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After breaking her arm in June and then suffering double pneumonia, Mom is under hospice care. Now in adult foster care, she is totally dependent on her care taker. Is this part of the disease?

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motherof5, I am so sorry to hear about your mom. I had my mother on Hospice for the final 4.5 months of her life. One of the first things they wanted to do was to take away all of her Alzheimer's medications. I refused to allow them to do that as she could still talk, bear most of her weight and very slowly take a couple of steps (with a lot of help from me) and I did not want her to decline any faster than what she had to. Unfortunately, Hospice seems to want to eliminate most meds. I think it is driven by cost as the Alzheimer drugs are quite expensive. If you want you could talk to her primary doctor and see if you can get her insurance to pay for the meds as I was able to. It takes very little time for a person's strength to fail if they are bed bound which is why it is critical to get a person up and also move their limbs. From your description you might also want to ask Hospice to check and see if your mother has a UTI and also to make sure she is getting enough liquids and has not become dehydrated. Both of those can saps a person's energy and will to live. One concern that I would have is depression. Is your mother receiving some depression medication? If not please ask her doctor about this. I also found that one needs to "wean" a person off of their Alzheimer's meds as if you go "cold turkey" this can cause significant physical and mental issues including depression. All of this (being put into Hospice which I suspect your mother equates to her being on death's doorstep, being taken off of the Alzheimer's meds and possibly medical issues like a UTI or dehydration) could lead to rapid weight loss and loss of abilities to sit up in a chair, etc. On the other hand this might just be the natural progression of the disease. Only God knows. I would say all you can do is to try a couple of things, like have her checked for dehydration and a UTI and ask if she can be put back on Alzheimer's meds and receive depression medication and see what happens. Even if the situation does not stabilize or improve you will know that you did all that you could and thus demonstrated to your mother how much you love her.
Take care and God bless
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Hi my mom has been on hospice for 3 weeks..today I was told that she loss 5 pounds in 3 weeks..(she has been at the same weight for the last 8 mths)my question is..when she got on hospice she was taken off her memory meds..since than she cannot sit in her chair or wheelchair with out slipping down..when they try to get her out of bed she dnt have the strength to sit up on the side of the bed without falling back..hospice said that she could be loosing muscle tone..could this be happening so fast..
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I had similar issues with my mother who recently passed from Alzheimer's. I would recommend looking into a "stander". This is a "lift" that will help a person "stand" from a sitting position and give them the support to stand safely for as long as they can. This can be useful for building up or keeping up the leg strength.
I would also look into a "sit-to-stand lift". These also help a person stand up from a sitting position but have a sling that gives total access to the waist/bottom area allowing toileting to be done in a natural way. It also helps keep up the persons leg and arm strength.
Finally if your loved one is bed bound I recommend looking into a Hoyer lift (electric if at all possible as that is much easier on the elderly person and on the caregiver and gives the caregiver much more flexibility on where they can stand and how they can help the elderly person when lifting or laying them down). If you go to the doctor and Medicare they will give you a cheap sling with mesh and metal bars, hooks and chains which is horrible. Please ask for or look into a "hygiene" sling and make sure you get a cloth one with cloth straps. This is U-shaped and allows easy access to the rear-end. With my mom this allowed us to lift her off the bed and put her over the commode, then easily remove the dirty brief and lower her onto the commode, then when she was done we would lift her up, clean her and move her back over the bed where we had already laid out the brief, lower her onto the brief, easily remove the sling and finish with her brief. Thus we did not have to roll her over on her side multiple times like one would have to do with the "conventional" sling thus making the toileting process easier for her and us and making it as much as possible a "normal" toileting process thus helping to preserve her dignity. I hope these comments help. God bless you for caring for your loved one.
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Vicki123, did your Mom get any physical therapy after her arm had healed from being broken?

Usually if an arm is immobile for 2 or more weeks, the muscles clamp tight, thus making it almost impossible to use that arm.... and it can throw one's balance off as you can't use that arm to help with the balance. It can take several months of physical therapy three times a week to stretch and stretch those arm muscles but it also can be very painful.
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If someone is on Hospice I do not think they are eligible for Rehab. Physical Therapy might help and you can ask your Hospice I am sure they have Physical Therapists on staff that can schedule a visit. They will see how much it helps and use that to decide on if they should continue PT or not.
As to if she will walk again..it depends on how determined she is and how determined you are to help her. And this is the biggie...is it safe for her to walk again. If she is a fall risk maybe she is better off not walking, broken wrist is one thing broken hip another.
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Yes. For every day spent in bed it takes 3 days of rehab. Insurance covers a limited amount of weeks for rehab based on studies after a certain amount of time recovery is at 80% to 90% of baseline. Age, diet and muscle loss adds to the mix. I feel sorry for your grief about this
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08/24/16.... Vicki, I believe this is a case by case basis.

