My mom cam home from the hospital two days ago after being in 2 wks...they pulled off some fluid but they seem to think its her heart is has two leaking valves which the mitral is harden..and she only has 30 % working....since she has been home she eats like a bird....and sleeps all the time///we called hospice in..me and sister think this is the end.. its really hard seeing your mom in this state.its hard to stay strong.
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Your response was very informative. Thank you! My condolences to your husband's passing. What a rough road.
I will check out Mayo's website. Dad's confusion seems to have exacerbated over the past three days. This afternoon he was actually better though. It just comes on suddenly from time to time but yes, it's when he's tired. He's the most cognitive in the mornings. And mostly, in the later afternoon is when we see errors. I am curious as to how your husband's Lewy Body was diagnosed, if you'd care to share.
Thank you again. And many blessings.
Thank you for your response. He has not been diagnosed with vascular dementia. Several doctors we've taken him to have not seemed to care much because he's 98 years old. I hate that attitude but not much can be done about it. His potassium level came out a bit high, so we've cut out his banana per day he was consuming. A nurse told me that was a good idea. He was checked for a UTI last weekend and it was negative.
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Caregiver, look up High Potassium on the Mayo Clinic website. There is a brief explanation there. I suggest you call the clinic and leave a message for the doctor asking about that level and if the test should be redone. That website also has an explanation of CHF.
My husband dealt with CHF for many years (30?). Its symptoms were mostly respiratory (shortness of breath, etc.). It did not cause confusion. He did develop Lewy Body Dementia and that, of course, made him very confused. He was fairly high functioning but occasionally he wouldn't know where some room was. This was mostly when he was very tired. And sometimes he'd walk around the house just looking at things, apparently trying to get oriented. Once he was standing in front of my closet, door open. I laughingly asked if he was thinking of borrowing a blouse. His answer: "I'm just seeing what is what." I think he was trying to cure his own disorientation.
Being confused as to time or place is very common in dementia. (Where is the bathroom? Should I wear winter clothes or shorts today?) When the confusion and other symptoms of dementia are consistently worse at a certain time of the day, that is called sundowning. In your dad's case, Caregiver, it might be that the confusion starts up when he is particularly tired. Does he have other symptoms of dementia? How is he the rest of the day?
You can look up sundowning for suggestions such as changing the lighting, changing bedtime, planning activities for that time of day ... environmental things that MIGHT help. I don't think there is any medical treatment specifically for sundowning.
Julie you are certainly in the very difficult position of respecting your father's wishes even though you might wish different decisions for him. I hope that my children are that respectful of me, when my time comes. Has he considered hospice? He would not need to go to a clinic anymore and they would take him off any meds that aren't helping his comfort level. They would also have other medications on hand to help with pain or anxiety, as needed. My husband was on hospice for 5 weeks in our home. It was terrible knowing that he was dying, but the hospice service brought comfort to both of us.
Best wishes for comfort for both of you.
Have you talked to the dr. about the potassium level? Has he been diagnosed with vascular dementia?
Sometimes the sort of confusion and agitation you describe can be caused by a Urinary Tract Infection.
Any change in mental status should be reported to his doctor, asap.
Dad has CHF & COPD. He started failing about four months ago and went downhill pretty quickly. I asked for a CBC to be done two weeks ago and we learned he has anemia. B-12 shots were given everyday (be an in-home health nurse), with three more being given this next week and then one per month thereafter.
He has gotten better physically and now his blood oxygenation is staying stable once again. But now we're witnessing terrible confusion (sundowners?) in the late afternoon until bedtime. Last night, he told me he didn't know where the bathroom was and I had to lead him over to the door. Is this sundowner confusion? Does it accompany CHF? And, if so, at what stage?
His blood panel showed he was high in potassium. The doctor hasn't mentioned any problem with that, nor any remedy. Is high potassium dangerous in this situation? What can we do about it?
Thank you so much for any answers you can give.
Right now, mom's condition is in the WTH mode. Her feet and legs are quick to tell the tale on her fluid retention; about a week ago, she seemed to be getting dehydrated again. I cut her diuretics in half for five days. It didn't seem to be making any difference, so the doctor stopped them completely. It's been a week, and still no fluid retention. The doctor doesn't understand it.
Mom is weak...still eating fairly okay...but not herself. I'm forcing bananas and raisins on her in case her potassium level is down, That's how she's acting. I just spoke to the doctor today, and he said to continue holding her diuretics until we see any slight fluid build-up in her ankles. Then one pill every other day.
Mom's on palliative care . . . I elected not to go into hospice yet with her. But the doctor is in no hurry to do tests, etc. I'm with him really. She has moderate dementia, can't walk without a walker/gait belt/and me. Suddenly getting sundowner's much worse.
If these diuretic adjustments don't pull her out? Then it's time to go home.
As to your loved one, I'd suspect dehydration. It's also my understanding that, when they drain fluids, it causes a massive loss of potassium. (I'm not sure about this...Pam above would know.) Both dehydration and low potassium could cause the symptoms you're seeing.
You're probably smarter than I am -- calling hospice in...
My dad had CHF and would get liters and liters of fluid pulled off of him. He was down to 10% ejection fraction and he lived on that for quite a while. The heart will protect itself if it has to and will create little arteries from its own tissue for the blood to get through. The heart can't go on like this forever but it does buy the person some time.
However, draining all of that fluid was very difficult on my dad and was hard on his body. The more they pulled off the more they needed to pull off and at one point, as his medical POA, I said "enough". My brother agreed. And we went to hospice just like you.
30% ejection fraction is really pretty good. Your mom may have more time than you think but calling hospice was totally appropriate. By the time our loved ones are at the point of needing hospice we're usually at the point of needing someone else to come in and take over the care and that's what hospice does. It's such a wonderful service.
Cry your heart out, hicky, if you need to. It's a sad situation.