Need to help Mom wear her bipap

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
KathyJo
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Need to help Mom wear her bipap

Post by KathyJo » Thu Dec 11, 2014 11:48 pm

Mom's equipment is ResMed Mirage Quattro Full face mask & ResMed VPAP S9
Pressure started at 20/16, lowered twice (by doctor's orders to possibly help her wear it longer) Now at 16/12.

My mother is 79 and has severe apnea. Dr. said "central". She's 5 feet tall weighs 123# (not or weight). Her sleep study (April 1, 2014) showed she quits breathing 52 times an hour and her oxygen goes to the 60s. She lives alone three blocks around the corner from me. She let me help her only 2 nights since she got her machine late May. She doesn't want to bother me.

I feel she is at a pivot point. If she doesn't start wearing it with some success, she will go down hill. She did not even want to ever get this machine due to worrying about what it would do to her hairdo. She quickly decided that she hated it and wouldn't wish it on her worse enemy. Her heart, neurologist, primary doctors all told her repeatedly that she does not breathe when she sleeps and it is very important that she keep trying to use it. Her memory is terrible. She does not seem to understand the concept of needing oxygen when she sleeps or it is damaging her heart, brain and her entire body. The neurologist thinks her memory problem could be mostly due to the apnea. A memory study is sceduled for January.

She has difficulty getting the mask on and when she does, she said it leaks and wakes her up, or she gets back pain or has to "potty". Her hands are weak from arthritis and she has difficulty with the mask, straps, and tubing. Her restless legs is getting worse. She just doesn't sleep well or long. She doesn't even attempt to put it back on after she takes it off after 1-2 hrs. Some nights she doesn't put it on at all. I occasionally call her machine rental co. and a nice woman there will tell me her "times" wearing the machine. We have had about 8 different mask fit appointments, she failed to fall asleep at a pap nap(Aug 2014)at the doctors office, and also could not fall asleep at her second all-night sleep study (Nov. 2014), where they were hoping to address her mask-wearing problems. (She did not take her usual dose of .25 Xanax that evening, even though they told her to take all her normal meds.)

Mom had 2 rather mild strokes (Oct. 2013 & Feb. 2014-2nd stroke due to biopsy where they took her off coumadin for 5 days and didn't "bridge" her).
Has atrial fib and they shocked her heart to correct rythm (June 2014) but it went back to a. fib due to her apnea not being reduced.

She told me this afternoon, she will have me come stay all night for 2 nights starting Monday to see if I can help her. I don't have a specific question just now, but I may in the future. I hope to learn more that could possibly help her to be able to wear it longer all nights and start feeling better. She has a wonderful sense of humor and looks forward to life. But she is really really tired.

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kaiasgram
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Re: Need to help Mom wear her bipap

Post by kaiasgram » Fri Dec 12, 2014 12:39 am

Welcome to the forum KathyJo. Has your mother spent some time using the mask and machine during the day, while awake, to see if she can get a little more comfortable with it? That's how many of us got over the "hump" early in this therapy.

Also check out this helpful article on Taming the Mirage Quattro mask.

When you do have questions it will be helpful for us to know which S9 VPAP machine your mother has since there are several models and you said that your mother has CSA (central). Look for the model number on a label, most likely on the side or bottom of the machine (the blower side, not the humidifier side). Something like 36004, 36018, 36018, or 36057?

There are a lot of factors we can look at including mask fit, leaks, and other aspects of the machine's functionality (Ramp, Climate control), as well as how well the machine at its current pressure settings is actually treating her apnea.

We will sure try to help your mother be successful with her machine. It sounds like it could really improve her quality of life if she can adjust and use it faithfully.

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Sheriff Buford
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Re: Need to help Mom wear her bipap

Post by Sheriff Buford » Fri Dec 12, 2014 6:20 am

Look up "Taming the Quattro" here. It is a short but very informative video on putting on the mask. That mask requires you to put the mask on in a different way you would normally don a mask. Have her wear the mask for an hour or so at night watching tv, reading or doing something she likes. This will giver her a chance to get used to the mask.

The only other advice I can think of is to maybe sleep next to her... knowing that she may awake at night fidgeting with the mask. That way you can help her. After reading your thread, I got the feeling your mother NEEDS to be successful with the cpap therapy. She is very blessed to have a daughter like you.

Please work all your issues here... we are here to help you and your mom.

