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We went through the same thing with my 96 year old mother. she would refuse to eat and slept all the time. she was in a care facility and they were very good to her. you need to have her doctor write an order for an evaluation and get hospice involved. they were wonderful and so good to all of us. we got her nutritional supplemental drinks in the grocery store and that helped to give her strength and ward off dehydration. about 2-3 months prior to her passing we set things up with a funeral home and in our case chose cremation. I got an urn through Precious Memories ahead of time. know what you are going through and it is so hard to watch. I cried a lot because she was not only my mother but my best friend and I had had her for 75yrs. we did our very best and that is all you can do. but please get hospice if you can, get in her what you can of fluids, and prepare. God Bless.
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Bronish Sep 2019
Cici.....I lost my mother too, who was my very, very best friend in the whole world....I had become her caregiver as she was legally blind and needed help.
I'm very grateful to the Lord that I was able to take her with me to our place, and I had a few years with her where we still had some happy times together ....but, as the end neared, it became very hard for me to watch her as she slowly began to slide into decline.... basically my life is ruined because I lost her and really cannot live without her.....but, still, I was able to be with her and minister to her, with Jesus help, until she breathed her last. This is by far the hardest thing I've ever endured, and Hospice was there for us...they are WONDERFUL....and to this day, I still attend the grief meetings offered by Hospice, and probably will continue to do so. They have been a great support to me in my deepest and darkest grief. God bless the Compassus Hospice we have here in White Mountains of Arizona.
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Seems gram is ready to die. Since she is refusing most liquids and food, she is pretty much stating her wishes. It is time to switch from sustaining life to making gram comfortable in the moment. I'd talk with dad about being ready to let her go. Ask family and friends to visit to affirm their love of your gram. Do what makes gram comfortable: music, lotions, oral care to keep mouth moist and breath fresh, flowers or perfumes of favorite scents. Tell her how much you love her and let her know that you'll be fine when she goes. Does the facility have a chaplain that can assist you and your dad when you go to visit? He/she can help with understanding the dying process and ways of coping.
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My father refused to eat. He understood and nodded when I told him if you don’t eat you will die. He wanted to go and I refused to let them put in a feeding tube. It was the only control he had and I know it’s hard. Keep her comfortable and let her pass her way
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Oh jeez. My heart goes out to all of you. Does your grandmother have an advanced directives or durable power of attorney for health care? It does indeed sound like she has given up. Has she been evaluated by a geriatric psychiatrist for depression? Has an appetite stimulant such as megace been tried? Have you had a hospice consult? Hospice can keep her comfortable despite the lack of eating and drinking. In regards to introducing a feeding tube, I would beg you to consider QUALITY of life not quantity. If she has expressed that she doesn't want one, please do not override her wishes. My father in law did that to my mother in law even though my husband was medical power of attorney. He told the hospital staff that she didn't have an advanced directives and she was unable to express her wishes due to a massive stroke. What a mess! It took my husband 5 months to admit her to inpatient hospice and remove the feeding tube. She died comfortably and in peace a week later. During this ordeal I was sitting with her and she took my hand with her non paralyzed hand, moved it to her abdomen and managed to mumble: "This is shit." ( apologies for the language). Additionally, our niece told us that every night when the feedings were introduced, she tried to pull the tube out. All of this is difficult as well as heartbreaking but now is the time to be unselfish and put her wishes before yours.
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Cgjivey Sep 2019
My father and I are her POA and her medical also. We both are, but it is his mother and I will honor and uphold whatever he decides because I simply feel that is what is right. She refuses all meds so an appetite stimulant will not work I dont think since she wont take anything else. She has not been diagnosed with depression though I am sure she is dealing with some form of it given her advanced alzheimers.
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Get a DNR in place. Contact hospice and get them in place. I have the DNR in place with my mother (Alzheimer's/Dementia) and she is almost 90 years old. Alzheimer's is a fatal illness. I finally signed the DNR when she had to go to the hospital in July due to sepsis and pneumonia brought on by two A & B's at the previous facility. There will come a time when the known cannot be put off. It is up and down, but when the end draws near, the DNR will help, as will hospice. My mom has lost 10 pounds in the past couple of months, and she is heading towards more weight loss and loss of abilities as she ages. I can see it every time I see her despite all that I have done to try to make it easier for her.
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elaineSC Sep 2019
Excellent recommendations! We had to do the same with my Mom.
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If your grandmother has lost so much weight so quickly, she is probably nearing end stage of life. I would suggest, you set up a meeting with your dad, yourself, er doctor, a social worker and any of the nurses who help care for her. Find out exactly what their diagnosis of her condition is and what is her prognosis. Once you know exactly what to expect you will be better informed as to what can happen to her. My mother had kidney failure and she had said many times she didn't want to live this way any longer. When she suffered a stroke, we asked the above questions of her doctor and after hearing our concerns and their concerns, it was decided to no longer do dialysis but to honor her wishes and ours. They never put her on dialysis again and within 24 hrs. she died. I still feel we made the right decision. This was 45 yrs. ago. He doctors even wrote us saying they admired our courage in coming forward and asking that they remove all life support. It is a hard time bu I pray you will find the right answer for you and her. May God bless you.
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As long as you are absolutely sure she has no other infections, in addition to UTI, it does sound like she is nearing transition. Be kind.
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How old is she? Weight loss of 40 pounds down from what weight? What is her general health otherwise? Does she give any indication that she is ready to leave?

