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MIL is on hospice care at home. She keeps having these episodes and we are unsure of what they are. When she uses the restroom, she becomes catatonic, limp, unresponsive, stares, mumbles if she can, often moaning uncontrollably. She has not eaten very much in about 2 months. We have informed the nurses of this but they don't seem to be as concerned as we are. They have not witnessed it. Her blood pressure drops dangerously low during this time. Is this a sign of the end of life?

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I would say that the response you describe is the CAUSE of the things you are seeing. Few people understand that the bowel can honestly cause a lot of cardiac symptoms during evacuation. In fact enemas used to be frowned upon for recent MI patients. I think that the low BP is likely due to the bowel movements, and the other symptoms you describe normal if they pass. It does sound like you MIL is quite end stage. Discuss all of this with Hospice. They are the best source now to know this particular patient.
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Lilfarmer67 Mar 2021
The heart/gut connection is definitely real. I have Roemheld syndrome where any movement along my gastrointestinal tract stimulates my vagus nerve which causes everything from PVCs to dizziness to swings in blood pressure. It is a real pain in the backside (no pun intended)
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If hospice isn't concerned, it's probably not end of life, although hospice is not God. My first thought was that it sounds like she's having seizures. Your blood pressure will drop when someone is having seizures. My husband suffered with seizures for 24 years after having a massive stroke when he was 48. The symptoms you are describing, sound exactly what my husband went through while seizing. Hospice can give her some medications for them. Please ask them about that. Best wishes.
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debadee123 Mar 2021
Thank you for your response. A friend told my husband that it could be mini strokes??
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My 94 y/o mother has the worst time during & after a BM on the toilet! She's out of breath, gasping & very weak afterwards for quite some time. I've always attributed it to the "vasovagal reaction." Often people need to tense their abdominal muscles and strain a bit during a bowel movement. This tends to stimulate the vagus nerve, which slows the heart rate and creates a feeling of general weakness. She also has congestive heart failure and other heart conditions, so what Alva is saying makes sense.
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debadee123 Mar 2021
Thank you for your response. The thing is she isn't having bm's because she doesn't eat.
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I also think its the bowel movement. Happened to my Mom when she had a good one. Her B/P went down and she had to sit down.
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I see you commented that she does not have BM’s because she is not eating much. She should still have some BM.
I am sure that the Hospice nurse is checking for bowel sounds and rigidity. But you should keep a written documentation of all BM and how much, how often and consistency.
My husband would also have episodes where he would all of a sudden stare off and is much like you describe. The Hospice nurse called it a myoclonic seizure and was not overly concerned. The fact that my Husband was not ambulatory at that time I did not have to worry about him falling. (I will say he first time it happened it scared me,)
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AlvaDeer Mar 2021
Exactly right. A large portion of stool is bacteria from our gut and there should still be some--tho less--stool even with little eating.
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Thank you. We got the nurse on it.
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debadee123 Mar 2021
Also, we're not taking her to the bathroom anymore, she has a bedside commode & a bed pan. The nurse also reccomended that prior to getting her up & out of bed she should sit on the edge of the bed & let her legs hang for 10 mins. to let her circulation get moving.
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