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She has recurrent UTI's and now before the chemo radiation fiasco which really took her under, she had a colostomy bag and port put in for the treatment. Since then shes been in hospital several X and recently contracted ecoli sepsis. Now on antibiotics it seems she has little more to give. Should we start planning for the end now because she seems to be on borrowed time thanks to the antibiotics but my fear is after that she will plummet again. I am the only daughter and in California trying to figure out how to best help my poor mom. Appreciate anyones advice or experience here.

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I am in a similar situation, both of my parents have lived with me for the past 5 years. My dad, 88 yrs old, has been diagnosed with Alzheimer and it is advancing fairly quickly. He had as stroke back in 2003, high blood pressure, Kidney disease and has fallen twice and broke a hip each time. The last time in January he did not bounce back like the first time. He has been in a Palliative care for several months. I have POA and healthcare directive, I finally decided to just let nature takes it course. After speaking with his primary care doctor and his Nephrologist and considering his quality of life. We have stopped the 3 blood pressure medicines and blood thinner, all the different vitamins and other pills. He is now only taking comfort meds-nothing that will prolong life. He isn't going to be cured and the Alzheimer is only going to get worse, so I am letting him enjoy what time he does have life, eating what he wants and not pumping him up with all kinds of drugs that really have no effect for him anymore and let him die with dignity. Sad thing is that I will have to make this same decision with my mother soon. She is diabetic, kidney disease, congestive heart failure, tore rotator cuff and severe arthritis in her hands and back that even taking 4 oxycodone a day is not relieving her of the pain. She is not a candidate for any kind of surgery. If she has heart issues, they cannot do an angiogram as the dye will put her into kidney failure and would need dialysis. She cannot do dialysis as the fluids will build up due to the CHF which will kill her. She is completely deaf now and her eyesight is failing due to multiple medical issues. I have looked that they had 5 more years of living while being with me and have enjoyed themselves. I know that some would think this is being cruel but in their case it is the best for them to enjoy what time they have left without filling their body with useless medications. Each of us have our own opinions but you will need to decide what is best for her and look at everything to make your own decision.
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Hospice is a choice, not a requirement, but I think it is a good choice when there is no possibility of a cure and when pain is present. They provide additional attention in a nursing home setting, and they excel at cutting red tape so that what they deem the patient needs the patient has almost immediately.
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gonsalisa, is your mother in CA or a different state? Check with her nursing home to see if hospice is allowed in when you feel it is time for them. Go ahead and get all the final technicalities out of the way. A friend of mine who had AIDS long time ago explained to me that he had to take care of dying so he could get back to living. He got his funeral and everything lined up, then went on to live a couple more years free of that worry.
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gonsalisa, I am so sorry to read about your mother. Anal cancer is a difficult one to treat. I do think you're wise to start tying up lose ends, like making the funeral arrangements. Make sure your mother's will and advance directives are up to date. Getting these technicalities out of the way will free you and your mother to be able to spend time together with less stress. It sounds like your mother's cancer is advanced and she has other complications. It is hard to watch. My only advice is to keep your mother as comfortable and pain free as possible, and enjoy the time that you have together. Pam's idea of hospice is a good one, especially if there is much pain. Hospice is not reluctant to help with the pain.

Wish there was something to say to make it easier for you. Big hugs to you.
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It's time for Hospice, but only if she consents to it. A lot depends on what she put on her Advanced Directives when she entered the nursing home. Many cancer patients refuse hospice at first.
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