I think this is the beginning of the end.

Barb, I'm so sorry.... Your mom's no longer in pain. Please take that as comfort. It really helps to know that you were there for her and did your d*rn best to ensure she was as comfortable as possible. You were always there for her - Always - even if it meant your tears was the only way to get her hospice care. You were a wonderful daughter for your mom. {{{{HUGS}}}}

Dear Barb so sorry Mom had to endure so much before she passed. Finally it is over for her but just the beginning for you and your family as you begin your journey through the maize of grief.
It is different for everyone so let each stage happen and don't try and get back to "normal"
It will be a new normal and will take a while to make new memories. Don't be surprised if it takes a year or more.
Sending you love and healing thoughts. Mom will always be with you in spirit so talk to her often.

Dear friends, just to let you know that mom passed away this afternoon. Will post more tomorrow.

About three weeks before my mom passed she had quite the fall. She had been diagnosed with osteoporosis years ago that was treated with Boniva. Her doc took her off the Boniva about four years ago because recent studies had shown long term use if it will cause bones to become very brittle resulting in pulverized bone with breaks that cannot be fixed.

Hospice suspected mom's behaviors, which had become completely unmanageable, were caused by pain from possibly a broken hip from the fall. We will never know for sure as if you are not going to do the treatment why do the test? It may have confirmed a break but, just additional testing would not be easy for mom. Then the excruciating decision of whether to attempt treatment. Mom passed three weeks after the fall.

My best to you Barbara and Stacey and families too as you are both on this final journey with your folks. Thinking of you both.

Barb, my Mom had Uterine Cancer, that metastasized to her hip bones and the lowest bones of her pelvis, the Ishium (the little U shaped bones, our butt bones that we sit on), They were literally desolving away from the cancer, leaving spikey edges, which caused her a great deal of pain. One day (post hysterectomy, post 30 days of Radiation therapy, now in the wait and watch phase, 6 months post my Dad dying), she was putting something away in her closet, her pelvis snapped, she fell into the closet, excruciating pain like I've ever seen before as we tried to get her out of the closet, 911, hospital ER, they knocked her out with pain meds and Vallium like drugs right away. Sent to xray, returned still asleep, and when the Dr put her X-ray up on the light box, I was standing there with my eldest brother and one sister, and looking at her films it was like "oh Sh*t, how is this even possible?", there was practically nothing left of her left hip socket, it was so eroded from the cancer, and I couldn't believe she was still walking at that point.

The Dr said inoperable, time for Hospice, can your family manage her at home? She was living with my eldest sister at the time, still recovering from the treatment, so I called her on the phone (she had stayed behind with her brand new Grand baby and the 2 other grandchildren. I told her the Dr said about 3 weeks (prognosis), Maybe! So of course sister said we'll bring her home. Same scenario I'm dealing with here with my FIL, Hospice sets up a hospital room in your home, and you rally the troops, if your going that route. I am one of six close siblings, so we worked like an army together, managing her end of life care, 5 months she lived, with a PIC line in her chest for the heavy dose Morphine (and I mean Heavy!) to be delivered into her, plus a push button, for when the pain was really bad. Urinary Catheter (same as my FIL), bedbound, the whole enchilada!

It is quite amazing how they send you home a patient who is So sick, So dependant, and your are left to Figure it out!

I tell you, just the medication management is a job in itself, and I feel like a scientist figuring out just the right formula to make him comfortable and manageable for us, and Hospice is very helpful in making sure the family gets some rest too, by providing Lorazepam to keep him Calm, and to get a good night's sleep! Heck, I almost want to sneak one of his magical relaxers at the end of some days too!! Lol!

The Hospice team is fantastic, so responsive to our questions and concerns! I know that it helps that I have a medical background, as I don't see how other people could do what we are doing at home to make his end of days as best as possible! The worst part is getting the poop part under control! 3 times today it's been "a mess", so the stool softens are the real tricky part!

While my FIL is not outwardly thankful to us in the day to day care, he did express extreme satisfaction to my daughter today, telling her that we are doing a great job in caring for him, and that he is so glad to be home with us, so there is that!

I'm so sorry about the possibility of a hip/spine fracture for your Mom, and thank God for good pain relievers! It's all about the comfort now! God bless Sweetie!

GA, when the doc came out to the waiting room to tell me I said " we haven't been to the beach"..... it's like the beginning of bladder stones. Needs to keep himself more hydrated. Such a relief!!!

I'm thinking that perhaps they missed a break in the ER. Remember, 4 years ago, my mom fell in AL, got sent to ER and cleared. Broken hip dxed three days later by alert pt who noticed mom was not weight bearing.

