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I not sure where to turn. Mom continually experience shortness of breath on a daily basis. Sometime it is really really bad to the point where she will froth at the mouth. Mom has had anxiety issues for years--but know that she has dementia it is hard to determine if anxiety has anything to do with it. I have a nice geriatric doctor who comes to the house-her suggestion is to have mom get breathing exercises. When thing get bad the only thing I can do is give her more Ativan. This is really stressful because mom will be begging for help, saying she's going to die. I've called the paramedics and mom has even been hospitalized a few times but they can't find anything anymore. Her blood Pressure is usually good--she has a history of hypertention. Along with dementia--mom has also had colon cancel (hasn't returned) Shes had a blood clot in the lung and neck and heart issues. With all this she is still relatively active, still walks around the house, able to go to the bathroom on her own. She still needs general help with bathing and daily living task. She eats on her own when the food is given to her. How do I deal with the shortness of breath issue--her doctor wants to cut back on the ativan but it seems like the only thing that works when she is having an episode--it's really scary and it's happening more and more. Any suggestions. Thank for any help.

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Elizabeth, that is a myth that no one gets out of hospice care alive.

There have been patients who graduate from Hospice to live for years longer.... this is partly due to removing many of the prescription medicines that the patient had been taking, which apparently had been overloading their system, making it too toxic.

By the way, a patient will pass on the same time table whether they use Hospice or not. The only difference the one not using Hospice could be dying in horrible pain. I will take Hospice, thank you.
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Regarding hospice care. You need to realize, if you don't already that hospice care is not interested in keeping your loved one alive. I've seen too much. They do nothing to sustain them. No one gets out of hospice care alive. They medicate heavily, will eventually deny water and the individual will die. Is this how you would want to be treated, or should I say not treated.
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GreenJean, thanks - I like my moniker too!

I have an idea where you're located generally, am wonder if you're close enough to the Portage or Bronson Hospital area to treat with doctors there. From what I know of Bronson, it's a top notch hospital.

Although it's quite far for a routine visit, there might be some Bronson affiliated pulmonary doctors who have multiple offices, as doctors do here in SE Michigan. There might be an outlying office that's not as far from you.

I reread your post as I had the feeling I had missed something, and I did. A HEPA air purifier can help remove dust and irritants from the air. I have one and use it when cleaning. I can tell the difference.

I've also used the Ionic Breeze air purifier which I could tell really did make a difference in the air, which felt clearer and less heavy, but after reading about its emission of ozone, I stopped using it.

I'm also wondering if your mother just doesn't like the therapist; not all of them "click" with their patients.
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pamzimmrrt,
She did previously use an inhaler. I will also address this at next visit. Seems an Rx for this has gotten lost in changing physicians - and it did not dawn on me. Sometimes you can missed the obvious. Starting to appreciate the last physician, before she moved in with us, even though he had no bedside manner. I really appreciate the counsel!
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GardenArtist,
Thank you for the response. We do have dogs. I like the idea of respiratory exercises. The doc that mentioned CHF was the area's favorite Geriontologist who is typically very thorough - the visit we had was the visit he indicated the hospital was closing his office permanently due to costs. It was not their standard thorough visit - based on previous experience. I agree, family Doc seems limited. I will look for a pulmonary doc - thank you. I wish they could do something for her pain - this limits her the most. The behavioral changes due to dementia are just simply sad to me. We are located in a rural area of SW MI so the pollution should not be an issue - other than the days they spread manure on adjacent fields :) Love your moniker!
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I;m gonna take the easy simple route here and suggest she may need a "rescue inhaler" for those times.. like albuteral ( you see kids sucking on them all the time) They can cause rapid heart rate ( which could increase anxiety) but they may also give her the feeling she is doing something to help? And sometimes they really do.. we RTs call it "allbetterol" It helps to open the airways... A family Dr or a pulmonologist can prescribe this, and it;s fairly cheap
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Someone has kindly pointed out an error in my next to the last post, an error which actually has provided some comic relief for me.

"As to the respiratory issues (which could be exacerbated if she has CHF), bake her to see a pulmonary doctor. " should be "TAKE her to see a pulmonary doctor."

I suppose if some chocolate chip cookies were baked beforehand, that might help as well. Chocolate as we well know has amazing therapeutic powers.
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GreenJean, another thing occurred to me, and that's the air quality in the region. In SE Michigan, there's a lot of traffic and sometimes the auto exhaust affects not only the quality of the air but the actual smell. I keep my windows closed because of that.

In your area I think there would be less pollution, but there might be some from other factors. That could cause breathing difficulties as well. If I mow the lawn on a weekday, I always wear a mask.
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Your experience with a family doctor is one of the reasons I find them so limited. And if any doctor said symptoms seem to indicate CHF without addressing the condition and what he/she could recommend for it, I'd ditch him or her and find someone who's more responsive. CHF CAN be treated.

As to the respiratory issues (which could be exacerbated if she has CHF), bake her to see a pulmonary doctor. She'll be given breathing tests to determine lung capacity, probably have a chest x-ray, and determination made if there are problems on that level.

She may also have cardiac issues; there may be something in the house to which she's allergic, or she may benefit just from respiratory exercises such as using an incentive spirometer. Are there any pets in the house? Does she have allergies?

