging education and advocacy. Mary is also an author of two caregiver advice columns and contributes articles to various websites. She is available for speaking engagements and would be happy to answer your questions or concerns while maintaining your anonymity.

About Mary
Mary's Column Archives: Caregivers'
Questions & Answers

Dear Mary,

My mother is 83 and just moved here to California from Ohio to live close to me in a board and care assisted living home. She got here safely and inside a week she fell and broke her hip. She had total hip replacement and within two weeks developed a severe MRSA infection that went all the way to her new hip prosthesis. She has additional health concerns, like type II diabetes. This infection and lack of activity has made her insulin dependent again and she is very depressed. She has always been an active person, strong-willed and knows what she wants. She is in the early stages of dementia and I am her agent as Durable Power of Attorney for healthcare. She recently stated to me that she doesn’t want to suffer anymore and nursing home and hospital stays are not how she wants to live out the rest of her life. I have given the staff permission to restrain her in bed and in her wheelchair because of falling.

The MRSA is not going away, even with daily intravenous antibiotics. Every time I bring up Hospice services to the staff, I get a look and attitude that I am crazy and insensitive. They even threatened me with having Mom committed to a psychiatric hospital to keep her on her medications.

Mary, I know my mother’s wishes not to have her life prolonged with life sustaining procedures. She wants me to consider her suffering, the expense, and the quality of her life when I have to make decisions for her. She does want comfort care when it is time.

My question is where does my mother stand? Should I contact the local Hospice now, or wait to see if the antibiotic medicine works? She has an HMO that will not pay after a certain point. If she discontinues all her medications, and her ailments took their normal course, would that qualify her for Hospice? Should not her wishes be considered while she still has a mind to make them clear? She is not a wealthy woman and will have to go on Medicaid if this merry-go-round continues. How do I help her?

As I have said before, MRSA, a staph infection, is very difficult to get rid of. Intense antibiotic therapy, time, and patience are necessary to combat the infection. Although your mother’s poor physical health and discomfort are of great concern, I am just as concerned about her emotional health. If she is not being treated for depression please have her evaluated by a psychiatrist specializing in eldercare. If she is being treated, her medication needs to be reviewed and possibly changed. Treating her depression is essential for her overall health and ability to fight infection. It is known that the immune system is negatively effected by depression.

Your mother’s MRSA infection is not considered a terminal condition nor is antibiotic therapy a life sustaining measure. To stop her medications would be assisting her suicide. However, you may want to call Hospice and talk to a counselor about the situation. The counselor may be able to help with suggestions about comfort care during her rehabilitation.

I encourage you to aggressively pursue the emotional aspect of your mother’s care. She deserves to feel both physically and emotionally well. Once her mood lifts and the MRSA is resolved, she may be able to go back to the assisted living facility.

God Bless.

* * *

Dear Mary,

Somewhere I have heard that there is financial help for children who provide care for their parents. There is so much information on the web that I am finding it difficult to find specific sites or agencies. Any help would be greatly appreciated

Yes, there is financial help available for caregivers. The Federal government has made money available through the Older American’s Act in the form of the National Family Caregiver’s Support Program. This program is in place to provide respite (time off) for caregivers caring for an older loved one, older caregivers (60+) caring for grandchildren, or older caregivers caring for a developmentally disabled child. To access this resource, call your local Area Agency on Aging. You can get the address and number of the one nearest you by calling the Eldercare Locator at 800-677-1116. The nice feature of this program is agencies are encouraged to be creative to meet caregiver needs. For example, your needs may be for financial help to pay for adult day services, while someone else may need a washing machine repaired to avoid leaving a loved one alone to go to a Laundromat.

You have not mentioned where you live, but each state and local Agency has other programs that meet caregiver needs, too. If you do not know exactly what your needs are, just talk to a representative in the agency’s Information and Assistance department. The representative knows the questions to ask and is willing to spend the time with you.

I hope this helps.God Bless

Email Mary:

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