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Mom fell and fractured her hip. She was already under hospice care and due to her condition, I made the decision to not go to the hospital or have any surgery (this was my mom's wish). She is now on pain meds and is sleeping all the time. She has had nothing to eat or drink in several days. What can I expect? This is so difficult to watch and I am already second-guessing my decision for no surgery. Any insight into this process will be greatly appreciated?

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Increased morphine
Decreased respiration
Comfort care
Hold her hand
TELL HER IT'S OK TO MOVE ON
Say good-bye to her current physical body
There is not death
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AND ... tell yourself it's ok for her to move on
Relax into your decision
Accept your inner knowing that you did the right thing
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Thanks, CarolLynn! She is still at the assisted living center and they will not administer morphine. She is taking liquid oxyfast and has a pain patch. I'm worried that this will just prolong her suffering but I may be wrong.
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Have you contacted Hospice? These end of life times are why they are there. Please contact them or have your Mom's doctor do so! If she is indeed getting close to the end, the care that Hospice can give her, and the support they can give you, is what you both need.
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Hi, Abby, what has Hospice told you?

I am not sure why you are not sitting by her where she sounds like her decline is apparent. Do go see her and make sure you make peace with her and that you are able to comfort her by holding her hand, playing her favorite music, reading Psalms to her, and if you believe in prayer, praying over her.

Bless you and your mom.
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Abby, if the Assisted Living will not administer the morphine, does your hospice have a facility they can move her to? If so, I would suggest doing it. If not, I would check with other hospices to see if they have such a facility - and if so, switch hospices. My mother-in-law was in Assisted Living too, but once she started declining (not eating/drinking or getting out of bed), we had her moved to the hospice facility where they have their own set of nurses to care for her and administer morphine. And CarolLynn is right on with her suggestions, but if it's like my mother-in-law - you can't sit there until she passes. Not only is it one of the hardest thing in the world to deal with - it could take a long time, unfortunately. Not everyone goes quickly - as my mother-in-law didn't. She eventually passed while sleeping, and all we could really do is hope she wasn't suffering so hopefully your mother will too. And if you can't find a hospice with a facility, you may want to check with the hospice company about their nurses coming to your assisted living and administering the morphine on a regular basis. Just a thought. My sympathies are with you.
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You did the right thing. Try not to second guess yourself. The hospital is no place for someone in your mom's condition.
As vw9729 points out, she could linger a while in this stage. Don't guilt yourself into sitting right by her bedside for days on end. Many times, people (who seem to be completely out of it) seem to wait until they are alone to pass. Our relative, who had a family members taking shifts to stay at his bedside, died when there was just one person there who had fallen asleep. Some people need personal space to die. Hospice nurses say it's commonplace for people to die even where their loved ones have just stepped out of the room for a short time.
I'm assuming hospice is still involved? They should be making sure she's comfortable, with or without morphine.
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Dear abby,

I would have made the same choice you did regarding the surgery. Surgery and especially the anesthesia is brutal on elderly people and unless your mom was vital and active prior to the broken hip nothing can be gained from having her go through a surgery that will result in keeping her down the rest of her days in the exact same shape she's in now. You made the right choice.

If she's not eating or drinking don't try to force her to eat. Many people make this mistake thinking their loved one has to eat. She doesn't. Some ice chips between her lips might feel good to her or a cold, wet wash cloth in her mouth.

I went through this with my dad last month. We didn't hold a bedside vigil although we knew he had little time left. I took a little time off work then went back to work and worked until I got the call that my dad had died. Life has to go on and you can't stop living yours but do what you need to do to make yourself feel better.

Your mom will stop voiding because nothing's going in. This is normal. You may notice a raspy, phlegmy rattle in the back of her throat. This too is normal. When my dad first went into that state, where he wasn't eating or drinking and not really conscious he muttered occasionally, his arms would move but this didn't last long. From the time my dad first closed his eyes to the time he died was 4 days. We thought we'd have a few more days but we didn't. I held his hand, I put cool cloths on his forehead, and I talked to him. Told him I loved him and like the others were saying, I told him it was ok to move on. When our loved ones get into this state it's only a matter of time. I work in healthcare and I've seen people stay in this state for 2 weeks before they die. It took my dad only 4 days so it varies. I wasn't with my dad the moment he died but I'm ok with that. I had been with him for days prior to that and had to go back to work. The day I went back to work after taking off to be with my dad, he died. It worked out the way it was supposed to.

