Help! My grandma is making me CRAZY!!!!!!!!!

  1. OK, my grandma has had sick sinus syndrome for a long time, had a pacer placed about 5 years ago. Last week, she went into a fib, and stayed in it. Her cardiologist, whom I love, put her on coumadin. I'm in agreement w that. So, what's the problem? Grandma is freaking out b/c she does not understand the directions for the medication change in response to the labs.

    She was soooooo anxious, I had to make her take a xanax on her first day home. I filled up a seven day mediplanner for her, and put in the alternate day coumadin doses, etc... She must have called me 3 times every day since to question how I put the medicine in? I found out why, b/c she didn't think I did it right, so she took it all out, and totally screwed up her doses!!!

    Last INR was 3.9, so doc said to hold x 3 days, then take 2.5 mg Sat and Sun, lab on Monday. I told her 3 x thursday, 2 x Friday, and 2 x Saturday we were going for lab work on Monday. I called her this am, and said, are you ready to go to the lab? Today? She says. I even wrote this down so she would remember. I asked her how she took her meds, and she said one pink one last night. I said, you are only supposed to take half a pink one (half of a 5 mg coumadin), so she says Oh yeah, that's what I did. Huh??? That was how I poured it in her mediplanner. She kept calling me and I kept saying, grandmom, I don't remember what white pill is which, please just take them from your box the way I put them in there. But apparently, she doesn't trust me. She never has. It is a cultural thing.

    I have been trying to get her to see my primary doctor for 2 years. She has only been seeing a cardiologist, b/c she refused. Her other doctor was a crook you know. So, I made about 3 appointments and she cancelled every one. Fortunately, my doc is a very patient man, and agreed to try again. My grandmother says, well, I talked to a few of my friends (yes, please take their advice over mine, I am only a nurse) and they really like this doctor, so I think I want to go to him. I made the appointment, wrote it on her calender, and on a paper for her. She has called me four times to ask when the appointment is. No, she is not going senile, she is as sharp as a tack, this is how she gets when she is anxious. She refuses to take the paxil.

    Today, I told her, I am not going to pour her pills for her (she doesn't take them anyway the way I put them in there, with her input I might add,) and I asked the doc to call her w the change in coumadin. I also asked them to call me, so I can be sure she understood the directions. I don't know what to do with her. I am rapidly losing my patience!!! And believe me, I am a really super patient person, but when she gets herself all worked up like this, there is no reasoning w her, everyone is against her, poor her, no one wants to help, her...

    God, please give me strength!!!

    Well, not sure what I wanted from anyone, just needed to vent. Thanks for listening!
  2. Visit hoolahan profile page

    About hoolahan

    Joined: Dec '99; Posts: 3,786; Likes: 128
    Quality Nurse & Home Health Nurse


  3. by   CATHYW
    A suggestion, Hoolihan:
    Since Grandma is with the program, can you make a chart for HER to check off her meds, the way we do?
    Best thing is, make one for breakfast (and label it), one for lunch, one for midday, supper, and bedtime. I had to do this for my husband when he was first dx bipolar and thought I was trying to mix his meds up, so that he and his kids wouldn't hink I was trying to tx him, myself! Anyway, Grandma can check off each half of each pink pill she takes. If her coumadin dose is qod, things get a little more complicated.
    Do any of Grandma's friends have enough sway over her to get her to take her Paxil? I would ask the one that seemed "most with it" herself to please help us see that Grandma takes the medicines THE DR. HAS PRESCRIBED.
    Sure don't envy you! Good luck!
  4. by   Brownms46
    I hear and understand everything you're saying hoolahan, as I had similar problems with my mom. My mother had severe HTN, and had already had one heart attack, when I returned home to help her. Frustration wasn't the half of it, and yes I didn't know anything after being an LVN for 8yrs at the time. She also consulted her friends, and only if they said the same thing...did she listen to me. Her long time persoanl MD had a stroke, and was never going to get any better, but she was going to wait until he came back to his practice. She REFUSED to consider getting another MD to manage her HTN!!! REFUSED!! She came home one day from a campagn meeting, with her nose bleeding so badly, that she was using a load of towels to catch all the blood!!! I picked up the phone to call 911, as she usually required her nose packed in order to stop the bleeding. She threatened me within an inch of my life!!! She WAS NOT going to the hospital. It took me MANY months to get her to have certains tests done. She would only go to the county hospital, as she knew most of the people there, as she worked with Child Protection. Just before she passed from her last MI, I had just got her to the point of interviewing a new MD! can only do what you can do, and you can't do much more than that! Sometimes our own families listen to us the least! I'm very sorry you're having to go thru this...but it's nice that you still have her around to be difficult. I know in the thick of all of this, and with the knowledge you possess, it's difficult to sit back, and not worry. But sometimes all you can do is pray, and do the best you can...
  5. by   Sleepyeyes
    I don't get why we can be so great as far as our families are concerned--- and then one of them gets sick. Suddenly, we alone are expected to "make" them get better (no input or cooperation from them; medicine is still voodoo to their generation); perfect English is gibberish (we're secretly trying to cleverly "lock them away and throw away the key"and they still have enough brains to stop that trick, by golly!), and the mystique of the practice of medicine suddenly takes on enormous proportions --"oh no, honey, I can 't call the DOCTOR over how much atenolol to take; he's busy" while I'm only 1500 miles away and have to pull answers out like they were diamonds in a bank heist!
    I hear ya!
    My 86-yo relative "cut down on" her atenolol, coumadin, and zocor rather than call the doc about her "A-trib" problem a few months ago, for instance. I could no more accurately tell her doc what she's taking than I can determine the numeric equivalent of pi.
    I can only step back a little and add to my arsenal of knowledge-- a lot of elders are probably doing the exact same dance.