My mom is 90 with vascular dementia, in a nursing home now for one year. She had only hypertension when she went in. She was still able to do some crosswords.

Over the year she has become anemic from not wanting to eat terrible food, and has lost weight, the NH staff wringing their hands because she is now hovering at 98 pounds. She hates the food and eats very little -- I wouldn't take that food to a dog fight, she has said. It's really not that bad today, mom, I say. Try eating it every day!, she has said. Well, she only weighed 107 when she came in, and her normal weight in life was only 118ish. A staff nurse suggested a few months ago that I consider hospice. She has no illnesses other than hypertension, and now anemia because she eats very little of this terrible food. I contacted hospice because eventually that will come into play. She does not meet the criteria for hospice.

Talking to my mom when I am with her at meals I explain what will happen if she doesn't eat -- that she will eventually die, and how do you feel about that? Her head is not in that mode. She also refuses meds at times. Some nurses crunch meds and mix with some type of mush. Well, if she doesn't feel like eating at that moment, she's not going to eat the mush. But maybe she will. If I am there, I sit across from her, feed her one whole pill at a time and explain the reason for each pill. She takes the pills willingly when I am there. She just wants to know what's going on. It takes about 20 minutes, max.

The NH doctor started her on an appetite stimulant, Marinol (which contains synthetic THC), about three months ago. Her appetite has improved though she doesn't pig out. An added benefit is, her mood has improved.

She is pleasant when I visit. We talk. Sometimes she is nonsensical and at other times she is quite lucid and entertaining. I lay down on her bed with her and we listen or music or chat.

When the time comes that she REALLY won't eat anything at all, and really refuses to take any meds, I will embrace that time. We will never consent to a feeding tube. A DNR is not in place at this time. But until that time, I am glad the doctor recommended an appetite stimulant. I am also glad with his recommendation of Marinol instead of other textbook choices...

These are some considerations to think about after your mom has been in a NH for two months.
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Cgjivey Sep 2019
She does not talk anymore. We have tried crushing the pills in ice cream and yogurt. She holds it in her mouth and spits it out as soon as she has a chance or flat out refuses it. I WISH I could lie in the bed and chat with her. That would be lovely but all she does is walk. She is very advanced in her alzheimers.
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Unless your grandmother has previously indicated that she does not want any life support, I would consider a feeding tube as long as there no other serious medical conditions. It is a simple procedure, and you and your family probably will be more comfortable knowing you gave her another chance. If she gets better, then you can restart real food. My mother had a feeding tube for about a year, one day she pulled it out. The NH doctor wanted to know if I wanted it reinserted. I said, no. My mother was fine for a few years afterwards.
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lealonnie1 Sep 2019
Ricky, did your mother have advanced Alzheimer's when you did this?? To put in a feeding tube in a woman who's been suffering from Alzheimer's disease for the past TEN years is beyond comprehension. Do you understand what it's like to go through such a thing, to witness a loved one suffering from what a friend of mine calls 98% amnesia? Not 100%.........but 98%, just enough to be thoroughly confused and agitated all the time, but to know that something is wrong and you've lost touch with reality. Yet, 'loved ones' will do anything to extend THIS life ??? WHY? Life support and heroic measures for a person with THIS level of dementia should never been considered for obvious reasons.

