If the person isn't drinking and their sodium levels drop, what happens? Does a nurse give an IV at home instead of going to the hospital? Or does the nurse (or whoever) do nothing?
Low sodium can be caused by other issues as well, one being a pituitary gland failure. Or, it could be your uncle can no longer absorb sodium because of some underlying condition or even his GI tract shutting down. There are many “could be” situations for any medical issue.
“The primary doctor and hospital doctors aren't interested in finding a cause and a solution, so they suggested hospice.” But you don’t know the diagnosis that hospice was ordered for. And you so easily agreed? I’m confused.
If you don’t like his providers get a second opinion.
Why IS he on hospice? There has to be more to this picture. Low sodium happens a lot to seniors and can cause mental status changes. Maybe the doctors tried IV fluids as a trial to see if it is an absorption issue & he failed the test.
Are you you speaking with his providers daily? We don’t know the specifics of your uncle’s state of health. Low serum sodium can be fixed with IV but if the sodium isn’t being absorbed there is a bigger problem.
Please let us know WHY he is in hospice. Who signed the hospice paperwork for him? How old is he?
He is 94 and is/was pretty healthy other than this low sodium and anemia. He has a low thyroid and a history of DVTs which he was on medication for and takes no other meds. He has dementia but it is mild to moderate The anemia may be due to a recent UTI and subsequent blood draws.
The first hospital stay involved a 48 hr IV which raised the sodium to a decent level. The second hospital stay a week later resulted in two infilrated IVs, which they did nothing for. He was discharged with sodium around 127-129, normal is 134.
Different doctors and nurses say different things. Some say he should be put under care, others indicated he could make a fairly full recovery. They were recommending physical therapy, etc. My cousin discussed things with the primary care physician who didn't think a recovery was possible, because the sodium levels were low. Uncle wasn't drinking and his appetite waned. But, I think that happens with low sodium anyway.
My cousin is POA and relunctantly signed the hospice papers. He thought they could treat him with IVs without going to the hospital. The hospital mistreated him on the last stay, we even suspect they broke his hip when they dropped him on the floor. He does not sense pain properly. My cousin was worried that protective services would put uncle in a nursing home if he ended up in the hospital again, they tried to on the second visit. Cousin was also worried about getting in trouble if his father died at home in a dehydrated state. Everyone with hospice acts like uncle has something wrong that will cause him to die (like cancer). Over the last few days, he's started showing signs of what I suspect is encephalopathy due to low sodium. He's saying crazy things like "let me out of the soda bottle." He sounds drunk, complains of pain when moved, and his appetite and thirst fluctuate.
I wish they had tried a salt pill or something. Even if they did now, I wonder about his brain and mental state. The nurse told us what I already expected, if he does not eat or drink, he will likely die within 10 days. My cousin is now wondering whether he should just let him die. He can't walk and likely never will. His brain is clearly messed up. What kind of existence is that? I don't know if he's even here, if you know what I mean. But the other day when he was fairly lucid he said that he did not want to die.
The low sodium issue has been ongoing, that's why/how hospice got involved. The primary doctor and hospital doctors aren't interested in finding a cause and a solution, so they suggested hospice. The admission nurse didn't think IV fluids was good because it can cause kidney and heart problems.
When IV fluids are given and the sodium level is normal, then my uncle eats and drinks a regular amount. He seems like his normal self considering he has Alzheimer's. My cousin tried adding in Gatorade and using more salt, but I'm sure the sodium levels have dropped again. He is not eating or drinking. Hospice says not to worry about it. I get the impression that the primary doctor thinks the end is very near. My uncle was talking gibberish and moaning for two days. I realize that is normal as the sodium levels drop to a critical level. The nurse mentioned encephalopathy to her boss.
I just thought it was strange not to try IV fluids one more time and add more salt into the diet. My uncle is indicating he is not ready to go. We asked him about it and he indicated he wants us to help him stay alive, we're unsure of how lucid he is. He doesn't want to be left alone, I suspect he knows he's dying. He also doesn't want to go back to a hospital - they mistreated him there.
The hospice nurse gave everyone in the family the impression that he would be alive for a while - for several weeks. I'm not so sure, especially if he's not eating or drinking. The sodium hasn't been tested, but we see the same behavior we've seen on the three previous hospital visits for low sodium.
when on hospice, it’s not strange to not try IV fluids. They don’t do anything to prolong life. If the low sodium isn’t causing pain and discomfort then hospice won’t treat it.