    (My mom for instance: her back itched. Dad, a tad myopic himself, scratched it. This went on for about 3 days before she noticed a generalized rash over her entire body and --gee whiz! her face was kinda swollen too -- oh by the way, she'd been taking Bactrim. They send her to the ER as a direct admit and give her some Benadryl. I call to talk to her in her room about 8 hours later, and she says, "Hold on a sec, okay?" and she comes back to the phone. Knowing her as I do, I said, "What did you do, Mom?" and she says (garbled because her face was so swollen by now she looked like a freak), "Well, I just felt so itchy, and I don't wanna bother the nurse, so I had a couple of Benadryl in my purse, so I took one."
    My response? I chatted her up til her nurse came into the room, and ratted her out.
    Oh, of course, she had already had one IV dose in the ER and another when she got to the floor.

    Ok, so that was about a year ago...
    Last edit by Sleepyeyes on Jul 1, '02
  6. by   thisnurse
    oh hoolihan....not many things worse than having to care for a family member. ESPECIALLY when they are noncompliant.
    until she settles down there is no explaining anything to her. i guess you already know that tho.
    i would just tell her...heres the pills, this is when you are supposed to take them. take them or dont. you have already done everything else. outside of tying her up and jamming them down her throat i dont know what you can do.
    best of are certainly going to need it.
    i remember taking care of my mom post op...oh i dont envy you
  7. by   sunnygirl272
    hey bout a home health eval for new Dx of afib...(right? can't scroll up) if she has medicare & is homebound she should be eligible..sometimes they are more compliant with a nursewho is not family...
  8. by   hoolahan
    Oh you guys are so great! Make me feel less evil. Well, I asked God to give me strength today, and he did. We both were nice to each other when I picked her up. I took her to the supermarket afterwards, and she insisted on walking back to her place. IT was only up to 77 at that time, and she wouldn't take no for an answer, honestly, she is spry for her 84 years. When we are in the mall, I try to keep up w her. I am a saunterer, and she is speedy Gonzalez.

    I had to call the docs office by 4:30 when we still hadn't heard from them. Grandma and I both agreed she should take her pills from the bottles, all but the pink one. I suggested she put her pink (coumadin) doses into the planner, and only them, as soon as she heard from the doctor, so she wouldn't have to worry about remembering, and she actually (today) thought it was a good idea.

    I had faxed the doc at 5am to ask for a HH referral Sunny, but after this day, she seems to have chilled a bit. We'll see how it goes tomorrow. We don't need labs until Monday, the day we have an appt w the new doc, but since that appt is so late, we won't get results until the next day anyway.

    Cathy, good idea to get her friends into the act. She does have one who lives accross the way. But I have to be very careful, some of her friends told her a pacemaker was a bad idea, and she refused it for one year, and was hospitalised 8 times, until we got her to crack. I told her I couldn't come there q time she had an irregular heart beat, call 911. That may have done it.

    Actually, I am thinking maybe she was feeling a little sorry for herself, since when she was on the telemetry unit, she got so much attn. She said to me on one of her admits. I got the palpitations, and I didn't even have to tell the nurse, she came right in and asked me if I was OK, she saw it on the screen. I said good, that is what they are supposed to do. But she was extremely impressed w that nonetheless. I really like the girls on the telemetry unit.

    Anyway, YES!!!! It is extrememly frustrating taking care of family members. But, you're right browns, it is good she is still so feisty to argue with me!

