Last Monday started the serious decline!

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My MIL with vascular dementia, has been told over and over again not to get out of bed or the chair by herself, but as dementia goes what we tell her goes in one ear and out the other! When my wife was getting her breakfast she decided to get out of bed, the result was that she tangled her leg in the sheets and fell to the floor, possibly fracturing the hip that had been broken and pinned about 6 years ago (the Hospice DR thought a possiblility when she visited on Fri). She was in a lot of pain and my wife called Hospice. The Hospice nurse started her on Morphine. All week she has been declining, mumbling words, calling for long passed cousins etc. She slept about 18 hours the past two nights. Yesterday her pulse was 188 Oxygen sats 83, today pulse 160. Yesterday when I tried to give her medication she couldn't swallow, the Hospice nurse advised not to try to feed her just swab her mouth with water, but continue the morophine since it is liquid. Today she is breathing regularly through her mouth ( it sounds like snorring), her eyes are half open, we don't know if she knows us and is uttering little sounds. The Hospice nurse thinks she has about a week, I would value any opinions from the many of our fellow caregivers with much more expierience. Thanks!

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Thank you for letting us know. If your MIL was ready to get off the train, that should bring peace and comfort to all. The best advice someone gave to me when my mom's time was near was not to FEEL GUILTY when I found myself enjoying my life again. I think your wife can truthfully say she did her best, and now it is time to have time with you and rejoin the living. I am an only child, too, so I understand her feelings. My advice is to give away or donate her mom's things ASAP. I still have things to go through, and it sometimes brings back the sadness I feel and reminds me of how much I miss her. My heart goes out to both of you as you discover how precious your time together is and how wonderful life can be, Be happy!
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Sorry for everyone's losses here and prayers go out to all us caregivers that still may have a long road ahead. I have noticed my Dad weakening and having much confusion along with memory loss. Many times it is so funny to hear him ask questions because they don't relate to anything but whatever he was thinking at the moment. He has been having some slow, sleepy days; constipation that I notice weakens him more, days where he is up & moving wanting to go somewhere, days where he has chest tightness a few times a day so we hit the liquid morphine. The weather has cooled down and I notice his hands & feet are cool to the touch. He isn't eating well but some days he is starved. Are we getting closer to the end? He seemed fairly worried with the chest pains but I told him it will be great where he's going and everyone will be there to meet you. He's a bit religious but like all of us, scared of the dying process. I'd think the suffering, immobility and lack of life would be scarier than dying.......just saying.
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It's over! My MIL passed this morning. My wife found her mom not breathing and cold on her extremities although her stomach was still warm about 3:30 AM. The Hospice nurse called it officially at 4:10 AM MDT. Our day has been spent with cleaning up and making arragements for her cremation at the funeral home. We are waiting now for the hopital equipment supply company to come and get the hospital beb, oxygen machine and the recliner chair. The Hospice nurse disposed of the excess meds and took back the un opened packages of pull up diapers. My wife is an only child so there aren't many close relatives to contact, only a few of her cousins, we left messages for them to call us but all were at work and only one has called so far. We have been at this for 5 months, it has been a living h*ll watching her go down hill especially this last week. I feel for all of you who have been doing this for years. Now the next task begins: going through 92 years of kick nack, collections and other things accululated. Even facing that daunting task it is a huge relief. My wife and I were able for the first time in 5 months to have a leisurly lunch without worry. Right now my wife who has spent most of the time here with her mother is taking a much needed nap (I have a full time job but was there to help evenings and weekends). This web site was a wonderful find, I discovered it by accident researching Veterans benefits, but have learned much reading other posts and other caregivers questions and answers. I will continue to check in occasionaly and help if I can, maybe not multiple times a day like I have been.

ba8alou it's ok, for the last few weeks my MIL has been on the "train" when she could speak. I recently found out from Hospice literature that she wanted to depart.

Hospice has been a God Send, this last week they stepped up from nurse visits 3 times a week to every day including Labor Day.