My Mom developed severe dementia after a serious head trauma due to a fall. She was 97 at the time. She went into rehab and they tried to get her to stand and walk. Sadly she was unable to do either. For some reason Mom would still try to stand up and walk, only to fall. I believe if she was much younger maybe, just maybe, the brain would have healed itself enough for her to become mobile.

You are right, it is sad to see this happening especially to someone, who like my Mom who use to walk 2 miles per days up into her early 90's, along with my Dad.
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Vicki, two years ago my mother went on hospice care in her nursing home, after breaking her hip. She continually improved and was discharged from the hospice program after 3 months. So I can tell you that discharge from the program does happen.

To be on hospice, a doctor has signed a statement to the effect that most people in the person's situation, with similar symptoms, stage of disease, will not live more than 6 months. Hospice care is intended to keep them pain-free and comfortable and engaged to the extent they can be. Typically hospice care does not involve any therapy or treatments intended to cure.

Those 6-month prognoses are obviously not always applicable to the given individual.

Ask about PT for your mother. It may or may not be possible under hospice. If she does improve and get discharged from the program PT may be appropriate then.

No amount of PT is going to allow my mother to walk again, but that is because of the nature of the break in her hip, not because of her dementia. She has had some PT since leaving hospice care, for her arms and upper body, to ensure she can continue to feed herself, etc. She is wheel-chair bound, but she participates in activities, socializes, enjoys meals, etc. At 96 she is content with her situation.

Vicki, yes, it is very, very sad to see our loved ones so weak and dependent. It is possible that your mother will get stronger, but that isn't the typical path at this point.
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I am constantly amazed how my cousin's ability to move fluctuates in Memory Care. I think that most cases are different in how the patient is effected.

My cousin has severe dementia and after a fall that fractured her spine, she went to a wheelchair. She had other fractures too, but, for over a year she was barely able to transfer out of the chair with the aid of another. Then, about 7 months ago, she started getting out of the chair without aid and falling down. She fractured both shoulders doing that and we had to put an alarm on her bed and wheelchair.

Last week, I saw her transfer quite well from her wheelchair to a sofa. I was shocked. She has little other ability though and needs all things to be done for her. From what I understand, her abilities fluctuate daily.

I think it's very difficult to predict how their physical abilities will progress or decline. I've just learned to expect the unexpected.
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I agree with the recommendation to get physical therapy for your Mom. I urge you be present for some of the sessions so you can guide her to do the same things when you visit. Sometimes the dementia patients 'forget' how to walk. I had to guide my Mom by saying, 'right, left, right left! REALLY try to keep her legs strong. Hospice or not, sometimes these folks have more strength than we anticipate. I now have a 98 year old MIL who has self induced inability to walk. BUT it has now gotten so bad, she can't transfer either. I know she won't last a month in a nursing home. The shared room and food will be the death knell for her. And as cillie says, at least make her stand. I used to have her stand behind a big strong chair and hold on to it. Get her talking s she doesn't realize what she is doing. It helps strengthen her legs. How old is your Mom???
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My mother also had Alzheimer's and dementia and Doctor put her on hospice about a week ago..she to cannot walk or do nothing for herself..since she has been on hospice she seems to be doing good...dnt know if it is the hospice care..but they took her off of meds that she dnt need to be on..if she gets better in 3 mths they might take her off..till we need them..
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Thank you. I am just so sad to see her getting more and more dependent, yet in her mind she tells us how she gets up, showers and dresses herself. We just nod and go on with something else.
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It is hard for us to know if this is a progression of the disease or if it is a consequence of her illness, or a combination of both. Elders take much longer to recover from physical trauma and often will never fully return to their old baseline. Since she has been accepted into hospice the docs must feel she is winding down, do you agree? Sometimes people will recover enough to be able to leave hospice care. If she is making some progress it may be worthwhile to try a little PT to see if she can regain the ability to help herself, even standing short term to assist with transfers and toileting is a huge plus.
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