Blessings to you, this is a very difficult time. Don't exhaust yourself and take care of yourself. There is wonderful information online about the last days/weeks of someone's life and what to expect. My dad showed some of the signs, some he didn't. Someone mentioned hospice. Hospice is wonderful, we had them but we didn't get hospice until it was pretty much too late for my dad to appreciate their services (his Dr. wouldn't sign off on it) but they were great with us, the family. But because of our situation they didn't have a whole lot to do. But again, they were very supportive of us and that was nice. We had them not quite 2 weeks.

I'll be thinking of you, abby.
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Perseverence, I think you misunderstood my post. I meant that I made the decision for Mom not to go to the hospital or have surgery. I have visited her all but 5 days since she's been in assisted living (10 months) and I sit with her for hours each day, now. I am working full-time so I have see her after work. I promise I'm not ignoring her or her care. I talked with Hospice today and they worked with the AL management so that Mom can stay where she is. Hospice has assured me that she will receive enough medication that she will not experience pain or discomfort. This "death watch" is so difficult, but I know that soon she will be in a better place. Thank you all for your comments and insight. It helps to talk to others who have walked in my shoes. Love to you all.
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Abby - how is your mom? Is hospice interfacing with AL to your satisfaction? Once the doc certified your mom as appropriate for hospice, the hospice folks should b able 2 make sure her palliative care assures her comfort. If your mom starts having dynamic changes on a continual basis, where it's not fair to her to wait 4 somebody 2 "come by", most hospices have 24-hr "critical care" with nurses at her bedside. If you think it's necessary & the one ur using is
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(cont.) ...not providing it, ask for it. If they don't provide the service, u may want 2 check into other hospice services & switch.
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Abby, you can go online and google, you will find information on the different steps the body goes through in closing down. It was a big help to us, knowing that information. Before the kidneys stop production of urine, the urine will become dark or light brown. Skin will turn yellowish. The skin on the forehead and on top of forehead will become "mottled" ... purplish. As well, on the third day it appeared that my father was being spoon fed by someone that we could not see, that he was looking at in the corner of his room, near the ceiling. Manna from heaven? Maybe his sister or mother was feeding him,. He would open his mouth then close it and begin to chew. The hardest thing for me was watching Cheynes-Stokes respirations. They begin to take deep rapid breaths... then suddenly stop breathing.. then they start back, and then stop. This may go on for some time. Some times you will think "this is it, they are gone" ... and then they breath again. It's totally nerve wracking. My father was able to squeeze our hands for about 3 or 4 days of the 7 that he was dying. And against some advice here, we did do a vigil, and that was totally our choice, very personal, it was what we wanted We didn't plan it that way, we just said, "he's dying" and they came... we took turns sitting at his side, holding his hand, and talking. My sister decided, like someone said here, that perhaps he wanted privacy. So, I went home, against my better judgement. He died, a few hours later, alone in his room. Take care of yourself. And so glad she's getting medication, they should not be dying without it.
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Abby33, dear, I wish I would have known to not force or assist my grandmother in eating or drinking anything, unless she wanted to do so.

I wish I would have known to allow her body and spirit to go through the necessary processes (that we all will go through in one way or another) without wasting valuable time on regret or second-guessing.

Let your heart be filled with love and peace, the best you can. It sounds like you're very much on the right track with all of this, it IS hard for us, isn't it?

Its almost as if we don't know HOW to "care" unless we "do"... But the time for "doing" is over, so just caring now is enough. It's enough.
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I can say that we did put drops on his tongue. We were told, unless he asks, don't give... but, he was full of morphine, how could he ask... when we put the drops of water on his tongue, his tongue just went searching for more drops, he wanted those drops of water... but of course you can't give more because of what the body does when it can't get rid of stuff... it was painful to watch, his dying, feeling so helpless, and I do not look forward to seeing my mother that way, I hope she goes another way. Peace to all...
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