Doeas anyone have experience with end stage CHF and TIA's?

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notgoodenough Asked September 2020

Doeas anyone have experience with end stage CHF and TIA's?

Mom is in hospice for end-stage CHF.

She fell last night; this is the 5th fall in 2 1/2 weeks, always at night. At first, I suspected the meds her doctor gave her to help her sleep (Trazadone). But Monday night after she fell, when I went to help her up, I saw that she had left the water in the bathroom sink running, full blast. Like she went to turn the water off, but instead turned it on and didn't realize. When we helped her up, she was having real trouble tracking our instructions - she could hear and understand them, but couldn't figure out how to make her body do what she was trying to make it do.

I started to suspect TIA's. The hospice nurse came out yesterday, and she feels very strongly that I'm correct - she ran through the stroke "tests" and found considerable more weakness on the right side.

My question is, does anyone here have any experience with TIA's during an end-stage illness? I know there's really nothing they can do to either treat or prevent them. What should I be prepared for, other than more falls? Is this a sign of the end coming sooner rather than later? I've been trying to find out some more info online, and I can't seem to find anything for guidance, so I thought I would come here to my "go-to" people, who might have had real world experience with this.

Thank you!!

Congestive Heart Failure End of Life Stroke

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score 0 · Answer 1

My response will be a little different. My father passed away August 14th. He was on hospice for about two months. He never was bedridden. Although, his legs were swollen to the point of seeping, he continued to take care of my mother, with dementia. I got a call at 9:24am from my mother, screaming she thought he died because she couldn't wake him up. When I got there, he was dressed and ready for the day. He must not have been feeling well, because he had his oxygen monitor on his finger. His death looked very uneventful, he just fell asleep. The day before, he was mowing his lawn. It sounds like your Mother is in for the fight, just like my dad. . Unfortunately, nobody knows how long they can hold on. The hospice nurse was shocked, she said he seemed fine two days before. It's very hard and I'm so sorry for the pain you will endure with this. Although, it gets easier, I'm just so sad. I know he is in a better place and out of pain but.....May your Mother have some wonderful days with you, before she is called "home". You are both in my thoughts and prayers

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Thank you, and I'm so sorry for your loss. I hope my mom will pass as easily as your dad did.

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Trans ischemic attacks are temporary, that is to say the symptoms go away. It sounds more as though your Mom may have had a stroke. There is no way to know either way other than the ultrasound of the carotids. Diagnosis and treatment of TIA with anything like carotid endarterectomy would preclude having hospice. But again, I think this looks more like a stroke, and only a doctor could let you know if that is the case. As to what that means to long term prognosis in terms of length of time she has left there is no way of knowing and it may mean very little. What you ARE facing now though is the need for 24/7 care, and perhaps she will become more bedridden. The hospice nurses who are right there are your best guide in all of this; they are right there and they know the patient so much better than we do.

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Well, she pretty much needs 24 hour care now, because I can't trust her to be alone. I've had to take a leave from my job, which is upsetting, because I really like what I do, but that's neither here nor there. The hospice RN said she strongly suspects TIA's. I also know that they can be an indicator of future stroke, but I'll have to cross that bridge once I get there.
I appreciate your input and support. Thanks!

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score 0 · Answer 3

NGE, I'm so glad you are getting extra help for your mom. Good thoughts to to you and her.

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Thank you, Barb!

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score 0 · Answer 4

I’m just so sorry you’re going through this! It’s so very hard. No idea on TIA’s, my dad only had those years before his end stage CHF. If your hospice nurse thinks you’re onto something, then she’s likely right, they have vast experience. I’m amazed your mom is still getting up. My dad didn’t get up his last five days, but this varies a lot between individuals. One thing our hospice nurse said was that as the dying process advances the body naturally defends itself by pulling all resources to the core, the arms and legs won’t get support as they aren’t vital to living. That may also be contributing to the falls and arm and leg weakness. Again, hugs and empathy!

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Thank you! You're not the first person to be surprised she can still get up at this point, but she's way too stubborn to go without a fight.

The point about the body defending itself actually makes a lot of sense, I had heard that about frostbite and traumatic injuries, but it makes sense with other illnesses too.

The hospice nurse said once she stops eating, that will be the earliest sign that the end is near. I am waiting for a call from the SW who is going to help me arrange for night-time aide to stay with mom.

Thank you for your support! Much appreciated!

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Doeas anyone have experience with end stage CHF and TIA's?

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