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My 83 yr old mother had a heart attack a week ago. She is now living with us and doing as little as possible to help herself. As long as other people are around she puts on a good show of being independent but the truth is she has used and manipulated me since childhood. To the world she appears sweet and easy going but behind closed doors she says really nasty things about people and thinks its funny. She moans and groans when there is nothing wrong. Whimpers and whines about every pill she has to take, going to the bathroom, getting up, sitting down, drinking water. I know she is weak-her ejection fraction is 35%. She's too ill for assisted living. My husband and want to take care of her but this is just the beginning of a very difficult journey and she is contributing nothing.  Feel I'm doomed before I even start. Joan

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Let me share what I learned last week about ejection fractions. They can vary, depending on health, exercise and other conditions. My father's was down at one point, up to around 50% at another, down to 28%, and now back to 44%.

When I queried his cardiologist how and why this could happen, as well as what could be done to keep it at a higher level, he explained that one of the factors is oxygenation, an excellent reason for someone who needs oxygen to use it as prescribed.

I'm summarizing the technical aspects as I remember them, so any nurses reading this might find it a bit simplistic or perhaps not as medically detailed as it really is.

With that caveat, as I understand it, oxygen helps all organs to which it is supplied by the body, including the heart. Improving heart function is obviously good, so is exercise. Simply, oxygenation can improve the ejection fraction, and oxygenation can occur better as people move around and become less sedentary.

(I hope I haven't got that confused)

So your mother needs to be recognize that one way to improve her condition is to start moving around and getting some PT.

Joan, if she won't cooperate in her own healing, then I do agree that you need to be considering some sort of facility assistance b/c her lack of mobility and cooperation will be overwhelmingly frustrating to you at some point. And the level of care she'll need will also increase.

However, if she's manipulative, I kind of suspect that she's not open enough to recognize what's the best for her, and that will frustrate your efforts to provide care.
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Joan, there is no way to really get ahead of it except to figure out what she can and can't do. I know how you are feeling, because I live with my mother who is sick all day every day for as long as I can remember. It will wear you down. I wondered if, since your mother is still in possession of her faculties, she might do well in assisted living.

Is she going through any rehab or counseling to learn to deal with her lower cardiac function? What GardenArtist wrote made me think of that. It would be excellent for her to know how to help her heart recover as much function as possible.

I feel bad for you and your hubby. You'll feel guilty, but I have a feeling the house may be a happier place if your mother goes to assisted living. I hope you can make that happen. You can still visit, but you won't have to come home to it every day. Take it from one who has been (and still is) there and knows.
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Joan, why did she end up in your home with you and hubby as caregivers? If you think this is bad now? Just wait you ain't seen nothing yet! Tell rest of family they better start getting other residental care lined up. If a nursing home a doctor's order is required for that. Hopefully gma's legal documents are in order POA's, DNR, Living Will, etc.
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Start looking ar skilled nursing care facilities NOW. Get the finances in order. POA? Guardianship? Private funds? Medicaid? It's obvious from your post you know where this is going. Start getting prepared.
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Maybe more input here would be helpful. Posting again to bring this to the top.
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