So, at this point, if she had a broken hip, pelvis, she wouldn't be able to survive surgery. So morphine is the right choice. Just peed Jeane Gibbs who had something similar, her mom was on hospice with an inoperable broken hip and survived for another 2 happy years. Could it happen for us? Maybe?. Going up very early tomorrow and will be in touch.

I just can't tell you how much I love and appreciate you all. Gnight!

OMG, a broken hip? Have x-rays been taken? How very sad for your mother; it must be agonizing to be in the situation your family is in. How are you and your brother and sister holding up? And how is your husband?

I've never heard of gravel in a bladder. That must be painful. Without being facetious, but trying to lend a bit of light banter to the topic, did he eat something made in China?

Mom is on morphine every 2 hours (originally scheduled every 4 and then prn, but she was still in pain...i suspect a broken hip or pelvis or vertebrae. Gotta be). I think maybe it was a good thing thay SIL, who has been relictant to do hospice, got to see moms level of pain today. Had to stay home today for husband's procedure. He has gravel in his bladder. Go figure. Took the opportunity to help out middle daughter by taking 5 month old granddaughter for a three hour walj in Prospect Park. My, that chikd has personality! I told her all about what we'll do next summer when she can walk. It was a very therapeutic day.

Barb
I'm crying with you reading of the afternoon -
Perhaps it seems that after taking so long, it now comes so fast

As in the past, you, Barb, are getting done what needs to be done

Rest your mind tonight. Hope tomorrow goes easily for hubs.

We're here with you

One of lessons I've learned here is that we are never prepared when it is our own parent. That's why advice from all of you is so valuable. Lessons from JeanneGibbs, whose mom bounced and graduated from hospice especially! Lessons from all of you about when to lay back with sibs and when to push.

BB, great that bro and sil are finally on board. So hesitant about morphine happens with many. I think people associate it with causing death, addiction (the least of the worries), and who all knows what.

My fil had prostate cancer years ago, was in much pain, still competent, but did not want morphine because of chance of addiction. Least of his worries, IMHO. He passed shortly after starting the morphine, but at least more comfortable.

Barb,
You are in my thoughts.

Glad family is on same page. That helps.

Youngest brother...there's always one...

It is all so sad. You are a real trooper! As much as we think we are prepared...we just aren't so don't beat yourself up over some tears. It's hard.

Peace be with you, your Mom, your brothers and SIL.

Me too, Golden!

Barb - that is funny. I know of a man who doesn't "get" emotions and has to ask his wife how he feels about any given thing. She tells him and after a while he realises she is right. Glad mum is breathing easier.Hope younger bro manages to get there before Saturday.

Thanks again to you all. Baby bro has always provided the comic relief. He's not a Hasbro in any sense, just a bit clueless ( he's a rocket scientist. Honest!). Big bro says mom is breathing easier but still restless.

Barb, oh my gosh, we all keep thinking we are ready for this part of the journey then we find out we aren't. Your Mom has always been such a trooper on so many medical issues. I know this is so emotionally draining especially when siblings are also making decisions, but it sounds like everyone is on the same page.

I am thinking about you, your Mom, and the rest of the family.

Just for comic relief... brother called up younger brother to tell him that mom is on hospice and " actively dying". Little brother said, "maybe I can come up Saturday. I can't think about this, my wife's not here." Good laugh was had by all.

Oh Barb, I am so sorry your mother is suffering so much. Thank goodness bro and sil are now on board with you. It should make things easier. I hope the morphine continues to make her breathing easier and manage her pain/distress. The sweet breath smell is ketosis from not having eaten and burning up body fats. At this point it is not a bad thing.
" Anorexia may be helpful as the resulting ketosis can lead to a sense of well-being and diminish discomfort."
You really have too much to do with your husband having a procedure tomorrow. I am glad you are looking after you and taking naps when you need them. Big (((((hugs)))) and prayers.

Barb, thanks for the update. You and your family have been on my mind since this current episode began. I'm glad that your brother is on board with bringing in hospice. That at least will smooth the way for their involvement.

Still, I can't help envisioning the scenario and thinking how distressing this must be. These are unsettling times.

I'm glad to learn that you're taking good care of yourself. It's too easy for family to be so overcome with decision vs indecision, anxiety, grief, and fear. Stay strong, my friend.

