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Michou Asked August 2021

End of the road... so soon?

Mom is 91. She is in a home for Alzheimer since her 84.
She’s still walking and eating by herself.


Recently she is cascading down: loss of appetite, in constant physical pain for mutiple problems hard to give her relief because she refuses the cares and regularly throw away her pills. She shows more agressive behaviour or is very agitated and calls loudly for God to bring her in paradise or her father to come to bring her home (she used to fear death, so this call to God is new). She thinks everybody is evil and jealous. They tell me that her new agitated behaviour is due to her physical pains.


At best she thinks I’m her little sister. But I’m still able to hug her and she tells me that she loves me... when I’m not as evil as the others!


None of all that as painful as it is were signs to me that the end of the road was coming, but the care director wants to meet me in 2 weeks and very gently begins to expose the few solutions they have to bring some relief to my mother and each one of them is bleak and seems to just push away the inexorable end.


As I understand it, I’ll have the choice in hospitalizing her for 3-4 days in the gerontologic section so they’ll be able to give her the care she needs but refuses and to make some exams and evaluation, with the possibility of a big dental surgery. This seems nice and good. But they warned me : All those good things will be very painful for her and very confusing, at risk to accelerate her cognitive loss and to augment her confusion and agitation. For a very brief relief after a long convalescence.


Or to let them give her morphine just enough to give her relief every day, but I know that it will bring her slowly but surely to the end of the road in some weeks or months at best. So soon!?


I’m very conflicted and I cry a lot. There seems to be no good choice.
l’ll pray till the day of the meeting on September the 7th.


And I’ll read all your advices and opinions. I’m sure they’ll be helpful. Thank you in advance. God bless!

Michou Aug 2021
Mom doesn’t urinate since yesterday evening and doesn’t eat anymore and sleeps all the time. So the nurse informed me that mom is hospitalized in urgency.
Thank you for your prayers!

ZippyZee Aug 2021
What kind of dental surgery do they say she needs? Seems like that would be something awful to go through for a 90 yr old dementia patient.

Sounds like she needs hospice, or at least an evaluation for it.
Michou Aug 2021
A very big one. That’s why I refused it some months ago. But since then the pain is barely controled by the medication. That medication has side effects that needs other medication. Mom’s behaviour is more agitated and she refused care for all the other problems she has. So I thought that in refusing the surgery I had made the wrong decision. Asking the care director if Iwas wrong drive us to the meeting on September the 7th and the suggestion of the morphine protocol and my panic.

But here I found kind souls to guide me to a better understanding of the situation.

Thanks a lot every one!

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Isthisrealyreal Aug 2021
Michou, when my dad started talking about dying and was no longer afraid, I knew it my heart that The Lord was preparing him to go home. It was a few months time from the 1st conversation until his death.

As difficult as it is to lose them, it is a relief that their suffering is over.

I pray that you are given peace, strength and wisdom for this difficult season.
Michou Aug 2021
Sympathies for the loss of your dad. Thank you so much for your comment: Mom has always be very afraid by the unknown that death represents. But for some weeks now, she says that if Jesus loves her He will come and bring her to his paradise. She asks Him to do it, very very loudly! Or her father to bring her home (as loudly): she believes he’s still alive.
I don’t think now after all that I read here and on medical sites that the morphine will precipitate her going to Heaven, but it will ease the inevitable.
The professionnals that take care of her seem to think that it is closer than I initially thought but perhaps later than the director’s comment let me believe yesterday.

With dad the morphine acted really fast and that’s why I thought mom at the end of the road very soon.

Only God really knows the moment. But for the first time in her life, she’s ready to go. I’ll focus on the end of her sufferings.

Thank you for the prayers! God bless you!
Cover99 Aug 2021
I'm so sorry, but know she lived for a long time, when many don't get that chance. It recalls the young man, 21, killed in FL. He won't get a chance to be physically there for his son.

When it's your mom's time to go, you and she will know.

Blessings.
Michou Aug 2021
Thank you most of all for the blessing. It helps toward peace of heart and mind. It clears my ears to really listen to her! She’s not afraid of death anymore, big sign! Not easy to hear though. But I’m on the way...
golden23 Aug 2021
((((((hugs)))))) michou. This is such a hard time for both of you. The signs of decline are clear. Sometimes there are no good choices - just better or worse ones. To me, your mum needs comfort and ease of pain and agitation now. She has suffered with Alz for 7 years, You have suffered too. I know choosing to ease her pain is a huge decision but so is deciding for surgery, more pain and decline and more agitation. What would she want? Prayers and more hugs to you at this time, to be at peace about your decision.
Michou Aug 2021
Thank you so much most of all for the hugs and prayers.
If I make the effort to hear what mom says in words and in acts, I must conclude that she says enough is enough.
Fortunately, I’ll have time to find peace in my heart. I’m not quite there but the encouragement I receive here helps a lot!
JoAnn29 Aug 2021
My Moms passing was a blessing. She knew no one. Her days were just sitting in her own little world that a broken mind was making up. When u looked in her eyes, they were blank. The mother I knew was not there anymore. Her last days were textbook. She stopped eating, wouldn't get out of bed, closed her eyes never to open them again. She was placed on Hospice.

