Mom may need emergency services; I don't want to take her in. Any ideas?

Amitebird, how are things today?

Just have to say, and maybe a Nurse member can back me up, that you can increase oxygen but it doesn't mean her body is absorbing it. Its not so much her Pause Ox number but if her hemoglobin is carrying the oxgen thru her body effectively. If hemoglobin levels are low than carbon dioxide is not removed from the body.

Get her to ER.

She needs to be taken to the hospital. They won't let you go in so you needn't worry about your own health. If you don't take her to hospital, she will probably die. I would have her re-evaluated for hospice while she is there so when she goes back to AL, they will know what to do.

I wouldn't make any decision based on fear of catching covid19, if your hospitals are anything like mine the restrictions put in place are very stringent and as someone else pointed out you are probably much safer there than in many other places. My reaction was based on the understanding that you may not be able to be with her, especially if she is admitted. I'm sorry you are in this hard place.

Last week my mother had a possible UTI with a TIA and symptoms that resolved in an hour, called a new local hospital and asked if any COVID19 patients and told us no cases. Asked if I could stay with mom if she is admitted overnight. ER called administration at home and got the ok for me to stay with my mom. I did tell them no other options, but to stay with my mom. She was given IV fluids and antibiotic. She was discharged next day and doing well. All staff wore a mask and limited contact with my mom, except meds. It has been 4 months since my mom was in the ER/ hospital for a serious UTI, so caught it early. I would bring your mom to the ER, call to see if any cases of COVID and go from there. I wore a double mask as well as my mom. I have no regrets on my decision. Mother was tested for COVID and came back negative. Good luck!

Are you willing, at 94 to ask again for hospice, or are you not? If not, call the ambulance and have her transported. You should not go there. Risking her life will happen EITHER way; it makes no sense whatsoever to risk your own as well.

Following on Pam's advice, given your concern about the ER, and if you have a pulmonary doctor, that's an alternative if you can get a quick appointment.   More than likely, tests would be done to determine if her need for the Albuterol and liter flow rate have changed.   

How many liters of oxygen is she on now?   That may make the difference.

When my father was on oxygen, 90 was generally considered the low point for acceptable SAT rate.  

Another possibility is to change the cannula tubes; they do get dirty and should be changed regularly (but I don't remember now how often).   And beyond that, I've had ones that simply don't carry the oxygen; they must have been defective in some way.     That's why I always carried back up cannulas with me whenever we left the house.

Same with batteries for the portable concentrators.   I always had charged back-up batteries, just in case.

This is her Hospice Co that she was on 2-3 years ago and she was kicked out because she got well. I am waiting to hear from them as they have all her info and may be able to re-admit her quickly. I have put the word "palliative" in my mind too now. Thanks.

Why not obtain another hospice evaluation. As people's condition changes, it might make a difference. That way, you call hospice with questions. With my LO, there is a sign in MC to call hospice before 911. Or, see if they have a palliative care program, if she doesn't qualify for hospice right now.

Is she on hospice? If so, then I agree with you not taking her to the ER or allowing her to be taken there. Why bother at this point I guess?

I would say she needs to be kept comfortable and beyond that, extra things may or may not be necessary at this point. Unless she is not on hospice and wants all measures to make her life as long as possible.

Good luck!

I've read post from lots of people here on the forum who actually had a loved one improve on Hospice as well as many who have been on it for years, it doesn't have to mean a choice between death at home or death in the hospital. With Hospice she should be able to keep all her COPD meds as a quality of life issue and they should also be able to prescribe oxygen if needed. I'm not sure of the process but you should be able to get at least a consult without having to take her anywhere. Just having access to their doctor and a visiting nurse could be priceless at this point in her life.

What I am wondering is why she even has a doctor if he has to depend on the ER to treat her? He says he doesn't have the equipment to do the tests. Why can't he ssend her someplace private who will do the necessary tests?

Well, I suppose you get to decide if she MAY die from going to the hospital, or she WILL die because she can't breathe.

What I do know is that teas will do nothing to help her.

If it was me, I'd take her to the ER, let them put her on hospice care, bring her home with the support of hospice nurses who can ensure she can pass as comfortably as possible without suffocating to death.

I think you have to decide whether you are comfortable with considering her to be palliative and this possibly being the downward slope toward the of end of life, if you are then it may be time for hospice rather than the ER.

Well, you can't really fool around with breathing issues, esp if her O2 levels are getting low even after nebulizer or inhaler treatments and oxygen. You can't self diagnose and treat her with homeopathic remedies in such a situation, imo. What does SHE want to do? Does she want treatment? If so, I'd take her to the ER or call 911, better yet, and let the paramedics determine what they feel is going on here. Does she need to be taken to the hospital? If so, they can transport her and you can show up later on. I doubt your risk of contracting the virus is too high........the ERs are kept clean and I think I'd feel pretty safe myself going to one in the event of a real emergency. My daughter is an RN in a big downtown hospital and says it's safe ........if it wasn't, all the staff would be getting sick and they aren't. Think of it like that, I guess.

GOOD LUCK!! What a stressful situation to be in for both of you. My mother is 93.5 and has had pneumonia 3x already in the past 5 years.