My mom was just in the hospital overnight for chest pain that responded to a nitro dose. EKG and troponin levels did not change, so no MI. This hospital stay, though brief, was very hard on Mom and on us. Mom will be 80 in July. She has had two MIs, one painless (a year ago, when she got really uspet and agitatied about a facility she was in she did not like and maybe also had a UTI), the other she can't remember (3 1/2 years ago, fell at home very confused, and also had rhabdomyolysis from statins that were supposed to prevent heart attacks, duh...) . She has bad type II diabetes, recently can't keep sugars under control even with high dose insulin and Januvia. No current UTI just minor skin fold redness. She has vascular dementia and strokes and is kept on baby ASA and clopridogrel. I think they will give her nitro if she needs it at her skilled nursing facility, and hopefully will not have to come in again for every time she has chest pain. Other than that I don't thnk there is much more they can do medically and she does not want surgery. Though this episode has pretty much convinced me that we could not manage her with home care - she needs too much care (immobile, incontinent, can feed hersefl and put on a wig) she really sundowns, and gets nasty when anxious, and I was so scared she was going to give herself a(nother) heart attack the way she was yelling and carrying on about having to wait to get into a room from the ER. ***But she has said she does not want to die alone.*** I was scared this would be it and we dropped everything and met her at the ER. Then once she was settled in her room upstairs for the rest of the night, she insisted she could not sleep if she knew I was staying with her and so after trying to outwait her a while, just had to say good night and go outside of the room to stay a while longer, but basically felt like she kicked me out. I could not have left at all if she had not been monitored, because she cannot remember how to use a call button any more or understand what they tell her. She just gets mad if people do not come right away when she yells or if someone else pushes the call button.

I wish I knew what to expect, how to try to make sure we will be there for her. She is running out of trust money but we have options to apply for Medicaid and if we COULD have her home for 6 months her long term care insurance would cover her again for maybe another 6 months after that. I do not have the option I have seen some people do to actually pay a private aide to attend one on one to just their loved one at the nursing facility, but we could look at any other ideas I guess. She has also lost the ability to dial her Jitterbug-style cell phone and could never remember or grasp the concept of a speed dial. It is hard to see her so helpless and dependent (other than self feeding, helping turn in bed, putting on her wig) yet aware of what is going on and interacting with us and wanting us to visit, however briefly. They even said she was calling out for me when she was having the chest pain.

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Dear vstefans,

I am so sorry to hear about what you are going through right now. I know how hard it must be to be in your situation. If it is any comfort after working in hospitals and long term care units for some time there is one thing I have seen often. When it is time for a loved one to pass on, frequently they hold on until that last family member is there. We have had individuals barely hang on until the daughter or son from out of town manages to get there and then they peacefully pass.

I know this is probably not the most comforting topic but I wish you the best and you are in my thoughts.

Nicole Bernd
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