My Mom (87) was given 6 mo to live after a diagnosis of severe aortic stenosis. Any advice? - AgingCare.com

My Mom (87) was given 6 mo to live after a diagnosis of severe aortic stenosis. Any advice?

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That was 10 months ago. The cardiologist told us to "call hospice..she'll be gone in 6 months. They wanted to do a TAVR, which she didn't want. I moved her in with me in March. We started with hospice about 6 weeks ago, after she felt like she had a heart attack. It was the best decision! She is now fighting a UTI. She has become very disoriented and has no memory except from her childhood. I know that is a common symptom of UTI's in the elderly, but even after a course of antibiotics, she's still the same. Do we keep fighting the UTIs? She doesn't feel any pain and thinks she is fine. She sleeps a great portion of the day as well as the night. She eats a little at each meal, but is sometimes too tired to eat. My father passed away about 25 years ago, and she wants to be with him. It's so hard to know the right thing to do. I have 3 siblings that "want her to live", but they see her about 1 every 2 weeks when they take her to lunch. They "want her to live to see their latest grandchild, their next birthday etc..", but they don't see the difficulties she experiences day to day. I love her with every fiber of my being, but I'm struggling too. Hospice workers tell me they can tell me if her "symptoms" are getting worse, but most likely she'll just pass in her chair or bed. How do I know the right way to treat her?

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Mommandl, it's funny you said your Mom speaks only of her childhood, my Mom too, mostly spoke of her childhood in the last few months of her life, she grew up in Wales, during WW2, but they were very happy memories, especially during her teen year's when she was working and when she was courting my Dad at age 16, but didn't really speak alot about all the years while she was raising us six kids, which were really happy year's as well! Weird huh? Stacey B
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Yes, don't second guess yourself. You're doing all the right things for your Mom. It's clear that she is preparing for the end. Your other family members must be made to understand this. This is about what's best for your mother, it's not about the emotional needs of the family.
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Mommandl this is probably one of the hardest things you will have to do. Treat the UTI, it is for comfort measures. Mom is already on hospice so I think your mom has already made her decision. If your siblings keep telling mom to hang on for next BDAY, etc. you may be the one that should tell her all will be ok and she should go be with dad. No one wants to see their patent suffer. Hospice's box of MEDS will help all her other symptoms. Don't hesitate to contact them anytime of day or night. That is why they are there. Don't second guess yourself, you are doing everything right with love in your heart.
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As someone else stated, the doctors don't know for sure, it's a educated guess. However, I'm a professional advocate and I have been a caregiver in a similar position you are in now. I would treat the UTI (you never know how long she might live), an have a meeting with the family to discuss things. The meeting with allow everyone to have their say, obtain some peace and make a joint decision. That way, you won't feel guilt about your decision, an it will prevent animosity between family members.
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Doctors really can only estimate possible longevity; your mother has already survived 4 months longer than predicted. Other co-morbidity factors may be in play as well.

I think the hospice medical staff would be in a better position now to give an indication of what they anticipate her longevity will be - they're seeing her more frequently.

I would keep fighting the UTI's; no one really knows how long your mother may live, and if the UTIs can be controlled, then so much the better as that will eliminate complications from those infections.

As to the family, I would take the approach that we all know, regardless of age - life is uncertain. Visit now, treat each day as if it might be the last, and don't have any regrets that someone didn't come, didn't say what he/she wanted to express to your mom, or that they may have held out for an event sometime farther on down the line.

I think it's really hard for siblings who want a parent to see a "next" family event; there's a juxtaposition between their anticipation of a happy event vs. the challenges your mother faces on a minute to minute basis.
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I will use my words wisely because this situation has caused you much anguish. I was a caregiver in an assisted living for 5 years in two different facilities. God is the one who brought us into the world and he decides when are last day is on this earth. But he your mom has lost her will and her quality of life is comprised it's not really a life. It's sound like she doesn't have much longer and is suffering in her heart and body. Your siblings really don't know what going on so they can have an opinion, but you are in charge maybe it's time to have a meeting. I will pray for you and your mom.
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MomMandl, it sounds like everything you are doing is right. The end of life is very hard. It would probably be a bit easier if she didn't have the UTI. If one antibiotic didn't work, it may have been the wrong one. Three that are commonly used are Microbid, Bactrim, and Cipro. Normally the will culture the urine to see which antibiotic is effective, but start her on one of the antibiotics until the culture comes back. I would see if switching her to another would help. This would be allowed under hospice, since it is part of keeping her comfortable.

The rest about listening to family -- you can listen, but this is your mother's journey. She has the say-so about how she wants it to go. I do agree with the path she has chosen for herself. She seems very wise, and you seem very loving. I would keep doing exactly what you are doing already.
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