She could also have a food allergy that causes shortness of breath. And as I discovered and wrote about recently, one of the foods I love has caused shortness of breath. When researching it, I traced it to systemic pesticides used by farmers on that particular food.

But first step is to see a pulmonary doctor.
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My Mom is 86 and has dementia. She gets short of breath some days from walking short distances in the house, watering plants, or bringing in cushions from deck. Some days she is fine. We have scheduled PT visits to strengthen her shoulder (torn rotator cuff/surgery/re-torn years ago) and hopefully for overall health - but she seems to get short of breath on these days without moving around and we believe she just doesn't want to go. My husband is at home with her during the day and I am home in the evenings. He hates to be the bad guy and tell her she has to go. This morning she was up and dressed (which she does on her own, as well as bathing etc) but when he told her she had PT she said she felt bad, was short of breath and went back to bed. I told the Geriontologist about the shortness of breath and he looking at the nurse and said "sounds like congestive heart failure" and then left the room. Her family physician reviews meds, does little to help with her constant pain and hasn't indicated any concern with her breathing. Sometimes I feel like because she is old they just don't want to do anything. I don't think she should have to be in pain all the time (from the torn rotator cuff and arthritis). Last week she didn't want to go to PT but wanted our Caregiver (lady from Church) to take her shopping! Are new situations potentially uncomfortable for her due to the dementia? She seems fine so often but has very little short term memory. Often is losing now old memories. She forgot she had a brother that died before he turned 20.
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Skilled nursing home care would not be my recommendationn either. If, in the future, you need help, seek out hospice (dementia/alzheimer's is a qualifying dx) or a place, like assisted living that is devoted to memory care, not just a wing, a whole facility. Check with the alzheimer's association as well. The alzheimer's association is familiar with all of the things that can come up for people and their loved ones that are suffering from memory loss diseases. This would include your issues regarding anxiety, shortness of breath, and many of the issues thtat our seniors often suffer from. In their work with seniors with alzheimer's, these people intrinsically suffer from the other issues common tot their age group.
In summary, first, call alzheimer's association- for referrals to providers with specialties that are appropriate as well as many other services including basic support. Second, ask your MD for a hospice referral and investigate your area's hospices, interview them and pick one. You will be amazed what they can offer you as well. Don't be afraid to ask for help when you need it, it will keep you sane and calm which will help your mom as well! You might attend a community event for the alzheimer's association and check out which area facilities and such are also there. The ones that choose to take the time to get involved are the ones to check out first. A website to check out right now is Jolene Brackey's enhanced moments site. In all my years of working with this population, I have never seen someone who has got it right! Jolene's attitude and approach is the way I have always believed it should be and it is wonderful that finally there is someone out there that is letting the world know as well. She is full -FULL!- of insights and ideas and experiences and you can share and ask her things as well. I trust her and she will lighten your load, and lift your heart! Good luck, let me know if I can help!
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You are welcome, agingcare. We have something in common. My prayer is always that I never, ever have to place my Mom in a nursing home if I can help it. Key for us caregivers is that sometimes there is nowhere else to turn and we need to make that difficult choice, be it due to our own health decline, etc. If it ever comes down to that choice for me, then I will know beyond a shadow of a doubt that I have done my best and, as my Dad used to say, "angels can do no more" if that is the case. I have little trust in nursing homes based on their very public national track record. Good news is that there are some good staff and facilities out there in spite of all of the horror stories we have seen and heard.
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I would definitely get another doctor's opinion. A plumonologist is a good idea. Also, dementia often causes anxiety. It they can't keep her on Ativan, then Klonipn (Clonazapam) may help. Her anxiety must be addressed. It's hurting you, too. You denfinitely need more medical advice.
Carol
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Thanks you so much. Yes, I will definitely go to a pulmonologist--She has seen one long ago, however, since they worked through the blood clot issue I had not thought about it. A nursing home will never be an option if I can help it. The chances that mom will be mistreated would overwhelm my mind. Again thank you--this site is such a good resource for the caregiver--now I have a place to go to ask questions and see what others are going through.
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Thanks for answering. Is the shortness of breath occurring throughout the day, or is it just episodic, or only when something happens that may be upsetting or confusing to your Mom? While she has been hospitalized does the shortness of breath follow the same pattern, or is there any difference that you have observed? If there is no difference while she is hospitalized and under clinical observation, her medical service providers may be right that there is nothing else medically wrong, which may point to anxiety or fear. Still, a second opinion may help to ressure you, especially if the second opinion is rendered by a pulmonologist. Have you considered asking your Mom's doctor whether your Mom may benefit from nursing home care, perhaps? Skilled nursing home personnel are trained to handle just about everything, in particular symptoms that scare the rest of us caregivers. I would be scared too, if I had to face the escalation of the symptoms you have described. Keep asking questions of your Mom's geriatric doctor to force her to help you think through your options. Your post reminds me that as caregivers there are so many times we are stumped and simply powerless. Don't lose hope that you will find answers. Keep sharing.
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Mom is 78 this year.
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A second medical opinion, perhaps, if only for your peace of mind? How old is your Mom, if I may ask?
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