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My Mom, who has Alzheimer"s,stayed in a nursing home for 10 days, while my husband and I went on vacation. When we got back we went to see her because she was going to stay a total of 18 days. For some reason at the end of the visit my husband said to look at her feet. When we did one of her toes were black. She does not talk so she could not tell them that her foot hurt. We asked the nurse and she did not know anything about it. We took her to ER and she was in the hospital for 10 days and is now home in a hospital bed with constant care and now one of the other toes is turning black. Now the Dr wants to call in Hospice. Just because of neglect at the nursing home. What would you do?

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Wait a minute. There is more going on than Alzheimer's Dementia. There are definitely some circulatory issues, maybe even diabetes. She may not have any feeling at all in the toes.
Gosh yes I would call in Hospice rather than watch the toes fall off. The pro is that you do not do surgery or aggressive treatment. The patient gets morphine and other drugs as needed. The con: having to accept that this is the end of the road and nothing more will be done. Having to repress your desire to call 911 or rush her to her MD is very hard to accept. Having to tell family that she is on Hospice and dealing with their reactions. Writing the obit and planning the funeral is a weepy time. At least Hospice will be there to keep you calm. For us, they were angels, guidance, counselors and comrades.
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You might want to stop focusing on what the nursing home was or was not responsible for. The important thing is what is best for mom. When my husband's doctor recommended hospice care for him, we followed through on it. I am glad we did. You can have a hospice representative visit you, and see what that person recommends. Then think it over.
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"What would you do?"

I'd want to know her diagnosis and what we were dealing with. I'd look at mom's overall quality of life BEFORE this happened and then want to know what life-saving measures would actually do to improve her condition. And what these procedures would cost her in discomfort and pain. If there was no pay-off, I'd concur with the doctor and call in hospice.

And that is SUCH an over-simplification, I can't even tell you. We know nothing about your mom...except I assume you love her and want the best for her.
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Thank you all for your responses. My Mom is in advanced Alzheimer's and she does Not have diabetes. She does have poor circulation in her legs that we found out after we took her to ER. She was very ambulatory before the nursing home. She got out of bed on her own and made her bed each time she got out, but that was ok. She would walk down the hallway at night to look for me as I was usually still awake and in our den which is on the other side of the house. Then I would walk her back to the bathroom and then back to bed. Now I have to help her get out of bed and to the bathroom and then to the recliner in her room. She cannot walk any further. I also have to feed her. Before this she use to sit at the table with my husband and feed herself. Her foot does not seem to hurt but I see her looking at it when she is sitting in her recliner. Probably wondering whose foot is that. One day I think I will pull the covers back on her and her toe won't be attached to her foot. We will see the vascular surgeon that opened up her artery in her groin to get the flow of blood working to her foot, this Tues. He really does not think she should have any surgery either as long as it is dry gangrene . Still up in the air about Hospice. I need to talk to one of their representatives, I guess.
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I wish I could help with some information or advice, but I'm not able to on this question.

I'm sure sorry this happened to your mother. What stage of AD was she in when you took her to the nursing home? Does she have any other medical problems such as diabetes?
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If your mom can't communicate I'm assuming that her Alzheimer's is advanced.

What I would do: Call hospice. Opt to not run around to Dr.'s, opt out of a possible amputation surgery for your mom's toes. Opt out of any kind of therapy/procedure that will prolong her life. If it were my mom that's what I'd do. I did it for my dad.
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