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My mother has dementia and the ailments above. She looks amazing for her age but walking winds her badly. Totally incontinent. 9 months ago she was rejected by Hospice but her kidney numbers continued to decline so they accepted her about 3 months ago.
Mom looks healthy. She doesn't remember anything a minute later but her spirits are good until Sundown. She then wants to go home and we all tell her we are taking her home to Dad and their apartment in the morning. She is extremely happy but then...forgets.



My question. How do I know when her heart and kidneys are worsening? They no longer do bloodwork. She looks strong in so many ways yet Hospice agreed it was time to have her accepted.



This is so new to me. I just don't know what will keep her in Hospice at this point. She will not recover to a healthy heart or kidneys obviously. Any insight is welcomed. Marie

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Your contact with the hospice company (in my experience the same caring nurse) should update you once or twice weekly at least as to the vitals of the patient.

My mother passed away the late night of the afternoon I was told that there was significant change with vitals and she predicted about a week more of life. Previously her vitals had been stable.
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Kidney failure is likely to show up abruptly as potassium levels rise and trigger heart failure. There are often no warning signs. For some young people with genetic kidney diseases, an autopsy is how the family finds out.

My MIL was on hospice as her vascular dementia was causing several of her organs to fail. Her potassium levels were rising, we knew the time left was short. She had spent the evening watching tv in the nursing home lobby with the other residents. They put her to bed and found her about an hour later, her heart had failed in her sleep.
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Talk to the Hospice Nurse.
Ask what you should look for.
Ask if there is anything that you can do to help her if you see problems.
Make sure you have the 24/7 number to call at ANY TIME does not matter if it is just to ask a question or if there is a problem.
Make sure you have the medications you need if she is in discomfort.
If you are not sure how to give the medication and or how mom will react ask the Nurse to show you and give mom a small dose while the Nurse is there so you can both watch for reactions.

For someone to remain on Hospice there needs to be a "documented, continued decline"
Decline can be anything from... she used to be able to walk across the room, now she has to stop and rest about halfway. Or she used to eat all of her meals, now she just eats half. Or she used to sleep 8 hours she is now sleeping 10 to 12 hours a day. Weight loss is also an indication of decline. Or retention of fluids.
Let the Hospice Team help you and teach you want to watch for.
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As they are no longer running tests you really will NOT know when this occurs. Eventually there will be profound weakness, shortness of breath, edema of extremities, inability to really walk at all or eat very much. Sounds that you are a long way from that.

You best bet is to discuss with her MD or the Hospice MD and staff. Your questions are best answered by people having medical contact with your mother for they know her, her general condition and her prognosis better than anyone, tho it is all pretty much guesswork.
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