Sheriff

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tortoisegirl
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Re: Need to help Mom wear her bipap

Post by tortoisegirl » Fri Dec 12, 2014 6:59 am

Sorry she is having so many problems, but good for you for being persistent with helping her. Another idea is to at least have her try nasal pillows. Is she a known mouth breather or did they just start her with a full face mask for some reason? Some known mouth breathers however can re-learn and use nasal pillows successfully. They are much easier to put on, less on the face, and would likely muss up hair less. The Resmed AirFit P10 would be a good one to try; very simple with only one strap. Agreed that using the machine during the day is key to getting accustomed to it and how the mask needs to be adjusted and such. Try to identify specific problems as much as possible. Best wishes.

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KathyJo
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Re: Need to help Mom wear her bipap

Post by KathyJo » Fri Dec 12, 2014 11:12 am

She thinks she's a side sleeper but when I stayed with her in Fla. for 5 weeks, helping to prepare her house for sale, she often starts on her back saying her prayers and would fall asleep and her mouth would come wide open. And when she stopped breathing for such a long time, she looked frightening, her mouth open like that.

I have helped her with the mask at night about 7-8 times. The high pressure never kept her from sleeping or staying asleep, so they even shortened her ramp time from 40 to 15 min. Each time I was with her and still awake to observe, the mask would do the face farts which wake her up. At that point she is in a somewhat combative frame of mind and gets quite adamant that she doesn't want to try to adjust it or put it back on. Also, she would not wake me up, if I was there sleeping, to help her. I printed a report to have her read about increase of heart attack and strokes in severe apnea about 2 weeks ago. And I have been softly honest with her, explaining she doesn't have any time to wait until she lets me or someone stay with her at night to help or she is going to be back in the hospital or dead. She loves life and doesn't seem to remember or comprehend the seriousness. We will have a dissussion, but then later when I mention the consequences again she responds like I am telling her for the first time.

I told her to throw her preconceived beliefs out the window, and since she gets so tired early in the day, go in her room, put her mask on and lay down and sleep if she can. She seems to think it is a weakness if someone her age needs to take a nap. She would always brag that she feels so much better if she lays down for just 20 min and doesn't need to fall asleep (even before apnea diagnosis). She had a nap about 3 months ago when she wore the mask and fell asleep for 1.5 hours. I got so excited that she would make it a normal routine. She did not.

Yesterday, she laid down with it on and she got a phone call from a friend she never hears from, talked for 15 min. with her mask on. Then she tried to sleep and realized 15 min. later she never plugged her hose into the mask or machine. I told her plenty of times to take the phone off the hook, she can't afford to allow any calls to interrupt her machine time. So I reminded her in a text and she replied that was a good idea, she had never thought of that!

I will watch the video, check her machine for model number. I am supposed to be staying with her Monday and Tuesday night. I don't want to wait that long but I dropped my kitchen 15 in. TV on my big toe last night when I tripped on the cord while I was caulking window leaks. I need to get an x ray somewhere today. Shh! Don't tell her or she won't let me stay all night.LOL

Thanks so much for you encouragement!!!

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chunkyfrog
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Re: Need to help Mom wear her bipap

Post by chunkyfrog » Fri Dec 12, 2014 12:27 pm

Cherish what time you have with her, and take care of that foot!

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Bill44133
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Re: Need to help Mom wear her bipap

Post by Bill44133 » Fri Dec 12, 2014 2:54 pm

Sorry to read about the issues with your mother. I have high pressures simular to your mother's with my bipap.
I would strongly recommend that you use a mask liner for her. This helps keeps leak down, and also more comfortable
then the mask on her skin. There is a nice lady on this forum: Becky at RemZzzs who would probably send you a free samples of the liners they offer, just send her a private message.

I wish you well...

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OkyDoky
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Re: Need to help Mom wear her bipap

Post by OkyDoky » Fri Dec 12, 2014 3:20 pm

Bill44133 wrote:Sorry to read about the issues with your mother. I have high pressures simular to your mother's with my bipap.
I would strongly recommend that you use a mask liner for her. This helps keeps leak down, and also more comfortable
then the mask on her skin. There is a nice lady on this forum: Becky at RemZzzs who would probably send you a free samples of the liners they offer, just send her a private message.

I wish you well...


The Remzzz might be a little difficult for her to place on her mask every night but I definitely would look at the PadaCheek liners that stay on the mask. I agree that with the liners my nasal mask was more comfortable and had less leaks.
I have since switched to the P10 which is less headgear, venting, and face coverage. My pressures are 15 / 11 and I have had very little problems with the P10.
ResMed Aircurve 10 VAUTO EPAP 11 IPAP 15 / P10 pillows mask / Sleepyhead Software / Back up & travel machine Respironics 760

sleepy1235
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Re: Need to help Mom wear her bipap

Post by sleepy1235 » Sat Dec 13, 2014 3:36 pm

My grand mother on my mother's side was always vexing to her two daughters in terms of what my grandmother needed to do.

