My mom is 87 years old. Her health and quality of life had declined severely over the past several years. This past Sunday she woke up with a horrible wheezing in her chest. She was taken to the hospital and diagnosed with the flu and pneumonia in both lungs, a UTI, and congestive heart failure. We talked with a palliative care doctor, and my mother chose to not pursue active treatment and go into hospice. She was admitted into the hospice facility late Sunday, overnight. The medications they are giving her every four hours seem to be keeping her mostly comfortable, except for when they come to care for her - bathing, changing depends, etc. Then, she yells out “no, no, no!!!!” and is obviously in distress. They have attempted to place a catheter twice, but for whatever reason, it is not working. No urine in the bag, but when they took it out she produced plenty. Since the catheter is not successful they will have to keep changing her depends often and cleaning her, which is horrible to witness and hear. My question is this: What are my rights here as far as pain control for her? If it were up to me, I would have her more comfortable and ‘out of it’, sedated if possible. Her doctor is making rounds and I’m not sure how to handle the conversation. I will tell the doctor all of this, but is there more I should do to keep her completely comfortable?
Do know that as the organs shut down there is a good deal of confusion. This manifests in a sort of dreamlike acting out, and often picking at covers and such. Much of this is done below a level of consciousness and pain.
As much as you CAN be there, be there, encouraging as much medication as can be given.
I am so sorry. Ask them to explain what you can expect to SEE and what it all MEANS and if they cannot you need to have them send someone who CAN.
I don't know if there is a good answer here, but hospice should help you with all of this.
Even if your are her MPoA, if your Mom doesn't yet have a medical diagnosis of cognitive impairment, she may still be the one calling the shots. I think this all depends on what state and maybe even county the hospice is in.
I recently went through in-home hospice for my Aunt. Her team would not talk to anyone but me, as the MPoA, once my Aunt could no longer talk or move her right side from the after effects of her stroke. My Aunt had always been a nervous person and pre-worrier, so I agreed to Ativan for her (to calm her) and then morphine as they needed to touch and roll her (she was 105 with paper-thin skin and achy from arthritis). I second-guessed this decision for several days after, but have concluded there was no better option for her, as the combo of those 2 meds settled her into an unresponsive but pain- and anxiety-free state.
Just so that you know to say everything you wish to say to her before she gets the comfort meds...
I wish you peace in your heart that you are doing your best for her.
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