I hope everybody reading comments like this makes SURE to write out a detailed living will and explain their wishes with total clarity!!! If my children or my husband were to extend my 'life' under such circumstances, I would be furious!!
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It sounds like this poor soul is getting to the end of the line. When these people are heartbroken as to what is happening with them, it is cruel to force them to have ways to keep them alive. They want to pass so they can have peace. Let nature take its course.
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It is not unusual for newly admitted residents to Healthcare Facilities lose their appetite. You don't say how old your grandmother is, but my mom is 97. I KNOW she does not like the food and I have worked with the dietitian in order to make her meals more appealing. She eats some of it, but has lost 20 lbs. in three months. When I bring her food from home....things I know that she likes, she eats well. I'm at a point where I don't care what she eats, as long as she eats.
Medications also play a big part in a new residents appetite. So, I would recommend that you find out just what meds she is on and perhaps cut down or out those for depression or those that make her sleepy. And, when you visit, bring her favorite foods to eat.
Not knowing just how old your grandmother is, I can't suggest whether or not you should have her be tube-fed. For my Mom, at 96, I wouldn't do it. But, then, she wouldn't want me to do it either.
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Cgjivey Sep 2019
She is 82 and we have brought food and drinks that she used to eat and drink all the time but she still does not eat them. We are trying different kinds of foods to see if anything else works. We are also keeping an eye on meds but she is refusing them so I dont think that is the issue because she wont take them.
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Is she on hospice? You said she’s very advanced in her Alzheimer’s so honestly as difficult as it is, you shouldn’t be trying to prolong her life. She no longer talks, she has a poor quality of life from what you said. It sounds like it is time for hospice and comfort care. I am so sorry, I know it’s a difficult situation to be in
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Last January my wife (Alz patient) stopped eating and lost much weight, and the Hospice nurse told us she had a few weeks left to live. We were giving her daily nutrition drinks which we made into milk shakes to boost the calorie content. Until one evening I was sitting with her having a few pieces of an apple, and she reached across to the plate I had and took a piece, and ate it, and swallowed it. So the next day I started her on soft foods, and then regular food, and she has been eating ever since. I told the Hospice nurse about this and she shook her head and could not give me a reason for this. The lesson is that this disease can be unpredictable, and we caregivers should not be surprised when things happen, which can even be good. My wife is still eating regular food even though the disease has progressed in other ways. As far as feeding tubes are concerned, whatever I know about them makes me glad that we have avoided that consideration. I have heard and read that they require full time ICU treatment, and even then they do not provide all the necessary nutrients, so that effectively the patient spends his or her last few months on earth in an ICU facility. Not a desirable end of life.

So my advice is, if the nursing home would permit it, to give her milk shakes containing a daily nutrition drink (like Ensure) with plenty of ice cream to boost the calories. And pray for her, and you and your Dad.
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MAYDAY Sep 2019
My girlfriend's mom was my mom's roommate.. Best thing ever.. She would call and say she had milkshakes from In n Out... Come by so we can feed them milshakes with added ensure, and dance :)

I thank God for that short time with my friend and her mom in the same room/facility... Made things so much better and easier.. TEAMWORK...!!!

We enjoyed every minute of it....
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As hard as this is, your Grandmother is in the process of shutting down..😢

My Dad decreased his eating, liquids, refused his pills..Dysphagia set in, then his final stage of ALZ kicked in.. I finally accepted help/assistance from Hospice..They taught me how the final stage unfolds, and how to make it as peaceful as possible for Dad..

A very hard life lesson..My daughters and I miss him every day but, we are grateful he left peacefully & comfortably, with our family and Hospice working hand-in-hand..

Prayers to your grandmother, you & your family🙏🏻
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I'm sorry for what y'all are going through. It's so very hard to watch our parents decline from this horrible disease. Maybe speaking to a Hospice Care Social Worker would help. They can provide care, in a nursing facility, ...Not just end of life care.
I care for Our Mom with Alzheimer's.
Her Dr., told me that Hospice could help, not just for end of life care. But, because Alzheimer's is not curable, Hospice can provide some help. I have Mom at home with me, but, Hospice also provides CNAs and Nurses , to go to a nursing facility. This might be something for Y'all to think about. They are Awesome Caring People.
Prayers for Y'all and Mom. Hugs.
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MAYDAY Sep 2019
Mom graduated out of hospice 3 times... last time she did go to heaven...

