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demstress Asked April 2018

Mother has a host of medical issues but a few days ago has become very weak and lost her appetite. Medical team has no explanation. Any advice?

My 93-year-old mother is in hospice care in my home. She has heart issues. Until a few days ago she was eating and using her walker. On Sunday she was very tired and would not get out of bed. She didn't want to eat and said that she was nauseated. She drank some water and Ensure. The hospice nurse came and said not to force her to eat. She gave her a low dose of liquid morphine. This medication made her have very bad dreams that scared her and so we stopped the medication. Her regular nurse came and took all her vital signs and said they looked good. When I asked what could be causing this sudden change she did not have an explanation. Today my mother has eaten just a couple of spoonsful of cream of wheat. What can be done to alleviate her feeling nauseated? She needs to drink but she is sleeping a lot and I am worried that she will become dehydrated. Can anyone shed some light on this situation? I will respond if you require more information so you can give me your opinion. Thank you so much.

Veronica91 Apr 2018
Demstres as has been suggested Mom may have started her final journey. You should know in a few days if the antibiotics are going to help.

As Joann suggested the antibiotics may cause an upset stomach and/ or diarrhea.
Offer sips of water or whatever Mom likes. Let her drink if she wants to but the important thing is to keep her mouth clean and moist.
Joann's daughter is a RN with experience in end of life care so I would expect her to recognise the signs of approaching death.
This is not the case with modern general nurses because far fewer patients die naturally in a hospital so the progression towards death is just not experienced
There is no specific training for hospice although there is a certificate that can be obtained by hospice and palliative care nurses.
Hospice nurses may be very experienced in their previous field but until they have worked in hospice for a while do not necessarily have the skills to recognize approaching death. That is not to say their caregiving skills are lacking

JoAnn29 Apr 2018
She may not eat on antibiotics, they make food taste funny.
What bothers me is the Nurse couldn't answer your question. When my Mom had been sleeping and not eating for a week Hospice was called in. My daughter and I went to the NH befo=e Hospice got there. My daughter is an RN who has worked Rehab/ NH facilities. She ran a few tests on Mom and said "it's time". Nurses should know when the time has come. For this Nurse to say she didn't know boggles me.

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demstress Apr 2018
Thanks all for your comments. I gave mother ginger tea and she liked it. The regular nurse stopped by again today. Found out mother has fluid in her lungs due to an infection and put her on a 5-day course of antibiotics. There was no edema in her legs or abdomen so congestive heart failure was ruled out. We shall see how she does.
Thank you all for being there for me!!

blannie Apr 2018
Your mom may be starting her final journey. Just know that she may have good days (where she eats and seems "normal") and bad days (where she sleeps and doesn't eat much or at all). Mom's hospice nurse said that for every good day, mom would probably have about three bad days. There are usually ups and downs so that it's hard to know what is going on until the final day or so. {Hugs}

freqflyer Apr 2018
demstress, whatever you do, if Mom doesn't want to eat or drink, do not try to make her to take anything by mouth. Sadly it could be that Mom's organs are starting to shut down, thus any food or liquids in the stomach would be painful for her. Any water would sit in the kidneys, again painful.

If the Ensure is chocolate, maybe it is creating acid reflux which can make a person feel nauseated.

I see from your profile that your Mom has Alzheimer's/Dementia, and you had mentioned that Mom is on Hospice care. My own Mom had a very strong heart but she was on her final journey being 98 years old. My Mom had stopped eating and taking in liquids. The morphine did make her calmer and helped with any pain she had.

Oh, don't be surprised if your Mom should "rally", thus sit up and talk, want to eat and drink for a day or two. I don't know why this happens, but it is common. Then Mom will go back to sleeping and not eating/drinking.

This is a very tough time for you. We are here if you have any questions, want to vent, or need comforting ear.

demstress Apr 2018
Heather 10, no she does not have an intestinal blockage or ulcer. I will try the ginger and broth and she if she feels better. Thank you.

Heather10 Apr 2018
Does she have an intestinal blockage or ulcer? An Ulcer will usually put blood into her stool, darkish brown blood.

Can you give her spoonfuls of ginger flavored water. If you have ginger spice in your closet, just add a 1/8th teaspoon of it to warm water.  Ginger is a natural remedy that may prevent her from feeling nauseated.

Also give her Broth. It will also keep her better hydrated, if you can wake her to give her a few spoonfuls every few hours.

If she has already been evaluated by competent hospice personnel, and they have ensured there is no infection or blockage, it may be impossible to know at this time.

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