One of the first symptom of low sodium is muscle cramps, then irregular heart beat. Sodium and magnesium need to be in balance with each other too. Also, constipation is another sign of low sodium.
only a blood test will reveal if this is the case...but those symptoms are pretty hard to miss.
solved it by adding Himalayan salt and magnesium supplement to my morning coffee ... hard to take in just plain water...eeeeck.
does she complain these problems? Does the hospice nurse see any signs too? Can you add this to whatever she is taking?
“The primary doctor and hospital doctors aren't interested in finding a cause and a solution, so they suggested hospice.” But you don’t know the diagnosis that hospice was ordered for. And you so easily agreed? I’m confused.
If you don’t like his providers get a second opinion.
Why IS he on hospice? There has to be more to this picture. Low sodium happens a lot to seniors and can cause mental status changes. Maybe the doctors tried IV fluids as a trial to see if it is an absorption issue & he failed the test.
Are you you speaking with his providers daily? We don’t know the specifics of your uncle’s state of health. Low serum sodium can be fixed with IV but if the sodium isn’t being absorbed there is a bigger problem.
Please let us know WHY he is in hospice. Who signed the hospice paperwork for him? How old is he?
He is 94 and is/was pretty healthy other than this low sodium and anemia. He has a low thyroid and a history of DVTs which he was on medication for and takes no other meds. He has dementia but it is mild to moderate The anemia may be due to a recent UTI and subsequent blood draws.
The first hospital stay involved a 48 hr IV which raised the sodium to a decent level. The second hospital stay a week later resulted in two infilrated IVs, which they did nothing for. He was discharged with sodium around 127-129, normal is 134.
Different doctors and nurses say different things. Some say he should be put under care, others indicated he could make a fairly full recovery. They were recommending physical therapy, etc. My cousin discussed things with the primary care physician who didn't think a recovery was possible, because the sodium levels were low. Uncle wasn't drinking and his appetite waned. But, I think that happens with low sodium anyway.
My cousin is POA and relunctantly signed the hospice papers. He thought they could treat him with IVs without going to the hospital. The hospital mistreated him on the last stay, we even suspect they broke his hip when they dropped him on the floor. He does not sense pain properly. My cousin was worried that protective services would put uncle in a nursing home if he ended up in the hospital again, they tried to on the second visit. Cousin was also worried about getting in trouble if his father died at home in a dehydrated state. Everyone with hospice acts like uncle has something wrong that will cause him to die (like cancer). Over the last few days, he's started showing signs of what I suspect is encephalopathy due to low sodium. He's saying crazy things like "let me out of the soda bottle." He sounds drunk, complains of pain when moved, and his appetite and thirst fluctuate.
I wish they had tried a salt pill or something. Even if they did now, I wonder about his brain and mental state. The nurse told us what I already expected, if he does not eat or drink, he will likely die within 10 days. My cousin is now wondering whether he should just let him die. He can't walk and likely never will. His brain is clearly messed up. What kind of existence is that? I don't know if he's even here, if you know what I mean. But the other day when he was fairly lucid he said that he did not want to die.
Have you considered palliative care as an alternative?
Will he tolerate an IV or will he pull it out?
When IV fluids are given and the sodium level is normal, then my uncle eats and drinks a regular amount. He seems like his normal self considering he has Alzheimer's. My cousin tried adding in Gatorade and using more salt, but I'm sure the sodium levels have dropped again. He is not eating or drinking. Hospice says not to worry about it. I get the impression that the primary doctor thinks the end is very near. My uncle was talking gibberish and moaning for two days. I realize that is normal as the sodium levels drop to a critical level. The nurse mentioned encephalopathy to her boss.
I just thought it was strange not to try IV fluids one more time and add more salt into the diet. My uncle is indicating he is not ready to go. We asked him about it and he indicated he wants us to help him stay alive, we're unsure of how lucid he is. He doesn't want to be left alone, I suspect he knows he's dying. He also doesn't want to go back to a hospital - they mistreated him there.
The hospice nurse gave everyone in the family the impression that he would be alive for a while - for several weeks. I'm not so sure, especially if he's not eating or drinking. The sodium hasn't been tested, but we see the same behavior we've seen on the three previous hospital visits for low sodium.
only a blood test will reveal if this is the case...but those symptoms are pretty hard to miss.
solved it by adding Himalayan salt and magnesium supplement to my morning coffee ... hard to take in just plain water...eeeeck.
does she complain these problems? Does the hospice nurse see any signs too? Can you add this to whatever she is taking?
I would make a call to the nurse or doctor if you are concerned.