My Team Hospice helped me,,, unfortunately mom declined on their weekend off... But I did find Angel... He was wonderful, and the Relief Nurse to help her go .....

Remember some people will go when LO steps out of the room... (Or when I stepped back in...)
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Cgjivey: Dear Heavenly Father, please lift this family up in prayer. Thank you, Lord. Amen.

Psalm 147:3
“He heals the brokenhearted and binds up their wounds.”

Love,
Llamalover47
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lealonni1

AFT Adult Failure to Thrive (FTT) is a real diagnosis; this is no guilt trip; same with her being in a NH that could have accelerated this. Feeding Tube is suggested by some not only for food but to give medicine as well. I'm sorry you feel that the other poster and I are trying to lay a guilt trip on th OP


Thank you for your comments Barbin Brooklyn(?)
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lealonnie1 Sep 2019
Suggesting a "nursing home could have accelerated AFT" is precisely why I said you are laying a Guilt Trip on the OP, which you are, whether you see what you are doing or not, considering her grandmother is IN a nursing home. If I have quoted you incorrectly, then I apologize.

There is no reason on God's green earth to warrant the placement of a feeding tube in a woman whose dying of Alzheimer's, a fatal disease, for the past 10 years. Medicine can obviously be administered in other ways without the need for a feeding tube. When food the woman has always enjoyed eating is being repeatedly refused, she is no longer wishing to put food into her body and a feeding tube is Force Feeding someone whose body is preparing to transition.

We have people saying Oh Just Take Her Off Hospice To Put In A Feeding Tube And Then Put Her Back On Hospice Afterward. Easy peasy. Does this not defeat the entire purpose and premise of comfort care at end of life that hospice provides by actually allowing the person's body to die naturally, and without medical intervention????
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Here's what I would do....
Get her out of that facility, and just bring her home, and asap, sign up with Hospice....they are an excellent support system, know all about how to keep someone comfortable, and they will show you how to do things, like keeping her clean while bedridden....they will provide various equipment to help her as much as possible to move around, and they won't force her to take drugs, or food, etc....hospice is strictly for the terminal patient, and are and excellent support system all around.
If she's done eating, don't force her to eat as her taste buds may not be working properly, or internal organs may be shutting down, ok
Please just take her home, whoever's home that could be, and just love her the best you can, and don't sweat about food or drugs....listen to your heart/conscience, and listen to Hospice!
I pray she is saved by Jesus Christ....many times, getting saved brings a calm, comfort and peace, knowing for sure where they are headed when they leave behind their bodies. Christ as Savior makes all the difference!
May God be with all of you. Shalom. 🌺🕊🌺
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May mom's caretaker, said time and time again,,, YOU WILL KNOW THE TIME IS NEAR WHEN THE BODY REFUSES TO EAT...

She didn't say because of this, or because of that...

Only said when the body refuses to eat... And she said this happens in NATURE all the time.. The body doesn't want food..or drink...

My FIL had esophageal cancer. He had a horrific operation, God Bless Him, so he could be around a bit longer for his one and only grandchild...He kept telling my MIL his body is different,..(obviously, he took out part of stomach and throat and reconnected it...very painful...) and he doesn't want to live like that.. Yes, he did have a feeding tube and he did not like it one bit... and it was horrible...

Then I knew a person whose daughter was born early.. she was quite young, and the feeding tube saved her life... She had a scar, and her mom reminded her that scar saved her life...

Weighing in the ideas of when to use a feeding tube.... For me at my age, I will say no to the feeding tube... It's okay... I do not want to be hooked up, and it may or may not work at my age...

LET's give the little ones a huge chance of LIFE... Do try the feeding tube if it is almost guaranteed that it will bring health and life to a little body trying to get a bump start.... My age, for me, I say no thank you.. But a little one, who has a huge chance to survive 15 years or more.. I SAY YES... give that lil one a chance. Who knows she could be the person who solves much of todays issues... Tomorrow..
I won't say President.... That is one thing I do not talk about to anyone... YIKES....
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ALZ PATIENT may be more active in pulling out the feeding tube or IV's.. My mom did with her IV's.. and her U tube... (peeing in a tube/bag) not the Youtube,.. U-Tube.
U get it. Eye hope.

