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Hi Constance
It sounds like you need to call her primary and request hospice. Or just call a hospice provider and ask for an evaluation. Have you already done that? Is she already on hospice?
Is she coherent? Is she free of pain and discomfort? Do you know her preferences for end of life decisions?
What now would really depend on her wishes. I know it is a difficult time. Keep us posted on how she is doing.
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constance72 Jun 2019
She is on Hospice. They say do not push ensure. She sleeps most of the time. Very weak. Has a pain patch and morphine.
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Already asked, but my first question is the same: Is she on hospice?

Is her pain (assuming she has some) being managed?

Is she ready to go? Lots of people that old are "done".

She could still stay alive for some time, but I would make sure everyone gets a chance to say goodbye and I love you and let her know it's OK if she needs to leave you soon.
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constance72 Jun 2019
Yes. She has been for almost 2 years. They say do not push the ensure.
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She is already on hospice. Has been for almost 2 years. They say do not push food it is bodies way of shutting down.
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Constance, when you ask "what now" are you asking "how long"?

Some people hang on in this weakened state for months, others less so.

What is your mom's pain from? Does she have a life-limiting condition like cancer or dementia?

Does she had an end of life directive, saying what she wants in terms of end of life procedures? Would SHE want a feeding tube? (I think that feeding tubes are wonderful for folks who have a temporary condition that is curable and when the patient will soon regain their ability to eat. Not so much for the extremely elderly who are not going to regain that faculty).

Have you read Atul Gawande's "On Being Mortal: What Matters in the End"? It's a book that will help you to clarify the choices you will be asked to make.

((((((Hugs))))))). This is soooooo hard. We all know.
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The hospice nurse told me this...

when the changes are noticeable from one month to the next..there are only months left. When the changes are noticeable from one week to the next, there are only weeks left. But when the changes are daily....there are only days left.

It is normal for the patient to stop eating...then stop drinking. As the body shuts down the digestive system is early in the process. Eating or later drinking becomes impossible because the stomach cannot digest. I was also told that the brain gives off endorphins, so she will not feel hunger pains at all.

i feel this is coming to the end. When it does come, please do not be alone. This was the single hardest 2 days of my life...it will haunt me for the rest of my life. Please make sure you have someone to be with you through this coming ordeal.
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Constance, so sorry you’re going through this. I just went through it with my mom in April. Very tough. You asked, what now? Does she wake up at all so you can talk to her? If not, you can still speak to her. Just pretend she hears you...they say hearing is the last sense to go so even if she doesn’t respond she may take comfort in hearing your voice. Watch for changes in her breathing or if it appears labored. The hospice nurse can advise you on trying to keep her more comfortable if it appears breathing is hard or she’s in pain. Try to keep her mouth moist with a little sponge swab. My mom only hung on 5 days after she stopped asking for ice cream, so this is a very hard time for you and her. Try to make her as comfortable as possible. Hugs.
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Her body is shutting down. Forcing her to eat is not good. Her digestive system is no longer working. With my Mom it started with anxiety. Then she fought the aides to stay in bed. She closed her eyes and never opened them again. She responded to sound and touch but just layed in the bed. The nurse called me to say she was not able to swallow anymore. I called in Hospice and my RN daughter who agreed, it was time. My daughter said one more week, Mom was gone 6 days later. From the time she wouldn't get out of bed, to her passing was about 2 weeks.

Just tell Mom its OK if she wants to let go. You will be fine. She is 91, thats a long life. Make sure everyone says Goodbye even if its over the phone.
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Hugs!

May The Lord God grant you grieving mercies and strength during this time.

May your mom pass peacefully and may you find peace.
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