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I have been the primary caregiver to my mil for 12 years. She was diagnosed with dementia after suffering a global hypoxic event due to an allegic reaction. She has always relied on me for complete care. She will has both long and short term memory issues. Limited vocabulary. Cannot dress or bathe herself. Is incontinent of both bladder and bowel. Will not change or clean herself. About a year ago she had a tia stroke. She has become increasingly clumsy, often bumping into walls or falling. She refuses to use h her walker or forgets she even has it. Over the last month she has grown increasingly weak. So much so that her last bath required 2 of us to get her out of the tub. She's developed a cough now and seems short of breath. She is sleeping 20+ hours a day. In the last 3 days she has only drank maybe 2 quarts and eaten nothing. If shes not asleep shes sitting with her elbows on her knees and her head down in her hands. Communication is almost non existent as all she says is ok but she denies being hungry or in pain. we do have guardianship and have decided not to interfere with the dying process. She's suffered for so many years already. Im doing my best to make sure shes kept clean and comfortable. Just curious if it sounds like the end is near and what kind of time frame we might be looking at.

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Thank you gladaimhere. I told my husband this evening i never realized how exhausted i really am until now. This is the second night she's been in hospital. Its been me and her as a team for 12 years and she's been my mil for 24. I'm definitely discovering I'm not as prepared as i told myself i was, but i know for sure she's more exhausted than I am.
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Kesha, yes hospice should complete an evaluation. Have you thought about moving her to a facility that provides hospice services? Hospice will have a CNA each day and other staff available. Many think that hospice is 24 hour care at home, that is not the case. You will get additional help but after 12 years I woyld want to step back at this point and have a facility provide the comfort care for her.
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Yes, Kesha, it's been a long 12 years. I agree that it's time to let go. No more resuscitative measures. I had to make that call also for my mom about 3 years ago. You did great for your MIL these past years. I hope she does get hospice services so that she's not in any pain during these last days. You take care. {Cyber Hugs}
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Thank you all for your advice. She suffered a massive stroke this evening. We are not allowing a ventilator or feeding tube and have told them not to resuscitate. Hopefully this will allow us to get hospice involved and keep her comfortable until the end. It's been a long 12 years, i believe its time to let her go.
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My mom had a terrible cough that was diagnosed as being caused by GERD. Once she went on medication for that, the cough left. Of course, your MIL could have a different condition.

I would ask about Hospice. Since you are honoring her desires and not taking extreme measures to extend her life, I'd try to get them on board to ensure that she is comfortable.

I will say that my cousin has been in a rather severe stage for over a year now, but, so far, she seems to be stable. And, I have observed other dementia patients in her MC who are bed bound, who stare in space or sleep almost all the time, are curled up with their body in contracture and who seem very close to death, only to survive for many months, even a year. It's very perplexing to me.
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Of course check for pneumonia, but if you don't see any signs of that then I have another thought. Something that causes my mom to cough at night is GERD or reflux, if I give her ranitidine she doesn't cough.
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kesha1, first let me praise your courage and dedication and loving care. You have quite a way to go if she can sit up and you can still get her in and out of the tub. If she can take liquids without choking, make her a vanilla milkshake in the blender with ice cream and ensure.
Now for the cough. Put your ear on her back and ask her to inhale deeply. If you hear crackling or wheezing, call the MD right away. It might help to have a fingertip pulse oximeter (drugstore item), so if you see heart rate over 100 with O2 saturation under 90, you can call 911 for transport to the ER.
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Thank you. She has had problems with aspirating before but this cough doesn't seem related to food or drink. It seems to be worse overnight.
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Ask your mother-in-law's primary doctor if it is time to bring in Hospice. Hospice will evaluate your mil's condition and give their estimate. If she is in pain, Hospice will help calm the pain down so her final months will be easier for her. They will be an extra set of hands to help you care for your mil.

Curious, does your mil cough right after having liquids? If yes, it sounds like some water is getting into her lungs, and eventually it will turn to aspiration pneumonia. My Dad developed that, and his passing was quick but painless.
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