    Sleepy, one of her admissions, she called me at home, and wanted me to call the unit and tell them she had gas. She had put on her light, and told the nurse, but she didn't do anything about it. I said what do you want me to do about it. Bring me my red pills from home. I said grandmom, you aren't supposed to take pills the doctor hasn't ordered for you, WHAT red pills?? (Phayzyme I found out, an OTC gas remedy.) She says, no lie, "OK, FINE, I guess I will just have to die of gas!!!" I said back, just as snotty, "Well, I never heard of anyone dying of gas yet, but I guess there's always a first time!"

    this nurse, tie her down.... I LIKE it!!!! LOL!!!
  9. by   prn nurse
    I have been taking coumadin for 6 years....have all my marbles and get screwed up every week with it....have inr checked q 2 weeks.

    First of all, that doctor ought to be flogged for putting her on the ""alternating dose " bull sh*t routine. Whichever day is the lower dose, e.g. 3 mg M_W_F and 4 mg T_TH_S_S......Just put granny on 3 mg seven days a week. the blood will be thin enough. If he wants to increase or decrease doses after checking inr's ....fine ! but keep the dose the same !!! every day !! her doctor is a jerk and he knows he is setting her up to fail.
    and knows he is setting her up for frustration. He is making a simple and easy pill taking routine a hassle and frightening experience.

    "Blood thinner" therapy scares everyone...everyone has visions of hemmorrhaging, etc. and in the elderly, g.i. bleeds, etc. an inr of 2.5-3.0 will be fine for her....

    if you think about it, what on earth is the advantage of the higher dose (thinner blood) three days a week? and the lower dose (thicker blood) the other days???

    A real idiot doctor. Wouldn't you want the same level 24/7?
  10. by   live4today
    (((((((((((((Hoolihan)))))))))))))))))))) Reading your thread sounded like you were talking about my own Mother Dearest. Your Gramma and my Mother sound like Identical Twins! We have gone through similar situations with my Mother, and she refused this and that...won't keep her doctor appointments...says the doctor is crazy...mean...doesn't know what he's doing...doesn't listen to us kids...says we are "meddling in her business too much"...always says that when she knows we are right. She won't take her meds, so my two sisters in Atlanta go over to her place and personally give her the meds she is to take, and stand there and watch her swallow them, THEN...say to our Mother Dearest "Open your mouth, Mother, so we can see if you REALLY swallowed the medicine." Arent' they sooooooo cute when they get old and cantankerous? My Mother has been doubly stubborn all her life, but the older she gets, that stubborn Irish streak of hers is getting in the way of our being able to properly care for her. She is 70 years old, and only gets SENILE on us when we want to know something she doesn't want to tell us. :kiss
  11. by   Brownms46
    "OK, FINE, I guess I will just have to die of gas!!!" I said back, just as snotty, "Well, I never heard of anyone dying of gas yet, but I guess there's always a first time!"

    BOY O BOY...the ole guilt trip"...:chuckle...that is one ...they ALL have down pat!!! But good come back.:chuckle.. One for hoolahan..
  12. by   hoolahan
    I don't know prn, all the docs do it that way around here, at least in the beginning. I know eventually she will get settled into a regular dose. She is more PO'd that she didn't understand it right away, so she took out her frustration on me. I guess that's good, I always say we always pick on the ones we love first. No doubt her calmer attitude today is b/c one of her friends probably explained it to her, probably the way I told her, and she won't tell em so, b/c that would mean having to admit I was right. My grandma has been known to hold a grudge for years.

    Yes Renee, doncha just love the selective senility. Grandmom claims to have not been able to understand my written directions because she writes in Polish, yet she speaks fulent English and has no trouble reading her English bible, writing checks, paying her Visa bill, or reading her prescription bottle instructions! Yup, that would be my fault for not speaking Polish I bet!
  13. by   live4today
    Hoo...gotta love em though...bless their ol' hearts. My mother knows she needs to live with one of her children now, but she retorts back to us "God has somewhere else for me to be." Yeahhhhhhhhh...HE sure does, MA! :chuckle about coming to live with me or one of the other sibs? Do you think she's budging an inch in our direction? NOT!
  14. by   canoehead
    They only consolation is that eventually we will all be just as cantankerous and hard to deal with because as former nurses we will have to know "why" everything even when we are to dingy to comprehend a breakfast menu.

    Hoolahan with any luck you will have grandchildren that will give you just as much attention and pillow fluffing when you are old. If not- just call them 5 times a day and demnd it.

    Good luck, you have more patience than I do.