NelWhite

[NelWhite]

Mum was diagnosed with vascular dementia about 6 years ago & moved into a care home 2 & a half years ago when it proved too difficult for my Dad to look after her.

Mum has recently been diagnosed with a prolapse & after a doctor's case meeting it was decided that she would go into hospital to be seen by a consultant prior to having an operation to rectify the issue.

My concerns are:

• Who will have responsibility for her care?
• How might she cope with being in hospital after being in the care home for 2+ years
• Will she cope with a general anaesthetic
• How will they manage to keep her in bed in hospital when she spends all day wandering around the care home

I live 200+ miles away and find it frustrating dealing from afar. My Dad is under the impression that the care system will take care of my Mum. Any advice please?

 

[Katrine]

To add to your list of very sensible questions:

• 'is there a suitable treatment/procedure that avoids general anaesthetic?'
• 'how would her post-surgery aftercare be managed?

She would probably need 1:1 care supervision in the hospital, which is best arranged in advance because nurses cannot be expected to do this. Some hospitals employ a bank of carers to do this.

Most elderly men are less than well informed about 'women's problems' and perhaps your dad would rather not enquire too closely. I would try to find out more about exactly what is prolapsed and what the options are for non-surgical treatment. A rubber pessary ring can be inserted at the top of the vagina to control a cervical prolapse but this might not be suitable if the problem involves bladder and bowels. They must have a good reason for recommending surgery, but have not considered the care aspect of their choice.



'

 

[love.dad.but..]

My dad 86 had to have an op after 18 months in a care home. He is a wanderer/pacer day and night. His post op risk was very high but the operation was necessary as an emergency. He came through ok but pre op after I was encouraged to go home for a few hours after staying the night I was told he was found by the entrance even though they assured me he would be monitored. From then on I stayed the whole 11days with him. Dementia care and awareness was lacking even common sense. He would not have been monitored properly in terms of fluids or eating and they would not have managed him. I struggled at times to keep a very determined dad from getting out of bed, leaving the ward, peeing inappropriately,pulling his cannula out etc. Even though they can get someone to do 1 to 1 for a mobile dementia patient they didn't have available staff or get one in. Tbh it was a nightmare and hopefully I won't have to repeat. Am assuming the hospital take over duty of care whilst a patient.

 

[NelWhite]

To add to your list of very sensible questions:

• 'is there a suitable treatment/procedure that avoids general anaesthetic?'
• 'how would her post-surgery aftercare be managed?

She would probably need 1:1 care supervision in the hospital, which is best arranged in advance because nurses cannot be expected to do this. Some hospitals employ a bank of carers to do this.

Most elderly men are less than well informed about 'women's problems' and perhaps your dad would rather not enquire too closely. I would try to find out more about exactly what is prolapsed and what the options are for non-surgical treatment. A rubber pessary ring can be inserted at the top of the vagina to control a cervical prolapse but this might not be suitable if the problem involves bladder and bowels. They must have a good reason for recommending surgery, but have not considered the care aspect of their choice.



'

Thank you

 

[Caroleca]

Thank you

Nell white my mom has a very large bladder prolapse...it is terrible...the dr. Said he has never seen one as big or bad....it is hard to find a dr. Who wants to take the chance for surgery...but it is really affecting her....she can't sit down and has to lay on her side in bed...and now that she is becoming incontinent... It is a huge issue. We think that they should take the chance and remove although we are very nervous.

 

[carol4444]

Nel, We found out that Mum has a prolapse about a month ago. She has told the dr that she definitely doesn't want surgery, she is 86. So we have an appointment with the specialist in January for the non-surgical options. Apparently it is a large prolapse and it lies against the tube that releases the urine. When she needs to spend a penny she moves it to release the flow. I know several women locally that have a prolapse and they all say that the rings are pretty useless. My worry is that Mum will have the ring inserted, it will work for a few weeks, by which time she will forget what to do in order to wee without it, and then, if it comes out, have the most terrible pain whilst waiting to empty her bladder. If help doesn't arrive I guess her kidneys will be damaged. I'm not remotely knowledgeable about medical matters so my mind works overtime with worry. My other concern is that as her abilities and memory deteriorate, could a carer be expected to sort this for her every time she needs the loo. I expect she will be fitted with a catheter at some stage which isn't going to be without its problems.

On the plus side, I have a friend, age 86 who has just had a hysterectomy because of a prolapse. She had the op on a Weds and was back at home on the Friday afternoon. She does lives with her son and daughter-in-law who could look after her. A week later we went for a short walk. The op was two months' ago and she is now living life normally so you may find your mum copes well. I think the golden rule is 'no lifting' or they may well undo the positive effects of the repairs.

I am doing my pelvic floor exercises daily! I hope you manage to find the best solution for your mum. I would be interested to know what the medics think will be the best solution for your mum. I worry so much about my poor mum and feel so frustrated that I can't help her.

 

[Caroleca]

A hysterectomy does not resolve a bladder prolapse...it is a lot less invasive as it involves the removal of the uterus...bladder prolapse I'm afraid is much more complicated. Unfortunately, the pensary does not work when the pwd can't figure out how to use it. We tried it many times without success.

 

[Katrine]

A hysterectomy does not resolve a bladder prolapse...it is a lot less invasive as it involves the removal of the uterus...bladder prolapse I'm afraid is much more complicated. Unfortunately, the pensary does not work when the pwd can't figure out how to use it. We tried it many times without success.

The vaginal pessary ring I referred to is fitted by a doctor or nurse and should be replaced every 6 months. If it slips out it needs refitting by a health professional, not the user. Usually displacement is down to it being the wrong size, but sometimes can be the result of straining to stool, or even a big sneeze.

I agree that a pessary ring isn't always suitable but if one has been prescribed then I would think the doctor was hopeful that it would be a suitable alternative to surgery. My MIL has had these rings for at least 4 years. She has no idea about it any more and doesn't need to. She can't feel it. The ring just does a supportive job. Twice a year she has a check-up with the nurse and a new ring is fitted.

 

[Caroleca]

Yes Katrine...that is the same one I am talking about...fitted by the specialist and to be changed every 6 months . I suppose it depends on the size of the prolapse. When mom was still living at home we found two of the pensarys on the living room floor! Unfortunately moms prolapse is very large ...I know they will not operate ...but now that she has become incontinent...she keeps developing Utis. I did try ordering special underwear to try and hold it up...but unfortunately, they did not work.

 

[Katrine]

Yes the rings can turn up in unusual places. I found one jammed on to the light bulb inside a table lamp.