So here's where we are right now.
I lost it this afternoon with the "agony face". There was a long discussion of pain meds last night, the APRN doubled the tramadol and when I arrived today, mom still had the intermittent agony face. I went out to the desk and started crying. The RN in charge, who is a friend of my brother and sil asked if we had considered hospice ( yes YES). She ran mom's hx by the med director who said " why ISN'T she on hospice?" and reminded me that as one of 3 healthcare proxies, i could request an evaluation , which I did. I texted my brother, who showed up to talk about meds other than morphine. Oy. Fentanyl seems to be what he was in favor of, longer acting he thought. Anyway, hospice RN showed up. Sil called in. Bro started signing the papers as sil was driving to the facility. She asked to speak to my brother privately and I waved brother away to talk. Hospice nurse looked at me and said " is that going to be a problem?" I shrugged. He came back 10 minutes later and signed off. Sil came about 5 minutes later and seems resolved.

They gave mom a dose of morphine at about 6pm. It eased her breathing a bit. She started coughing more, which I think is good, but she is very very frail and hasn't eaten in several days. Breath smells sweet, according to hospice nurse.

I have no idea where this is going. My husband is having a urological procedure tomorrow, so I won't be there at all. We shall see what get next few days bring.

I can't tell you all how much comfort and knowledge I've gained from you all, and my appreciation is boundless. I stay hydrated, and am alert to falling asleep while driving. I'm an expert at pulling off and taking 15 minute naps. Thanks Again! B

Barb this is so hard for you and Mom. Morphine is not the only pain med that can be used to relieve Mom's pain. Many people hear the word "morphine" and panic. Ask the drs to prescribe something stronger and different. Most things can be given into an IV if swallowing is too difficult. Much easier for all concerned. Would bro and SIL be against something different or are they of the opinion that people should be able to withstand pain and not give in ,of course as long as they are not the person suffering. Once the pain is under control Mom may no longer be anxious but if she is they can add an anti anxiety med. Are they crushing the tramadol and giving it in apple sauce.
Don't let them give Fentynal, it is very effective but wears off too quickly.
It is probably better if she is not fed if swallowing is a problem. Just make sure her mouth is kept moist and clean. Nothing worse than feeling your teeth are wearing sweaters. God be with you Barb

Oh Barb,
Seeing mom in pain has to be so hard -
is she running a fever?

You be sure to stay hydrated - I know I don't get enough fluids when I'm with mom for hours at a time

Hugs

Barb, I'm so sorry this is going on for your Mom, and your family, the long wait is excruciating, I know!

From everything I have read about and witnessed, the Morphine actually helps to open their airways and assists in easier breathing. I'd opt for the Morphine if at all possible!

When and if for the time comes that she is struggling to breathe, they often add in mucous thinners, and anti anxiety medicine for that too, even so far as to make the patient unaware, but obviously not you, so that is when it is time for you to get your own anxiety meds from your own Dr if you think you m6need them, as this is so difficult for you too!

I have been right where you are several times with my Dad, and now my FIL. I Never would have thought that FIL could have survived the Pneumonia and Sepsis, and so many other bad things, in his recent hospitalization, and now he is dying in our home, On Hospice, from this new diagnosis of Lung Cancer, and our world is turned upside down.

Hospice has been Godsend, and they have been so very supportive to us, especially for us the Caregivers! Go for the Hospice!

I wish for you and your Mom, peaceful recovery or journey, whichever is God's plan. But honestly, I do believe that Pneumonia is the old man's friend, as our folks would never wish to recover to a point of being even worse off than they were previously, of that I am sure.

Please know that I am thinking of you, and praying for your safety as you drive to and from your visits with your Mom. It is very easy to become tired, anxious and exhausted, when your mind is racing and thinking about other things, so be safe, drink plenty of caffinated beverages, and get safely to you destination! God Love You Sweetie! Love, Stacey

I do too, Barb. I am so sorry your mother is in discomfort. Morphine should ease it. Let us know if hospice is recommended. I am glad you are there for her. ((((((hugs))))))

My brother came by when he got my text. He's in agreement with hospice if they recommend it. I think that's good news.

I just requested a hospice evaluation. I am allowed as healthcare proxy, but signing for the service is up to my brother.

Mom keeps having this terrible grimace of pain, or anxiety, or I can't tell you what. They've doubled her tramadol but she's having terrible problems swallowing it. I want morphine for my mother and for whatever reason, my brother and sil are against it. Mom had morphine when she had a mastectomy...we know it Works!

Thinking of you, Barb. Wishing you strength, clarity, and peace about everything. And patience. It's been a long road and may go on some ways, who knows. I hope your mom is more comfortable today and her pain is better managed.

Safe Travels.

Sending you mental and physical strength to face the day barb.
You are in my thoughts all day!
Hugs

Wishing all of you the best and comfort for mom, Barb.