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!


Okay. I take it that you are not going to take her off hospice to get her hip surgery? Do you realize that in a facility, she could have an alarmed bed, rails on the bed so she couldn't get up without alerts?
Check the BP. A few hours before death it will be low, so low you have trouble getting a reading. God willing, she will pass peacefully in her sleep. Hands and feet become cool, sometimes bluish. She may mumble, she may appear to be reaching for something.
Sorry for the decline you are seeing. You nay very well be near the end. There is a very help video in YouTube called Gone From My Sight. It is a talk about 1.5 hours by a hospice nurse. You will find that the description you gave may answer your questions. Check it out right away.
Don't blame yourself for your break. Mom broke her hip while I was 10 feet away in the kitchen. She forgot she couldn't walk alone and got up without her walker. I never thought she would do that. She is now fastened in her chair. **** happens. We can only "fix it" after we know about it.

It sounds like, yes, she is near the end. And it sounds like it will be peaceful. God bless her little heart. And yours.
pam & vegaslady thank you for that information. ba8lou she is 92.5+ years old, also with chf it is not likely that she would survive surgery and to what end? Being alive but not knowing who anyone is, or who she is.
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.
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
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...
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.
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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