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Caring for Aunt-in-law. 74, permanently bedbound. 512 lbs. permanent broken femur (August 2021). Osteoporosis. Had MRSA in March (before we started giving care). CHF & CKD. Permanent AFib. Severe sleep apnea. Health has taken serious decline. Just spent 2 wks in hospital for 2 drug resistant bacteria in kidneys. On furosemide & Flomax with severe urine decrease but showing signs of retention again. BP avgs 102/54 pulse always below 58. Fluid pockets in lungs (not safe to drain & not enough). Pronounced cognitive decline in last couple weeks. Should we be prepared for death? Drs don’t give any info- a lot of I don’t knows or subject changing. She keeps talking about it, she’s had her will made, & she’s been discussing what needs to be handled with belongings & such. Her rapid general decline has me worried. I’m afraid I’m going to find her gone one morning.

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CHF means literally Congestive Heart Failure. With a weakened pump attempting to keep alive someone of this weight and with this many underlying conditions I am afraid that death may indeed be possible, especially with blood pressure this low (perhaps this condition exacerbated by medications for CHF which do lower pressure.).
Whomever is the POA needs to discuss all of this with the MD. If the MD will not discuss ask for a Palliative Care consult with an MD who will treat, but who recognizes that this is indeed a very very ill person. The Palliative Care MD will let you know when Hospice is appropriate; that may be now or in near future.
With someone of this weight I would think you are limited in time you can do this care on your own. Aunt sounds as though she requires SNF care at this time to me.
I sure am sorry and I wish you the best.
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Cover999 Jul 2022
The permanent A-Fib as well as being bedbound and so heavy, plus the strain of when she would need cleaning and changing.
Only so much the heart can do.
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Starting over - just lost an entire post!

I respect and admire your dedication in facing and working through such challenges. You must be a very special person!

1. Are you your aunt's sole caregiver, or are other family members involved? Is your aunt in a hospital now, or some type of facility?

2. Given that lives are finite, the perhaps impending recession, the potential for escalation of intra and inter country friction and the hopefully remote possibility of a third world war, I think it's wise for everyone to plan for unexpected or potential outcomes and changes.

3. If palliative and/or hospice care is needed, have you had a chance to research potential facilities? When I did, l learned that some with great reputations weren't that great on pre-choice negotiations. Some didn't want to provide specific answers; others wanted me to come out and see how great their facility was before I was even considering it.

Eventually I went with a Catholic owned and operated step-up care company, ranging from rehab to IL, AL, etc. They were very compassionate, respectful and even went out of their way to accommodate us.

4. What specialties of doctors are involved? Are they all "fudging" or avoiding direct responses? I would turn the issue around, and ask more general questions. Of the cardiologist, you might ask if her cardiac conditions now are indicative of a short remaining span of life, or how they factor into the whole picture. Same with the pulmonologist. Estimated times are relevant as well: weeks vs. months might be a starter.

You would probably get a range of answers, but it might help you focus on the more serious issues right now and in the short and long term future.

5. Have POA or better yet DPOA as well as Living Wills been executed? Are the appointees up to date on her condition, and ready to serve?

6. As to preparation for the end, you wrote that her will is in place. Are you the Personal Rep, or Testatrix (f/k/a Executrix)? If so, do you have the data you would need to manage and/or close out the Estate? If not, does the named PR or Testatrix have that data, or access to it?

7. Does she have assets, i.e., real property, stocks, bonds)? If so, and they haven't been inventoried or aggregated, you might want to ask her where to find all the data you would need to manage the Estate, such as recorded deed for real property, quarterly reports for stocks, and other data,so that the assets can be transferred properly.

8. What is the extent of her family, and how involved are they? Do you keep them updated so that they can be aware of the situation? (I used to e-mail family and friends whenever there were changes, or even when situations stabilized and improved.)

I know this is more than you asked for, but in fluid situations in which changes can be quick, it's easy to forget some important aspects.
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Cover999 Jul 2022
Nice one fluid changes
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It must take a while to clean and change her.
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JL0904 Jul 2022
Yes it does. When she actually lets me clean her properly. It’s often a fight. She struggles to move her bowels daily even with high doses of stool softeners. She just can’t push properly no matter which position she’s in. And she has a 36 inch wide hospital bed; she literally has 1 1/2 inches of mattress on either side before she’s smooshed in the rails. But her insurance won’t pay for a bigger bed. So that’s really rough on me. And since she’s so much weaker, she doesn’t have the ability to help when I have to roll her to change her underpad & wipe her up. I literally weigh 120 lbs & I have to use my entire body to hold her up enough.
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JL, thanks for taking the time to respond to my post. I want to think over your response and answer later, but I really do appreciate the fact that you responded.

Have a good night's rest, please! There's so much going on now that you'll need that change of pace to forge ahead.
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