Mom is on comfort care (like hospice) which means no life extending treatments, no tests, PT or x-rays, and no iv's, feeding tubes, or CPR etc. We agreed the NH should treat for UTI as that falls under keeping her comfortable. At 101, 82 pounds, with a fractured pelvis, broken arm and dementia Mom will never recover, walk again or care for herself, needs 24/7 care and will live in the moment and constantly try to get up.
One of the questions on the list was if she develops upper respiratory distress, should they x-ray and treat or just administer oxygen. I told them I couldn't make that decision without my sister, and she too, does not know what to tell them, whether it is right to prolong things with antibiotics or keep her comfortable and let her pass naturally.
So, I am asking my forum friends, what would you do? What is the right thing to do?
No one has made any predictions about how long mother has and I don't suppose they can. The doctor said in cases like mother's often their heart stops in their sleep and they don't even know why. I am sad too - end of life is always sad I think. I have no idea if I will be able to get there when the time comes or if I will get a phone call that she has gone. I will go down in a week or so and see it as a farewell visit though she may go on for a while. This is such a difficult time. ((((((((Hugs)))))))
I have heard a palliative nurse say that they can control their deaths up to a point, if she wants you there she will hold on until you are present, if she goes at night it will be because she preferred it that way.
My sister is home now and visited her yesterday. She isn't eating. They moved her to another wing which appears to be people who are bedridden. They said they moved her for handling security or something like that. I think they mean she needs more experienced people than the usual aids and took her off the rehab wing. I haven't been there yet, hubby going in for surgery today so I won't be able to go until tomorrow.
I find it very difficult to find someone with the medical authority there who is able to answer my questions, like what happens now, what should we expect, etc.
I feel very sad that when the end is close, I might not be able to be there unless it is in the daytime. Neither my husband nor I can see well enough to drive at night and the NH is 40 miles away isolated on a country road. There is no place to stay within 15- 20 miles. My sister can't drive at night either.
One day at a time...........
Keep us updated. These strong centenarians keep going,,,
As Veronica91had mentioned, pillows can help, the nurses would put a pillow under Mom's knees while in the recliner, and that would help slow Mom down from trying to climb out.
My Mom also had the air mattress where the side would cradle her, but she would still find some way to try to climb out. It was so sad to see. I was always trying to put her legs back to the middle of the bed, and my gosh Mom was so terribly thin. And Mom would also pick at the sheets, like she was trying to make something that looked like an old fashioned fan.
Like you, every time I left after seeing Mom I would think, please Lord take her.
I can understand why she tries to get out of the geri chair, they are the most uncomfortable pieces of furniture ever invented. Make sure she has plenty of pillows to cushion her and maybe she will sit still. She needs a cushion under her butt, one or two behind her head,one under each arm and a couple placed lengthwise under each leg. Unless she is really short of breath and distressed by it skip the oxygen, it irritates and dries out the nose and puts pressure on the ears which can be quite uncomfortable. Discontinue any IVs, they can also get quite uncomfortable. Consider a urinary catheter but make sure it is not too big a size 14 French is a good size to start with especially if she is small Yes, they do cause more UTIs but that is better than having to haul her around to change her every few hours. Be sure she does not become constipated because that can make the elderly very restless especially if they are non verbal. Keep her mouth moist with wet swabs and ice chips.
I find myself sleeping while watching TV, no matter what is on... my gosh, I even fell asleep watching a Republican debate.... now that is seriously being tired.
I do take something daily for my nerves, but now I feel like that isn't helping... I am just scared silly to try anything else as I am pill sensitive and usually wind up with all the side-effects listed on the pharmacy sheet.
When it comes to going out for dinner, I haven't been out in seven years, nor to a movie, or for a ride out in the country. Forget vacations, I want the safety of my home [cocoon]. And I can't concentrate on anything for too long, either.
As for your Mom, I would vote yes to treating UTI infections as it is part of the comforting of the patient in Hospice.
They might notice a change in her behavior ie: more confused and disoriented.
Some places will automatically do a urinalysis if they even suspect a possible UTI. The problem with this is that if you've decided not to treat a UTI with antibiotics there is no point in doing the test. So be sure you make yourself clear to the NH what your families careplan for your Mom is. A NH may suspect a UTI but the only way they would know for sure is by doing a urinalysis and again if your not going to treat, why do the test.
My Mom was also trying to climb out of bed and numerous times her room-mate would signal the nurse as Mom would get either caught up in the rails below the bed [it was set as low as it could be] or she fell on the mat.... also kept trying to climb out of her geri-recliner getting her legs tangled up in the metal parts.
But that heart was healthy as all get out !! The doctors/nurses/aides were amazed my Mom was still with us at that time. I, too, was so physically and mentally exhausted... I thought my Mom was going to outlive me.
Our treatment goal for our Mom is to use whatever medication is necessary to keep her comfortable but not to prolong her life. To us, the use of an antibiotic would only prolong her life. It would not improve the overall quality of her life.
avoidablecare/wp-content/uploads/2012/04/Sharpe-Handbook-A-Caregivers-Guide-to-Advance-Dementia.pdf