What to think about purple, swollen lower legs in elderly mother?

Yes. I’ve seen my mother’s appetite decrease too. But she is still eating for the most part. I’ve often wondered about her kidneys. When she comes off the water pills, she doesn’t urinate much. In fact hardly anything comes out. When she’s on the water piles, she’s in the bathroom every 15 minutes. Thank goodness she is still somewhat ambulatory. But it’s getting more difficult.

I'm not a medical person, so this is just based on what I've seen.   Not getting good blood flow can result in purplish spots, but from what I've seen they're kind of splotchy, if that's a word.    In activity can also be a contributing factor. They're not solid, like a bruise is, but from what I've seen are more striated.

Taking Coumadin or Warfarin can also cause purplish blotches, but they're more solid and generally larger. 

My father developed larger, more solid purplish spots on his feet as he moved closer to death.   One of the nurses told me that was a reflection that he was getting closer to the end.

So, I think it depends on the type and consistence of the purplish spots.    The hospice nurse should be able to distinguish between different types and provide an indication of what the underlying issue is. 

Has anyone given you insight on why her legs are weeping?

I have seen this in geriatric patients as they approach the end of life. The color is likely re: decrease in oxygenated blood reaching her extremities. The excess fluid is related to her congestive heart failure where the weakened heart cannot pump forcefully enough any longer and pooling occurs in the lower extremities. I do not believe the pacemaker is the cause of any of the problems with your mother's legs, though I agree it is related to her heart. There are 2 factors needed for an effective heart. The 1st is mechanical in nature. This involves the heart muscle being strong enough to continue to pump effectively against hardened arteries and constricted blood vessels as we age. Medications can help to strengthen the heart contractions, decrease the pressure from the arteries, and remove excess fluid via the kidneys with water pills. The 2nd mechanism is electrical. The heart has both a mechanical and an electrical system. When the latter isn't functioning correctly it can result in abnormal heart rhythms and heart blocks. The pacemaker assists the heart in maintaining its electrical function. If your mom is being optimally managed with medications for her congestive heart failure, it is unlikely that replacing the pacemaker will improve the mechanical pumping or beating of her heart. Hospice should be administering her regular heart meds as determined necessary by her medical provider, the patient herself (if possible), and her caregiver/POA. The medication morphine sulfate is one that people think about being used for significant pain. However, it is often used with great results and particularly with Hospice patients to help improve breathing and the function of the heart at the end of life. Best wishes.

P.S. This is my first day on this website. Please forgive me if it was not meant for the general public to respond to questions. gg

My mothers legs were like that. She had kidney and heart failure. I dont know what caused the purple color . She was on torsemide which seemed to stop wrking.
We stopped teh med about 4 days before she died, Mom had stopped eating and drinking the week before.