Anyway, that would be very uncomfortable for a person trying to pry out a feeding tube. and the looks on mom's arm where the IV was, was not a pretty site.. I didn't look down elsewhere... U tube.... but I can imagine that was painful...

Just think and know where your LO's (lousy one, lazzy one, lol one, limbo one.. you decide what LO stands for) mind is at, and think about what if that was you... and you didn't know what was going in and out of your body, foreign objects... Not understanding what or why those things are there.... All you know, it's not natural... it's odd, and uncomfortable... maybe more worse than this: You have a cast on your leg....for a couple weeks, and then..... YOU GET AN ITCH!! And you cannot reach it... and it just grinds on your nerves... THIS ITCH... What can you do about it?... If you could, you would rip that cast off and SCRATCH IT..But you can't do that... It's a Cast. and it must be there to heal your bones, and You have the COGNIZANT mind to understand THE CAST MUST STAY ON FOR A BIT LONGER...
so now your LO( use these letters as you wish) has a mind that DOES NOT UNDERSTAND that these foreign things on or in the body MUST STAY THERE..So what does LO do? LO removes such items from body, because they do not feel good... IT COULD BE THAT ITCH... and NOT UNDERSTANDING, THEY SCRATCH THE ITCH or remove Article that is blocking them from scratching the itch...That's all that is in the forefront of their thoughts.. This issue that is causing them from SCRATCHING THE ITCH.

In my opinion, sometimes feeding tubes are not viable...especially, in a person with ALZ.

GN
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After Dad died just as he was going into hospice, they gave me a book called Hard Choices for Loving People by Hank Dunn, who is a healthcare chaplain with long time experience in nursing homes, hospice and medical center. He discusses CPR, feeding tubes, palliative care, and comfort measures for the patient with a serious illness. The section on feeding tubes is informative. There are pros and cons for some patients but more risks for people with end stage Alzheimers, such as aspiration pneumonia and infection. I wish we had gotten Dad into hospice sooner because they can do so many things that a nursing home can't.

Dad had a good appetite until someone in the hospital decided he was "packing" food and needed to go on a thickened liquid, pureed diet. Not very appetizing. You didn't say if your grandmother can feed herself. My father had a stroke in rehab and had to be fed. The home was worried about aspiration so, when they couldn't get him to the dining room, they no longer offered him food/drink. Not even ice chips. I still think a person on hospice should be offered food and drink; just not required to eat.
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The consideration when thinking about placing a feeding tube: Will this improve the quality of life, or just extend misery? Old age ( with or without dementia) is terminal. At some point, we must let go. No one can or should live forever!
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It is easy for someone from the outside to look at your situation and have an opinion because we don't have the emotion involved.  From the outside looking in, I see an elderly woman who is at the end of her life...she has dementia and is in a nursing home...what quality of life does she have?  She is merely existing at this point.  The kind thing to do is to get hospice involved and make her comfortable so that she does not suffer.  Spend as much time with her as you can as she leaves this world.
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Are you asking why the quick decline? Or asking what to do now that she is rapidly declining? In my opinion... For the decline to have been so quick, just one months time, I believe it is due to her being placed in Assisted Living. She is aware of the change in care & lifestyle. It is not a coincidence, imo. I would remove her from the facility and bring her home on Hospice Care surrounded by her family. Just love her every day she has left. Can she still communicate with you? Have you talked with her? Alzheimer's has many different levels and differing symptoms, abilities. I understand the heartache your father (and you) are feeling right now. No easy answers. I'm sorry. I will pray for your family.
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If your mom is able to drink, take a blender in and make her a strawberry(fresh strawberries) shake with protein powder. Look at my profile for more ideas. This was a game changer for my father. The drs gave my dad 6 months to live & it's been 6 1/2 yrs.
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Think back to when she was healthy & how she expressed any end of life wishes. Does she have an Advanced Directives? If so, honor it. If she didn't, have another person either relative, close friend, or pastor speak with you regarding the options that you have to choose from. Think of what she would want done for herself. With Alzheimer's you do need to think of quality of life the person may have. Your grandmother may pull it out every chance she gets which may cause complications such as agitation, aspiration, etc. If you decide on not placing the tube, involve hospice in her care. I pray for peace of mind for your family. My mom died from it last year & we made decisions about her care based on what she wanted not us. We miss her, but know we did what was right.
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