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bawawa Asked July 2014

How can I tell if my Mom is giving up and wanting to die?

She had a stroke 4 years ago also has high bp and afib. Recently, she has begun breathing heavy upon mild exertion less communicative uninterested in visitors sleeping more during the day with some restlessness at night cant get straight answers from cardiologist

Veronica91 Jul 2014
First of all is her A fib well controlled. if not it is very very exhausting for the patient. not getting enough oxygenated blood to the lungs as well as pulmonary issues can cause difficulty breathing. Afib in itself can lead to heart failure if it is caused by disease of the heart valves which can not pump effectively. Is she in any condition to be dragged around to undergo testing and would she agree to it anyway. Apart from telling you what is wrong with her the treatment will likely not change because it will continue to be mainly symptomatic.
I can not tell you if she has given up as such she is clearly very tired and her body is showing signs of winding down.
The test garden artist mentioned is called spirometery and is very simple requiring the patient just to puff into a tube. It is linked to a computer which prints out a graph telling the dr how much air her lungs are capable of taking in. Don't worry about testing her Oxygen saturation at home, you know she is short of breath so leave it at that. Have you considered hospice. Ask her cardiologist if he would recommend it. if you have hospice the RNs will assesss her and be on the look out for things like pneumonia. it really all boils down to your mother's wishes and wether she can and wants to tolerate Dr visits and tests which will be totally exhausting. the cardiologist probably already knows the answers to all these questions but may be wanting to spare Mom or you the bad news, You have a right to know so press hard for answers and don't; leave till you get them. if you think you want hospice you can just call them yourself and they will come out and evaluate Mom and then you can ask her Dr to make a recommendation. many people don't know they can just contact hospice themselves and wait for the dr to suggest it when you could have enjoyed the benefits much earlier. Blessings

vstefans Jul 2014
She could also be having congestive heart failure, and it is not fair you have to think she is psychologically giving up when it is so likely something physical giving out. I found a lot of times you really have to push on doctors and other health care providers to give it to you straight, we often don't realize that we are seeing one thing that seems very obvious to us, but a loved one who is not going to be able to be objective, even if they are unusually medically sophisticated, really needs told some basic things in plain English. That said, there are meds that help with a failing heart, and significantly and a chest x-ray and maybe an echocardiogram would tell them if adjustments need to be made.

That said, its possible she is already on all the meds that will help, and the other thing you have to help decide is how aggressive to be with more care. It is not an easy thing, or an easy time, and my heart and prayer goes out to you!

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GardenArtist Jul 2014
Breathing heavy on mild exertion could suggest a pulmonary issue. Find a pulmonologist ASAP and have her tested. She may just need oxygen.

If she a smoker?

You can also buy a pulse oximeter to check her oxygen saturation rate (SAT rate) when she's stationary and after exertion. There are different threat levels - we've been told by different doctors as well as home care people that 95% SAT rate is great, even 90% is great; other medical professionals will say that 90% is on the low end. But concern generally increases below 90% SAT rate.

Medicare has standards which need to be met to provide oxygen during the day and at night. A pulmonologist would probably first test SAT rate while walking, do a test (the name of which I can't remember right now but it involves breathing into a machine which measures pulmomary capacity), and/or order a night monitor test.

If she's having difficult breathing, she will become tired more easily and likely want to sleep more.

Other facts that could cause respiratory distress are no a/c in the home, high levels of humidity, dust in the environment, smoking.

Best to get a pulmonary eval ASAP, and at least rule that out or get treatment for it.

Ba8alou asked about pneumonia. If she's bringing greenish (even pale green) sputum when she coughs, it's indicative of an infection, possibly pneumonia. Could also be bronchitis. That's an indication for a visit to the ER to get a Dx and antibiotics.

jeanelliott Jul 2014
Sorry I can't give a better answer but I can relate, I do think my Mom has given up and is ready to go. She doesn't want to go to the dr at all. I don't know what to do either. She takes her meds but is just waiting on her time she says

freqflyer Jul 2014
Get a second opinion from a new Cardiologist. Maybe it is as simple as she needs a different type or different dosage of blood pressure pills. Having high blood pressure and A-fib can happen to even younger people, and they live normal lives.

BarbBrooklyn Jul 2014
Does she pneumonia?

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