My Mum has late stages Alzheimers. I haven’t been to see her for a month as one of the staff contracted COVID-19 and visiting was stopped. However, it has restarted and I have a visit scheduled for tomorrow morning.
I was telephoned by a nurse today to say that she had been sleeping all the time and was unresponsive. Her heart rate, pulse, blood pressure etc were all normal and fine but she was very pale and clammy. A call later in the day and the nurse updated me by saying there was no change but that because she was sleeping for hours and hours she hadn’t had any food or hydration.
They said that she had deteriorated over the last few weeks and what was my view? Do we send her to accident & emergency at the hospital or do we leave her be at the Nursing Home? What do I do for the best? I am unsure and don’t want to do the wrong thing by my 88 yr old mum.
We chose not to allow it. Her mental state is declining and I did not want to put her through that trauma. She has always had a horror of ending up on life support for no good reason. I talked to the nurse and they agreed to give her iron supplements and wait to see. A week later she was fine.
IMO SNF don’t want the death of a resident on their record, at the same time nor do hospitals. So these poor elderly people are shuttled back and forth between facilities, each hoping they don’t get stuck with the hot potato.
Sometimes when you think about any treatment in terms of realistic expectations of what you want to accomplish, it makes decisions easier to make.
You are making the right decision.
Do let us know how the visit went?
What preparations have you made in your own mind. Is Mum on Hospice Care now? Have you decided on palliative care and no further hospital treatment?
I don't know what to tell you. If your Mom passes peacefully and you have honestly been expecting that this has been the trajectory she has been on it is something completely different than just saying "Well, we don't know what's going on and this sure is unusual, but should we check temp, blood sugar, Urine, all those things that can be done in just seconds?
I am uncomfortable in guiding you. I don't know the background or expectations and the last thing in the world I want for you is to think you could have done something to reverse this.
In my Aunts case we knew her kidneys were done, and got the call should she be transported; even her aids in facility knew she would not want that.
I am so sorry. Just tell me this isn't a sudden change in an otherwise generally healthy woman. A desire for "no heroic measures" doesn't mean not trying to find out what is going on.
Are your hospitals currently overwhelmed with covid cases? Is this why there is no MD advising here? I guess I would tell them you want the advice of an MD, however that is got, but again, saying that without knowing the history here.
I wish you good luck. I hope you will update us.
I asked another doctor who was proposing some God-awful procedure if he would put HIS 90 year old mother through it. "Hell no" was the response.
There comes a times when the time for intervention is in the past and the time for comfort is the right thing to do. I know that you'll find the right answer.
Does she have a DNR?
Is she on Hospice?
Are you clear about what her end of life wishes are?
As my mother's Vascular Dementia advanced, it became QUITE clear that trips to the ER (A and E by you) were doing more harm than good. We talked to the NH and they agreed to handle all issues like pneumonia and UTIs "in house" and would consult with us before sending mom to the hospital.