She has a very intense rash on her back and her stomach. It keeps her up all night. Hospice gave her some benedryl and anti-itch cream. She is also nauseous every morning until mid-day. Hospice gave her some anti-nausea meds and anti-diahrrea meds. Since she’s been on hospice for over a year, she hasn’t been to a doctor, so I don’t know anything about her kidney function (GFR) or her uremic count. I am wondering if her kidneys are failing and this is what the rash may be, from toxins her kidneys are not flushing from her body? I am overwhelmed and I’m hoping she will go to our hospice facility soon. Odd how the congestive heart failure is no longer the main problem. And edema is very bad. They cannot give her more water pill dosage because her blood pressure is so low.

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It could possibly be Shingles, after she has had cancer.
I really don't know, but it is my understanding that hospice is about comfort care. One can barely do that if there is no diagnosis by a doctor.
There is a hospice doctor, right? Not sure, but you can still have her seen by outside of hospice doctors? Others will know better than me.

From what I read, shingles can be very painful. It also may be communicable, I would have to look that up. (the chicken pox is communicable to immunosuppressed persons if they have not had chicken pox). That was a very simplified explanation, sorry.

In light of people 'graduating' from hospice, after improvement, not dying when expected, I would look into a diagnosis, then go from there since hospice does not do 'life saving/life sustaining"

Keep in mind that a person can go for treatment instead of having hospice. I am not recommending you do that, every case is different.
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You say that the CHF is "no longer the main problem" but you observe edema. The edema is likely a result of right sided heart failure. If there is shortness of breath then there is also left failure from fluid in lungs. If Mom is developing rashes it may be due to medications or any other reason. Dermatologists are great for saying "Who knows, anything but an exact science". Your hospice nurses are caring for Mom and are the ones most likely to see what it "may" be. You mention uremia, so you are well informed. Opioids, uremic acid, almost ANYTHING can cause a rash. Sorry; it does so complicate when there is already ENOUGH suffering going on. I hope Mom can move to in facility care soon.
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My first thought when I read this was perhaps your mom has developed shingles. My husband was under Hospice care in our home for 22 months and he also had developed a rash on his chest and back. They(hospice) asked me if I thought it could be shingles. I answered, how would I know. I've never seen them or had them. They decided to treat his rash with some kind of powder and cream that was supposed to help with a yeast type infection. It didn't help, but my husband had so many other issues and the rash thankfully didn't seem to bother him, so we left well enough alone. It's been my experience with Hospice that they tend to do much better with those patients that die in a more timely manner, unlike my husband and your mom.
And as far as her kidneys possibly shutting down, if they were, you would notice your mom's pee being much less and dark in color.
All of this is tough on you and your mom, and I am so sorry you are having to deal with all this. Just please enjoy whatever time you have left with your mom, and make sure that Hospice is doing everything in their power to help you. ( I had to stay on top of them ALL the time). Hopefully your hospice agency is better than my husbands was. God bless you.
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nymima Oct 2020
They are good. They are coming almost everyday now. Covid slowed them down somewhat, but they’re picking up again. I’m glad they’re there. I don’t ever see her pee or anything else. I will ask hospice to check it, as they would know more what they’re looking for. This is so much now. Too overwhelming for me. I have non-Hodgkin’s lymphoma - diagnosed in 2017. I treated for it and had to step back for a while, but now with all this going on, I’m feeling overwhelmed again, and my attention is totally on her again. Hospice says that their criteria now for going to our hospice facility is that she has 3 months or less to live. I can’t imagine she has more than that at this point. But, because my mother is still of sound mind, and she is still managing around her home, there has been no decision to move her.
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