For example, my grandmother in her 90s considered not taking her heart medicine because she thought it was too expensive. However, she had a generous medical plan that paid for it 100% on the spot.

My aunt would have my brother contact my grandmother and just tell her what she needed to do and that often would solve the problem. In fact this was done often when my aunt couldn't talk sense to my grandmother.

My grand mother was born in 1902 and passed away in 2000. She was of an era where doctors were male and authority figures were male.

It might help to have a male relative tell your mother what needs to be done. My bother was also blunt. That might help also.

I think the technical advice given in these other replies is useful for the technical issues. I am merely speaking towards the issue of your mother not accepting the medical advice. There might be some problem with her equipment or set up and her complaints shouldn't be summarily dismissed either.

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Tatooed Lady
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Re: Need to help Mom wear her bipap

Post by Tatooed Lady » Sat Dec 13, 2014 5:58 pm

I feel for you. We have a 91 year old neighbor who is just as stubborn. Can you put up reminder notes for her? A little "you NEED to do "A" or "B" will happen?" Or remind her that spending time helping her is a form of giving back for all the years she took care of you and is MUCH more pleasant (even on a bad day or night) than planning her funeral?

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bwexler
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Re: Need to help Mom wear her bipap

Post by bwexler » Sat Dec 13, 2014 9:03 pm

You need to introduce your mother to my brother in law. He is 79. It took me 2 years to convince his doctor to test him for apnea and another year to get him to even try to wear the mask.
Now after Many very blunt discussions and even TV news about a medical study on apnea, he tries to wear the mask most nights. He is averaging about 2.5 hours a night and his AHI is still about 18 with the mask. He denies the mask is leaking, but there is software available here for free, Sleepyhead, that allows me to monitor his usage and details of his results.
I strongly recommend you get a copy of SleepyHead and learn to use it to monitor your mom's therapy. I know you care more than her doctors. You can read about SleepyHead in the sticky at the top of this forum.
I would also suggest to look into other masks. I find full face masks very difficult and high pressures don't help. When you get setup with SleepyHead you may be able to determine lower pressures will treat her apnea and also reduce mask farts.
You will need to be very persistent and very blunt. Perhaps a male influence could help. I know I get more accomplished than my wife when it comes to her brother and helping him to better take care of himself.

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KathyJo
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Re: Need to help Mom wear her bipap

Post by KathyJo » Fri May 22, 2015 1:28 pm

Update: Mom' extensive cognitive testing showed she probably has Alzheimer's dementia and has been taking Aricept and will be replacing that with Namenda soon. This certainly explains so much of what I have been dealing with and why she was not able to understand the importance of wearing the bipap machine.

She is extremely upset with the Alzheimer's diagnosis, although she takes the medication for it. She asked that we never mention the word again and insists she does NOT have it. She insists she can handle all her affairs herself, although she has made several mistakes with medications, bills etc. These are things the doctor insisted she have supervision with. He also wanted her to take a driver evaluation at the hospital, which she decided she does not need to do.

She has been able to do much better with the machine, though. She doesn't wear it every night, but she has been able to wear it 4, 5, 6 and sometimes 7 hours. We have been changing the part of the mask that touches her face every 30 days, as is allowed through the insurance, and that seems to have helped the most. When I change them, I notice the older ones are quite smeared with make-up and normal facial oils, although she says she washes her face and the mask regularly.

(I think her ResMed S9 is 26940)

I do appreciate all the comments from those who took the time to do so. Thanks for your concern. I appreciate it very much.

SewTired
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Re: Need to help Mom wear her bipap

Post by SewTired » Fri May 22, 2015 3:25 pm

It sounds to me that your mom finds this a torment. Ask the doctor if an oxygen concentrator machine would work for her. At 80, my late Dad could manage that without problem. He chose to sleep in a well padded recliner because he could breath better. Dad clearly had apnea, but the doc never insisted on a cpap - just too much for him due to his weaknesses from heart damage. Did it help? Well, he used to snore so loud that you could hear him on the other side of the house, in the basement with all the doors closed. After he had the oxygen concentrator, I never heard him snore again. However, insurance doesn't always cover stuff that is simply considered 'convenient' despite the patient being frail, so you will have to check on that. Dad had a diagnosis of COPD that resulted in the oxygen concentrator.

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