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Mom has had 4 falls since Christmas Eve. She's on Xarelto. There's concern of what to do. Leave her on it or take her off of it? If she stays on it she's at risk of falling and having a brain bleed; if she comes off, she's at risk of having a stroke or massive heart attack. At this late stage, is one worse over the other?


I'm hoping palliative care will be extra hands on for my mother's care, and I'm also wondering, since the AL facility recommended it for her, that Mom is heading toward hospice faster than I realize.


Thoughts?

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When my mom's doctor discontinued most of the meds I thought were keeping her alive - including aggrenox, an anti platelet medication - I was sure she would stroke out and die within weeks or months. She lived another 5 years and it wasn't a stroke or heart attack that got her in the end, so you just never know.
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AbbyRose Jan 2020
Wow, another 5 years. You're so right. We don't know, and we're certainly not in charge of the timeline. Thank you for sharing.
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Stage 6 is really close to the end, drugs or not. Being on palliative care means that you have come to terms that her dementia is terminal and that you can't cure it, but you can keep mom happy by not pursuing treatments to cure her. My mthr is currently in stage 7 - can't walk, can't toilet herself, can't talk, can't feed herself. It would be wonderful if she had some other disease which could possibly take her out. As it is, she's pretty healthy. If she had any other diseases which could have allowed her to avoid her internal isolation from the world, I would have been thankful for them to take her earlier.

I would take my mthr off her blood thinner in the hopes that it would shorten her ALZ journey and I would make sure mthr has a DNR in place. Mthr was eligible for hospice once she crossed that Stage 7 threshold, and it is very nice to have the extra eyes on her to know when she's in pain for arthritis, for example. But she is alone in her own world except for brief moments when someone is right in front of her face. I would not want to be so alone.
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AbbyRose Jan 2020
You are so right. It is an internal isolation. I've never looked at it that way, but that is so true. I pray for peace for my sweet mom and also for grace for me when the time comes that I have to let her go. Thanks for sharing.
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I would contact a palliative care or hospice organization. Have a good discussion about your mom’s care. I went through a similar situation with my mom. Lots of falls, broken bones. Looking back I feel I enabled her to live to long in a horrible state. I wish I had started hospice for her much sooner than I did.

I just read your profile. You are having a tough time, I can tell. What I had to keep asking myself was, would I want to continue living with all these meds, assistance with daily living activities? Would my mom, in her right mind, want to continue this hopeless battle?

Mom died over 2 years ago. Now I’m going through the same decision process with dad. To what extent should I demand medical intervention for various crisis and ailments?

Its tough but we must think about what is best for the elders not whats best for us. Don’t let grief and guilt guide your decision making.

Best wishes to you.
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AbbyRose Jan 2020
Thanks for your insightful reply. Mom has already been accepted into pallitive care as of yesterday (1/17/2020). I'm anxiously waiting to meet with them after they review my mother's history. I see her declining almost daily. She no longer takes Aricept as it no longer helps her. You're right, grief and guilt are the devil! I still struggle with both, even though my mother no longer remembers that I'm her daughter when I'm in front of her. She's starting to lose her words. I'm just lost and sad. Thanks for listening.
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Its a catch22. Because of the falling, I would take her off. She could break a hip and that is serious in the elderly.
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