Hi. I am mainly interested in the opinions of health care professionals that have dealt with issues like this before.
My Mother is 96 and has resided in a nursing home for 6 years now. She has osteoperosis and weighs about 75 lbs. She has a fair amount of dementia too. She recognizes me and we converse, but it is a confusing type of conversation. In other words, she is able to speak intelligent sentences, but her facts are sometimes very unclear.
I got a call from the nursing home last week and they suggested, based on the resident doctor's advice, that my Mom be initiated into what's called "Comfort Measures Only". From several people, I have gotten many differing opinions on this, including completely opposing views from 2 registered nurses.
The doctor's reason is that Mom has very poor nutrition and is losing weight. However, she has weighed no more than 80 lbs ever since she was admitted to this facility. I do see she has very little appetite, but I dont see an overwhelming weight loss over the past 6 years.
And on the other hand, Mom does experience falls from time to time, and occasionally breaks a bone. I worry about her falling and breaking something critical, like her neck (which she actually did break in 2008. That was a horrible experience and difficult recovery).
So my question is, is putting my Mom in "Comfort Needs Only" appropriate under these conditions? Mom has lived a long life and I dont want to prolong anything that could become dire. But I dont want to jump the gun on this either. The doctors explanation of why this should be done sounds a bit feeble to me. Is it possible I'm not seeing what he does?
Nowadays, if you don't specifically request DNR and palliative care only, there's a strong possibility that your mother will be subject to pointless (uncomfortable and even painful) tests and procedures. Also, as perverse as it sounds, a staff member or EMT could initiate resuscitation measures, including pounding on her chest and using a defibrillator.
Logic and humanity have been all but abandoned in the medical industry's treatment of the elderly. So, family members are having to make the agonizing decision to specifically prohibit treatment. Without that, it's almost impossible to die of old age in this country anymore.
If you're concerned that the facility is being lazy or just doesn't want to do the job any longer, think about this: financially, it doesn't benefit them to reduce her care, right? If it were me, I'd be grateful that they're concerned about her health and comfort, and not simply sustaining a life, because it's technically possible.
If you're seriously concerned, and the facility physician is NOT your primary care doctor, consult with her/him and see if they agree. If your mom is lucid enough, ask her what she wants, if you don't already know.
And take a deep breath. It's very, very hard to hear 'end of life.' Most of us cling to it, despite the loss of quality. I doubt any of us are ready for it, even when we think we are.
Love, Laugh, Learn
LadeeC
Anyway he is home now and doing fine, very little dementia, mostly just age related forgetfulness and the fact that he doesn't have my mom around any more (she passed away in 1999) to keep him mentally sharp.
When you mentioned the weight loss I am wondering if more appealing food would make a difference. Food you know she likes, many pureed quality food that is easily absorbed into her body. Maybe supplement her diet with a couple of Ensures a day. I started taking food to the NH the last couple of weeks there and he would eat everything. The pureed food they would bring for his dinner he had no interest in.
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