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My Mom stays in her room almost all day. She has leg pain and I take her to a rehab facility. They massage her calf and put heat on her leg which really isn't doing much for the problem; She had 2 compressed fractures of the spine requiring surgery 3 months ago.This was an outpatient procedure. The rehab tech doesn't beleive the leg pain relates to her spine. She is taking pain meds and I have an appointment for her with a pain management clinic. My concern right now is her lack of appetite, wanting to stay in bed all day, and not wanting to bathe. She is 100 years old and has signs of dementia. I need guidance on how to deal with these issues.

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When they stop eating, you call the MD and ask if it is time for Hospice. It's usually a sign of things shutting down. So sorry. The pain from muscle contraction is also an end sign.
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100 yrs old?I think anyone would be worried at that age.
(My concern right now is her lack of appetite, wanting to stay in bed all day, and not wanting to bathe. She is 100 years old and has signs of dementia.)
Your trying to pervent the unpreventable at 100 yrs old.You can't force feed her.And can't force what is not wanted.If you can't bare to help her anymore contact hospice.At 100 yrs old your not gonna get her to run a 4/40 track lap anymore.If don't use it you lose it.At a 100 yrs old is there any to use anymore.
It's time to let things be what they are.And enjoy the time you have left.
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NanSea, I went through this with my father during his final months. I kept trying, but I knew he was slipping away. The pain in his legs grew worse, sometimes he fell, he didn't want to eat -- not even the sweets he had once favored. Beyond these things, his temperature and blood pressure got lower. We kept making food for him and doing the normal things, but the rest I put into God's hands. Let your mother be the guide in telling you what she wants. If she is nearing the end of her time on earth, it may be more important for her just to be comfortable and not so worried about being fixed. There will be a lot of signs when the end is nearing. I think contacting hospice is a wonderful idea if you want to keep her at home.
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Let her indulge in whatever she is still able to enjoy. Spend time with her, even if it is just sitting by her while you read a book, recall happy times if she can. Don't expect her to push herself, she hasn't the strength and pat yourself on the back for being her loving advocate.
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You are right. Staying in bed all day will just hasten immobility. I wouldn't be surprised if she bypassed needing a wheelchair and went right to being bedbound.

As for her appetite have you tried Ensure or Ensure shakes? A can of Ensure, some ice cream and a little milk. You can't force her to eat (or to do anything else) but try tempting treats. Favorite foods. You've probably tried all of these things already but again, you can only do so much. You can't force food down her gullet. Have you asked her what she'd like to eat? There are so many articles here regarding elderly people who don't want to eat. Maybe you can get a few ideas from them.

Staying in bed all day is the worst thing an elderly person can do. She will become weaker and weaker if she's not up and moving around at least every 30 minutes. But once again, how to get her to get up if she doesn't want to? You can entice her with a movie or some other activity she enjoys. Don't bring her anything while she's in bed, make her get up and get whatever it is she needs. And her lack of desire to bathe may be tied in with weakness from staying in bed. If she feels weak she's not going to want to bathe. Getting her out of bed is the key to all of this, I feel. I work in home healthcare and we have patients who need home healthcare because they've been in the hospital, in bed, and they lose all of their strength so that we have to come in and do PT and OT with them for weeks so they gain their strength back. I'm sure you've been told all of this at the rehab facility. And if she's going to rehab on a regular basis but laying in bed the other days that will undo any good the rehab is doing for her.
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What are you expecting from 100 y/o woman. Her time has come.... she is slowing down and getting ready to depart... I am sorry, but you should call hospice.
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A lot of these symptoms sound like my own mother, who is certainly not ready to die. And we have plenty of 100 year olds in my family, some of whom are having health issues, but none of which are volunteering to just let someone pull the plug on them. So, let's not assume this woman is ready to die without more information.

If the rehab isn't helping, maybe you should consider stopping it. There's a difference between not wanting to eat and refusing to eat. My own mother has no appetite and doesn't care about food but will eat because she knows she has to to keep up her strength.

It's possible that she doesn't want to get out of bed, bathe, eat, because of the pain. Or, it could be the dementia. Or, it could be something else. I found out that my mother didn't want to bathe because she feels dizzy, for example. It turned out to have nothing to do with dirty habits or dementia, just that she feels like she's going to fall. However, she had a hard time explaining it, so the problem went on for a long time before I discovered the real problem.

As for being in a wheelchair, it's not the end of the world. Lots of people end up in wheelchairs and scooters. If there's a way to prevent it, that's great, but I'm not clear that this is as much a problem, possibly, as finding out what's causing her pain.
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My father was on PT and OT during his last months of life. My mother thought if he would get up it would make him better. My father didn't want to do it, and I realized that there was no point to it. Everyone knew my father didn't have long to live, but still there was the PT and OT. He had a small stroke during one of the PT visits, so I cancelled PT. Mom wanted to continue the OT, though. Was it useful? No. After a few appointments his time had come and he went to the hospital. And then the hospital put him on PT and OT. WTF! The man is barely alive and every organ in his body is going. PT and OT? They talked to us about transferring him to a rehab program upstairs and sent me looking for a SNF to transfer him to. Finally after two days I said, "We want to call in hospice" and all the craziness ended. Unfortunately, hospice arrived a few minutes after he died that afternoon.

If someone can be helped with PT and OT, it is great. But there does come a time when wisdom has to be used. I would have saved my father a lot of grief if I had advocated better for him in those last two months.
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I should add that one solution does not fit all. We can't know what is best for others, because we aren't there. All we can do is share our experiences.
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My mother is 94, with dementia. We are fortunate because, even in her dementia,she knows she needs to maintain mobility. She enjoys walking to a window where there is a bird feeder and blooming flowers on the windowsill (cyclamen, Christmas cactuses, spring bulbs...whatever is in bloom). On sunny days, spending a little time outside on the deck or on the walk in front of the house is fun. If you use a wheelchair (we have one for places it is not possible for her to walk the distance), she can certainly get out of the chair (outside, for instance) and walk a bit. While my mother has pain in her legs and is often very unsteady, there are still things that motivate her. As I say, we are fortunate; but maybe you can think of simple things she used to enjoy to provide motivation. Would a walker be helpful?
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