It is now time for us to step back, take a deep breath and re-claim our life!

take care all! as they say on sign off on Ham Radio 73's (best wishes)

Celtic Edwin

P.S. We were suppossed to have flown to Glasgow Scotland on Aug 29 for vacation, but we had to cancel.
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Celtic; I'm sorry, I didn't realize that your mom's dementia was so advanced that she doesn't know anyone. I'm so sorry that my first answer was so insensitive!
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There isn't much I can add to the previous postings. I was blessed to be there when my mom passed away. I know she could hear me, because I told her that her lips were dry and I was going to put some Chap Stick on them. She was always very feminine and wore makeup all of the time. She was unable to move her body, eat, or drink; but she put her lips together like we ladies do with lipstick or gloss. I talked to her, played and sang along with our favorite music, and read to her from a birthday book I had given to her years ago. The book touched upon the different stages a mother watches her daughter go through as a child. Mom and I had read, discussed, laughed, and cried as I read the book to her. So, I talked and did what I thought would please her. When the Hospice nurse told me, with a knowing look, that her breathing had changed, I gave mom my love and blessings if she was ready to go. She always worried about leaving me, since I am an only child. So, I assured her that I had my husband and close friends...that she and my dad had given me the tools to create a beautiful life...and that I would miss her terribly but would be OK. She took one more breath and peacefully slipped away. I don't know about dementia patients, but I think you should talk to you MIL as if she understood every word; that is, of course, if you are comfortable with that. I know my mom could hear me, and who knows just how much your MIL will understand? At least she will know someone is there and possibly take comfort from that. My heart goes out to you at this painful time in your life.
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MM i ididnt know your mum had dementia? your profile says heart/stroke? is this recent since the stroke? I ask because my friends mum had a stroke last year after a triple bypass now a year later my friend thinks her mum maybe getting dementia I told her not to guess but tell her doctor asap? I know this is possible after a stroke but is it possible a year after? I couldnt advise her but just to tell her doc and maybe demand a brain scan? I dont know much about strokes and the aftermath? also her mum recoverd well with no stroke damage then?
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Maggie, you didn't have a crystal ball, you made the decision not knowing what the future holds. That's all any of us can do.
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Celticedwin, I'll add something here knowing your mom's age.

My mom was aggressively treated for her hip break. Very painful when it happened. Very painful after the surgery. Pain meds are a double-edged sword with old folks. The good stuff makes them prone to falling and dizziness.

She had 2-1/2 months of rehab (in and out of the hospital for pneumonia twice); very challenging for her. Very painful. Her dementia is worse. Her physical condition is worse.

Just before that, she bruised her leg on her walker. A slight bump, but at 87, her skin is very delicate. The bruise coagulated awfully, and all the skin died, resulting in an open sore about 3" x 5" that looked like raw meat having to be dressed and cleaned twice a day for two months while she awaited a skin graft. She was in so much pain when I dressed it, she would cry. After the skin graft, two wounds to dress for another month or more.

And JUST BEFORE THAT, I'd brought her back from death's door. What did I bring her back to? I'd really like to know...
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Do not blame yourself for anything, Hips break all the time and many think that the break is what causes the fall.
As you realize surgery is out of the question and the advice from the hospice nurse is absolutely correct. try to give the morphine about half an hour before you plan to move her for any reason. if she seems to be in pain by screwing up he face or moaning ask for an increase in the morphine. She will become more drowsy and gradually slip into unconsciousness. Just hold her hand and talk quietly to herand give permission to go. If she belonged to a church a visit from her minister will be comforting. As Pam said her hands and feet may become cold,you may not be able to feel a pulse or get a blood pressure. None of these things matter now.
keep the bed covering light and the room comfortable even though her skin feels cool, she does not feel cold herself. her breathing may change and she may even stop for a few seconds, don't be alarmed this is all expected. She may also develope what are called terminal secretions where a lot of fluid drains from her nose and mouth and her breathing sounds bubbly. Do not attempt to suction this it just makes it worse. Turn her on her side if you can and put a towel under her head. she may wake up hours or the day before she dies and be quite lucid but then slip right back and finally pass. It sounds as though this is going to be very peaceful for her. For your own peace of mind someone should be will her but don't feel guilty if she passes when you are out of the room, some people seem to wait till they are alone before they die. Your hospice nurse may be telling you a week today but when she sees her tomorrow may say two days and the next day just a few hours. Things change very fast as the body shuts itself down. Personally I find being with someone when they die is a very spiritual and peaceful experience so don't fear the actual moment. Blessings
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ceticedwin my mum has vascular dementia but not this far yet has fallen a few times out of bed but was lucky like you say will do nothing they are told? So sorry for you and i too hope she goes peacefully now. Its a shock when they just suddenly decline like this. Hugs and prayers to you and your family.
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