I would not put Mom thru surgery. I would call Hospice in to give her comfort care.
Michou Aug 2021
My sympathies, even if the mom we knew is only partially there, saying goodbye is never easy! Mom still hugs me despite all her physical pains and cognitive losses. That’s making the decision to put her on a morphine protocol so hard. But my head knows more and more that it will be for her best. I’ll mend my heart knowing she’ll suffer less and less before going finally to God.
MJ1929 Aug 2021
Get hospice involved, and then the director of her place has zero say about anything to do with her care. Her job becomes supporter to the hospice folks.

Throwing away the pills is her telling you she's done with them. My mother did the same thing for months. Finally, I told her hospice nurse that we're done with her medications and she agreed because they really weren't doing anything anyway. She was put on anti-anxiety medication and morphine, and the hospice nurse said the dose was so low it only worked for about two hours, but it helped her rest a bit and made her less combative when she and I would do wound care on her legs. Bit by bit, she just wound down over the course of about three weeks, and she finally went to sleep.

I keep going over and over in my head how we may have been doing too much for too long with my mom. We weren't trying to cure what ailed her, and it seems wrong to just cut off her medications, but once we did that, she was much more peaceful, her body didn't really do anything it hadn't already been doing (her heart rate didn't go through the roof, for example), and she was finally allowed to let nature take its course. She held on as long as she was meant to, rather than via artificial means.

Definitely get hospice involved. Surgery is absurd at this age.
Michou Aug 2021
Thank you so much! I think your experience with your mom (my sympathies) looks like what’s going on with mine. It sheds light on what is waiting mine and I understand better what the care director means by « morphine till her end ». It is a bit less bleak. It is a question more of comfort than care of her many health problems.
For the dental surgery, I refused it months ago, but seeing the cascade of problems going on, I had sudden doubts that it was the right decision. Your answer comforts me that it was and still is the right one.
Yes, mom is done with cares...even with life in suffering and confusion! It’s still a bitter sweet and sometimes very hard passage to live that with her .. . till the end.
Tynagh Aug 2021
Dear Michou, It's so hard to begin to say goodbye, isn't it? You are facing a difficult decision, but look into yourself and you will find the right answer. We never want to let them go, but are you keeping her here for you or for her? If she is miserable, don't add to her misery. Dental care is painful and the change of location to the hospital will certainly confuse her. I know, this is so very hard and painful. You can cry about it. It will do you good. Whatever you do, remember to do it with love.
Michou Aug 2021
Your question are to the point and I will keep them in mind in my refexion.
Thank you for your compassion
Lizbitty Aug 2021
If it were me, l’d focus on what will make her the happiest, because in the end, if she’s miserable, it’s just not worth it. She can’t have many years left, so if you think after the treatment (after talking to the doctor about how she’ll feel after care), if she’ll feel better for longer with treatment, I’d go that route, so long as it won’t trigger a sudden downturn.

If I am too nervous and suspect the risk to be too great, then I would medicate with morphine. Personally, when I had surgery, I loved morphine. It was like liquid sunshine and made me feel great.

Talk to the doctor and see what would help make her happiest. At this stage you can’t worry about her becoming addicted or screwing up her liver. It’s all about making her last years comfortable and happy.
Michou Aug 2021
Your reflexion is well balanced and touches exactly what is still unknown in the whole situation and why it is needed to meet the director and other specialists.
The dental surgery could be a relief, but only if suffering less, mom accepts the care of her other problems. And it’s a big if!

Also I feel that they prefer the morphine solution. I’ll know the September 7th if I’ve well understood the sub text « till her end ».

Thank you so much!
Grandma1954 Aug 2021
I would certainly not opt for surgery at this point.
Very small controlled doses of morphine will allow her to have relief of pain. The use of morphine does not mean that it is "the end of the road in some weeks or months". If she were to be at the "end of the road" in weeks or months she would be there with or without morphine.
And if she regularly throws out her pills she may also refuse morphine. And if she refuses morphine will they still administer it? If so why are they not doing the same with her daily pills?
It sounds like an anti anxiety medication might be in order.
I think an evaluation by Hospice might be a good idea though.
Michou Aug 2021
The anti anxiety medication is already in use and they succeed with ruse and perseverance to give it to her daily despite her throwing it. But the medication is not efficient anymore neither for pain or anxiety. They already augmented the dosage, it can’t go up indefinitely so that’s why morphine is now suggested.
And unfortunately the director (and my own experience with my dad) seems to suggest that the morphine on the long term will accelerate her end due to her not optimal condition
I will know more on the September the 7th.

Thank you for trying to encourage me, it’s appreciated. You make me see better with more distance.

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