Difficulties in Determining Cause and Severity of Illness

We have had an ongoing issue - one for which I am not getting good resolution via my own efforts nor those of her physician.

Marilyn called this morning from Mom's apartment.  Our first thought was that her stomach ache of the night before had been very real, leading to diarrhea.  Her apparent diarrhea had been severe.  Both of us began working on the clean up process.  I took charge of getting her into the shower that Marilyn already had running while she took soiled objects out to the laundry area.  I made sure Mom was in the shower before I removed her pull ups to keep the contamination as localized as possible.

You can't imagine how much work it was just to get her into the shower and have her understand she needed both feet in the shower.  Then getting her to lift her feet one at a time required much coaxing before I could finally take the whole mess and put it in the waste basket.  Marilyn was on hand to take it to the trash outside immediately.

Once I had her cleaned, which in itself took me a long time as feces was spread all over her, Marilyn dressed her.  I took over the laundry and spot removal while Marilyn launched into serious cleaning of the bathroom.  Then I made sure Mom had something to drink.  Her hand shook as she drank the Vitamin Water I offered.

Having the first load of laundry going and Marilyn handling the other details, I called the advice nurse at TVC.  Still working under the assumption that this was the beginning of vomiting and diarrhea that has been going around, I wanted to know the markers to determine if she needed to go to the ER - and while making that call, I also moved Mom to another physician, one that is not as busy as Dr. Tsigonis and hopefully more responsive.  I took Mom into see Dr. Tsigonis recently because those at FRA commented regularly that her stools were noticeably loose.  No remedy to this situation was suggested and I began to feel that Dr. Tsigonis was a bit more hands off than what I need right now.

So, having dealt with a situation that had been on my mind for awhile, I then waited for the advice nurse to answer.  Bonnie was on duty today.  She is so nice and good at what she does.  She listens to me and gives me practical, doable advice.  She asked if she had become incontinent.  We told her that we saw small slips, but nothing like this before today.  She asked if she was running a fever - dang if I hadn't forgot to bring down the thermometer.  She asked if she'd been exposed to anyone ill.  Yes.  She asked if she was hungry - no.  Was she willing to drink liquids.  Yes. How long had this been going on?  There'd been comments from FRA about loose stools earlier this week, then she wouldn't eat yesterday.  Today was the first day where things were out of hand.

Finally, based on all those symptoms she told me to buy Pedialyte to replace electrolytes and to use an over the counter medication to reduce the symptoms of diarrhea.  She stressed that Pedialyte was more effective than sports drinks which did supplement electrolytes, but not at the levels needed for dehydration resulting from diarrhea.

We pulled together what she suggested and administered them earlier today.  She has not had another incident today, which raises the question of whether it is really diarrhea.  It could be a symptom of something else; it could be the onset of incontinence - although she has not shown signs of this issue during the day.  Maybe that is because those at FRA keep track of her and ensure she uses the toilet regularly.  

It is possible that the Immodium worked quickly on a digestive system that had little residual food, but how would I know? She did ask for help to get to the bathroom today and has not had another incident. These are things I need to record to tell Mom's new physician when she has her initial visit.  We are able to get her into see her 1/18 for a first contact visit and we can get her in to see her earlier if she becomes ill.

Dementia throws an extra level of uncertainty into any diagnosis.  For mom, it always is a bit of this and that.  How to determine what is going on and how much needs to be done to ensure her comfort and well-being challenges me constantly.  Would an assisted living home care giver go to the lengths I do?

But I do know this .. being complacent about her cleanliness and how her digestive system is awry isn't cutting it for me.