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My Aunt, in her mid nineties, was thriving two weeks ago. We took a long walk in her transport chair one afternoon, visited with her in-home therapist the next, and five days later I took her to the emergency room for dehydration and lethargy - she was refusing food and drink - and they discovered Bradycardia, an arrhythmia caused by congestive heart failure. They offered her a pacemaker, which she declined, and sent us home on Hospice care. She has been steadily declining since we brought her home in spite of round-the-clock loving care from family. We are trying to reestablish with her Palliative Care Team because they're fantastic and she's familiar with them.
Besides the heartbreak for both her and ourselves - we miss her as she was - we're facing new problems. She now takes her Depends off at night and tosses them over the bed rail. I sleep in her room but she's unable to remember to hit her buzzer to wake me up and her speech has declined so badly that she can't get enough out to wake me either. I've taken to setting my alarm to go off every two hours to check on her. Because she's not as mobile as she was she's difficult to move. And getting her to eat or drink is an ongoing challenge. We have a little fridge in her room with water, Ensure, pudding, etc but digesting enough to stay healthy and hydrated is nearly impossible. The emergency room said nothing about dementia or stroke but the major damage is obviously neurological. Does it sound more like a stroke? We're having her evaluated this week but my heart is aching for her because I miss my buddy and don't know how to help.

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If your Aunt has bradycardia and has declined a pacemaker eventually she will experience congestive heart failure. She will also probably not be able to maintain an adequate blood pressure. That means less oxygen to her brain cells which may cause increased confusion etc. It also means less blood supply to her other organs and their eventual failure which can also cause confusion etc. Supplemental oxygen may or may not help. As sad as it is, it sounds like your Aunts heart is just worn out. Hospice care sounds very appropriate. Use them not only to help make your Aunts final days as comfortable as possible but also to help you and your family. It's hard to watch someone you love die.
It's obvious from your post that your Aunt was a very special lady. I hope you hold fast to those memories of the good times you shared with her. I wish you and your family comfort and strength during this difficult time.
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Thank you everyone for your kind responses. We're holding steady here.
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gladimhere is correct. There aren't always symptoms with UTI's.

However, there may be no one thing to point to and say, "That's what's causing all the problems." Your aunt just may be declining.

I work in hospice and I started with a patient on a Monday. He was frail and weak but ambulatory. He was talkative. And from that Monday to the next Monday he declined. I told the family that he was declining over hours, not days or weeks. He died one week from when I started with him. His decline was that fast.

You're very devoted to your aunt. Setting your alarm every 2 hours has to be very difficult on you. I hope you find some peace.
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Especially in those with dementia UTI's do not exhibit common symptoms, like pain with urination, something in the brain is not transmitting pain signals because it is broken. Or, there are also physiological changes in the urinary tract as we age that even those without dementia do not experience pain.
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Gladimhere, she was never given meds for the chf. She only takes thyroid meds and never had a problem with them. She hasn't complained of painful urination but I'll speak to her doctor this week about that. Thank you.
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It is possible that the meds she is on is causing other issues. What meds were added for CHF? Has she been checked for a UTI?
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