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No focus and barely swallowing her thickened ensure/protein drink. She is lying in bed with her legs bent and will never be able to sit in her wheelchair again. The caregiver/nurse said her legs are "bladed"...Is this pacemaker keeping her alive in this condition? She is with Hospice and they visit a couple of times a week in her Board and Care- I just have so many questions and am so extremely sad to see this beautiful spirit disappear in this manner.

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Update, you have all been so helpful and kind. Thank you, today was difficult. She has had no food or drink for days. The caregiver showed me another sign today, the bottom of her foot is purple. Her blood pressure is 91/54 and pulse 171. I wish I knew more medically, however, they are answering as many questions as they can. Hospice will be back to see her on Monday. Last night her eyes were opened as wide as can be ALL NIGHT LONG and today, still no sleep. I don't even understand how she can lie there and not close her eyes to sleep.
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Kitty, usually there's something like albuterol or ipatropium bromide in a breathing treatment. I've been told it's for the respiratory system, so it does help breathing.
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You are all quite dear! Thank you for taking the time to share your knowledge. I have her in a Board and Care and Joy (appropriately named) is simply giving her the most loving care possible. There are 4 others in the home however, nobody needing everything done for them like momma.  They are turning her in bed every 2 hours, taking pressure off some very tender areas. She hasn't had a bowel movement for 3 days, guessing it's because she is eating so little. She swallowed on her own her breakfast (Ensure, Protein powder and pureed fruit) She is very congested and I hear a rattle; she can't clear her throat. I talked with her today about Dad (her love for 60 yrs, gone now since 2006) and she smiled. That told me she actually processed what I said. She has always been deaf wearing hearing aids, no aids now however her hearing seems acute! Thank you again, everyone. They gave her a breathing treatment while I was there, which seemed to be just steam to help clear her airway~
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Kitty, it is so very difficult to watch a loved one in the kind of situation you describe. I hope you're taking adequate breaks for yourself to help deal with the challenges of end of life stage.

I think the hospice nurse is the best person to ask about what might happen next. But when my father was staring at the ceiling, fixed and rigid, breathing heavily, I knew the end was near, and one of the nurses confirmed it. He did pass shortly after I left.

Spend as much time with your mother as you need, hold her hand if she doesn't jerk away when touched, tell her how much you love her. Nurses have told me that the hearing ability remains sharp, even if someone has dementia, so your mother could probably hear you.

Just say what you want her to remember, and what you feel may make her more comfortable.

I've heard from others who were with their parents that the ceiling staring is often described as "seeing the angels", or "dancing with the angels."
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A pacemaker will only pace her heart from jumping around while beating. However, it won't keep her heart from stopping as in her passing away.
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The pacemaker keeps the heartbeat from varying wildly. It is more of a comfort measure than a life-saving device.
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I am very sorry about your mom. I’m glad she has hospice to help her and your family.
My understanding has always been that a pacemaker will not keep one alive. My mother and my mil died with a pacemaker. Here is an explanation from the web.

“This is a common misunderstand- ing. A pacemaker does not actually beat for the heart, but delivers en- ergy to stimulate the heart muscle to beat. Once someone stops breathing, his body can no longer get oxygen and the heart muscle will die and stop beating, even with a pacemaker.”
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