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My mom has pneumonia, she cannot eat or drink without aspirating and it has come to the point where medical care is of little use. She also suffers from heart failure and dementia. I have signed a DNR, and am now considering hospice and comfort measures only. I know that she has said in the past that she does not want to be hooked up to tubes and machines, but I still feel horrible about all this. How do I talk to her about this in a way that will get through the dementia? A gut wrenching conversation will be of little use if she does not remember it tomorrow. I am so torn right now. My siblings are keeping their distance and I have been given power of attorney to deal with her needs. Just feeling so helpless right now....

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What is it you feel you need to discuss with her? She has already told you her wishes and you are honouring them, I don't see any need to rehash it. Tell her you are bringing in extra caregivers to help look after her while she is ill, which is nothing but the truth.
You aren't killing your mother, her body is failing because she has a terminal disease and any treatment now would probably buy only a few more weeks or months of misery. I'm sorry your family are in denial and hiding over this instead of giving you and your mother the support you need.
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mike, The logical part of you recognizes that your mom is dying.The emotional part of you is understandably very distressed. It's so very hard to lose a loved one. I just want to reassure you that none of this is your fault. You didn't cause her to have pneumonia or heart failure or dementia. And you won't be the cause of her dying. It's your name on the document, sure, but it does not mean you will be causing her death. It's the nature of life. It sounds like she knows that considering her past statements regarding tubes and machines.

As far as a conversation with her regarding these issues, I'd avoid as it will probably upset her for a short time. I know you want permission from her to let her be in peace. There's no talking through dementia though. Just be there for her and assure her that you love her. Once eating and drinking are gone she needs hospice/comfort care. Hold her hand, stroke her face and just be there for her. That is all you can do at this point. My sympathies to you as you are in a very hard place. I hope your siblings come around to acceptance of your mother's situation. They are missing out on a very important part of your mom's life. Bless you for being the one that is there for her. I'm certain she feels your presence and love.
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((((((mike))))) what you have ordered is the care your mother needs as she goes through the dying process. She will die with or without what you have ordered. With a DNR, hospice and comfort care measures she will die with as much ease as modern medicine can manage. Without these, there is a chance that she will be in distress as she dies. I am sorry that your sibs are not joining you in caring for your mum at this stage of her life. Your mum has already given you permission to do what you are doing. I agree with others that there is no point in trying to discuss it with her at this time. She trusts you with this big responsibility and you are carrying it out with love. It is all you can do. She may well have a sense that she is passing. Just be there for her. I have POA and my mother is on comfort care too and she has said in the past that she does not want any extraordinary measures taken to prolong her life. I will see that she has as much comfort as possible when the time comes. No one said it would be easy and it isn't, but you are doing it well. more (((((((hugs)))))))
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Mike, I just kept telling my mother that everything was going to be all right. Hold her hand and be strong for her. May she never be afraid, and may she have no pain.
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Thank you for your kind words.

You nailed it. I am seeking permission. I had not looked at it like that or was denying that is what I am doing. I do not feel any better, but it puts it into perspective for me. I know mom would want to go with some shred of dignity, and my brain is telling me that it is for the best, but my gut is being ripped apart in dealing with all this.
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Mike, I just went through that in September with my Dad. He also had aspiration pneumonia. I kept wondering if I was doing the right thing. I kept thinking something could be done to help him. I just wasn't ready for this. This was too quick. I figured pneumonia was pneumonia and that is treatable, but it was the aspiration that made it so very complicated.

Don't be surprised once your Mom is on Hospice that she rallies, wants to sit up, be chatty, wants to try to eat [Dad tried but aspirated which was sad as he loved mash potatoes and gravy, and wanted so much to eat it all]. The coughing was exhausting him, and here he was 95 years old. Sadly the next day he passed.

The caregiver said that night my Dad was calling out to my late Mom who had passed in December... he was ready to see her. That was my saving grace from feeling so helpless. Dad got his wish to see Mom again.
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Mom left the hospital last Monday and is back at the care center under hospice. Her outlook has improved being back in familiar surroundings and she seems to be more at peace with all this than any of us. I am still in inner turmoil, but I figure that will go away over time.
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Be at peace, Mike - no doubts and no regrets about the care you gave your beloved mom - you loved her and she knew it
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I think we all feel that way when our loved one is dying and can no longer communicate, at least like they would when they were well. My father died of brain cancer and it was so painful watching him lose his ability to talk. There was so much I wanted to talk with him about. Luckily we had a super close relationship throughout our lives together. I still talked 'with' him recounting past good times and things we shared. You may already know this, but hearing is one of the last senses to go, so warn your absent siblings to avoid any upsetting talk if they decide to show up. You are doing a great service for your father. May God bless the both of you.
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Mom passed away yesterday morning.

She had been feeling sick and was looking pale the day before, but she seemed to rebound later in the day and was happy and smiling at dinner.

The next morning she was happy and cheerful when she woke up, went down to eat breakfast and after she finished eating, she simply slumped over in her chair. The nurse took her back to her room while they called us. We were there in about 3 minutes, but she had already left us. I am thankful that she went quickly and peacefully.
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