Middle-aged daughter, diabetic, now with nephrotic syndrome, edema, in hospital.

[No Vested Interest]

She lives alone and has never tended to her diabetes very well - ate cake nightly, etc. Fairly hard-headed, though amenable to advice and help at times of trouble. She's needy psychologically and monetarily, on SSDI and Medicare.

Last weekend she fell out of bed and was on floor for 14 hrs, her fluid-filled legs not able to support her getting up.
She finally crawled to her phone, called 911, and was transported to ER and admitted to hospital, where she remains eight days later and will stay until at least Monday, when arrangements have been made for her to go to rehab in a nursing facility. She had muscle breakdown due to being the floor so long, was considered critical at first, then down-graded to serious. More fluid was given by IV to protect the kidneys. The extra fluid - ten liters- has largely left her body, but legs, feet, body, hands are still large with fluid.
The physicians - internist and nephrologists- at the large teaching hospital seem competent.

I suspect she will remain in rehab the maximum allowable under Medicare - 20 days-, but am at a loss as to what is the best course for her after that, in order that she eats properly and tends to her body's needs.

Thoughts and advice in this area would be appreciated.

[kickysnana]

1. Thoughts and prayers are with you.

FYI One of Auntie's PCA's had to leave recently because her mom in the Chicago area was in the hospital her diabetes out of control. It turned out her pen was defective and it was a family member who did some sleuthing or she probably would have died when she continued using it after her hospitalization.

[No Vested Interest]

3. Thanks for your response. Defective pen - just shows that

there are so many small details that have to be monitored.

[DeadLetterOffice]

2. Has she considered counseling?

It's hard to accept serious medical diagnoses, and some people handle it by NOT handling it -- denial of the seriousness of either the disease or its consequences is very common. Perhaps some mental health counseling to help her face the reality of the diabetes would improve her health behaviors and compliance with doctors' recommendations?

That being said, I also want to say that her health behaviors and choices are her own, and she has to be the one who wants to change them before anything good can happen. As much as you love her and want what's best for her, you cannot be responsible for her choices, and you cannot make her take better care of herself. Only she can do that. It's awful to watch people we love do stupid things, but sometimes that's the only option we have.

Many hugs and good wishes,
DLO

[No Vested Interest]

4. DLO- You are of course correct re the behavior of others being

their own responsibility, and in general I have known and respected that. She has been "diagnosed" in recent years with Aspergers syndrome - I'm not sure that's the most correct diagnosis, but will accept it in lieu of no diagnosis. Gregarious but doesn't recognize personal boundaries.

I am a senior, healthy enough but with limited energy. I do have the financial means to provide proper meals, perhaps delivered to her, if necessary. If there were a living situation that would look in perhaps daily, I could also provide or assist with that, though that would clip her wings in some ways that she would chafe at.

While recognizing that resolving the problems may be difficult if not impossible, I just had to get this off my chest last night, as I have never reached out to DU in this manner before. There is much wisdom and support here, which is why I stay, despite the squabbling that goes in some of the forums.

Thanks for hugs and good wishes.

[nadinbrzezinski]

5. This is what is called an ideal intervention moment

contact the facility once you know where it is, and ask to have her have a serious conversation with the RD, as well as medical personnel. As in a one on one with a diabetes educator.

Being in critical condition usually is a good scare. Aspergers could complicate matters as in she does not see this is as a serious crisis, but usually being admited to the hospital in pretty serious shape is a wake up call. We used to use these crisis when I was a medic to reach people. Did it work all the time? Nope, but it did work some of the time.

[No Vested Interest]

6. Thanks for your response, Nadin. Daughter was in hospital 10 days,

then in physical therapy rehab for ca 4 weeks.

She is now in my home, with various therapists due to visit several times a week, for up to 9 weeks (Medicare.) Plus a nurse daily for this week at least.
She's trying; still has terrible edema of legs and feet - can't wear shoes, only a soft pair of Dearfoam bootie things, with a light sole.
I fear that I've bitten off more than I can chew, preparing meals for her, monitoring therapy, calling for drs.' appointments.

I tell myself - take a deep breath.

[nadinbrzezinski]

7. You do it because you love her

[No Vested Interest]

8. Yep. Gotcha. Thanks for listening. nt

[No Vested Interest]

9. Taking daughter back to Emergecy Room at Doctor's Advice.

Things don't always go well.
Keep us in your thoughts today, please.