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I'm sorry your mom is doing poorly and that you are feeling guilty. First, please be kind to yourself. You NEED a break! While people react differently to being away from their usual home, I'm 99.99% sure that what is happening would have happened anyhow. Give yourself permission to have had a needed yet short break.
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Wyoaviator Sep 2022
againx100 is correct.
Correlation is not causation. Just because she deteriorated at the home is no guarantee she would not have deteriorated with you taking care of her.

I know itis difficult, but don't carry that guilt burden. YOU did not cause this. Consider what would have happened if you did not take a break-you may have hurt yourself and been unable to care for her at all. As it is, she is comfortable with you rather than in a hospital down the hall from you.

The logical fallacy is "post hoc, ergo propter hoc." Literally "after this, because of this." If you want to say she deteriorated after you placed her in care, then you can say she deteriorated because the sun rose this morning too.
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CareGiver2Mom,

I'm a retired RN and know that any change in location and the loss of the familiar for one so aged can cause a cognitive decline and that may be a contributing factor here. You cannot feel guilty for needing Respite, please remember that adage about needing to put the oxygen mask on yourself before helping others or you'll be no good to anyone. You needed a break, understandably.

The severe ankle swelling - without anything other than your description to work with here - may very well signal heart failure - CHF. Usually, unless there is circulatory obstruction, foot swelling and edema are indicators of the heart losing capacity to pump the veinous blood, resulting in third-spacing of fluids in the peripheral tissues. This swelling will temporarily decrease once the lower extremities and the heart are at the same level, decreasing the pumping demands on the heart. The swelling may have also decreased so markedly because she was given a diuretic drug while in Respite.

Since your mom had an indwelling catheter placed, they can act as a wick to bring all manner of bacteria into the otherwise 'sterile' bladder and cause a UTI - urinary tract infection. The urine being cloudy is possibly indicative of this. UTIs are capable of taking an elderly person down so low and so fast that this may explain every aspect of her changed behaviors that you've described. UTIs can cause cognitive and depression changes, lack of appetite, and a host of other symptoms.

I would contact her primary care MD, or her/his nurse, fully describe her rapid decline and the volume and cloudy appearance of her urine (you could also check it for any foul odor), report all of this and ask for a urinalysis and culture - UA/UC. You can bring a specimen in with a container that you go pick up and drop at the clinic lab. They should have record of mom's drug allergies and given the severe decline, should be willing to order an antibiotic - abx to treat this probable infection. You'll have to push fluids to help flush all of this through her system.

Ultimately, our lives and the lives of everyone we love are given a pre-determined number of days and whether this is a UTI or heart failure or some combination of these and other factors, we cannot change the timing of any passing.

Love your mother and be with her in whatever setting you can manage for as long as she has left of her earthly toil. Sometimes the slightest change may seem to hasten the inevitable, but we are all subject to a greater plan and this is not anything that is due to our actions, it just is.

Wishing you comfort in this distressing time.
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Judycares Sep 2022
You are so wise...and smart! Good messages and advice for all of us. Thanks.
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Any guilt I may have had is push far back in my brain. For the reason CTTN55 said, I was the only one doing the caring. Look at it this way, if you had help you wouldn't have needed respite care.
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You should not feel guilty. Look at how much you have done for her. You have siblings who have done NOTHING. THEY should feel guilty for never helping -- THEY could have provided respite for you at the very very least!

How is it that it all became your (and only your) responsibility?
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With stage 4 kidney disease and a GFR of 25 anything could go wrong. I was put on dialysis when my GFR reached 26.6. You putting your mother in respite is not a reason for you to feel guilty. I doubt that putting in a cath caused her decline. At stage 4 CKD every day is a gamble.
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bundleofjoy

She went to an Alive hospice facility and the 2nd day the social worker from there called me asking about a cath being put in and I said No I doubt my mom would allow one, they said she was wanting to get up every hour to pee like she did at home and is a fall risk which she has had many bad falls with hits to head.
Anyway when the nurse called later that day they told me they asked my mom about a cath and she agreed to it, I was livid they had went around me. I am POA too.
I hope its just a set back from the cath and what your saying, maybe a UTI. She has stage 4 kidney disease and eGfr of 25, number may be worse now though. I will ask her hospice nurse tomorrow cause I would hate for her to get/have an infection from it. She was on macrobid to prevent any UTI's and they took her off a few weeks ago. She is very week now and has no strength and can't even walk or hold herself up.
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lealonnie1 Sep 2022
White particles in the urine (for a female) can be due to kidney stones or a UTI. Also with chronic kidney disease at play, that can be why. It can also be b/c she had the catheter in, which may not have been such a bad thing since she's a fall risk. Give her a few days and see if the white particles disappear. If she's dehydrated, offer mom fruits that have a lot of water in them like watermelon. Smoothies made with juices are good too, esp if you worry about her being a choke risk. Shakes offer good hydration with little choking risk.
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Thank you, yes we know she is super dehydrated and her urine has white stuff in it? What is that? My hubby got her up in the wheelchair today and she had some scramble eggs for breakfast, a little sips of coffee, ate a baked potato with butter then I went and got her a frosty from wendys and she's been sipping fluid here and there. I worry about her choking at times when I see her eating so it scares me.
We have her back in bed and she's resting now.
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bundleofjoy Sep 2022
dear OP,

hug!
you’re very caring and sweet. it’s amazing all the love you give to your mother, all the wonderful things you cook for her, etc.

1.  her urine has white stuff in it

definitely get it checked out. sounds like UTI.

your mother was suddenly given a catheter in respite. catheters almost always create UTIs.

small UTIs can go away on their own: just drink lots of water.

big UTIs need antibiotics, etc.

by the way:
typical of UTI:
…makes the elderly person weak (hence more difficult to walk)
…can also create mental problems: strange talking, or slurred speech, etc.

whenever an elderly person suddenly feels weak:
think:
maybe infection.

2. sudden (physical and mental) decline after respite

i really hope she bounces back to normal (her “normal” before respite). it’s possible.

unfortunately, some facilities really do a bad job: sometimes there’s neglect, or over-drugging (it happens here in facilities where i live). over-drugging, like zombies, so they don’t bother staff.

of course i have no idea what experience your mother had in respite. i just mean, — sometimes — the cause of sudden (physical and mental) decline really is the facility, because they’re negligent.

hospitals also sometimes over-drug the elderly, so they don’t bother staff.

also, in facilities sometimes they don’t help the elderly to move/walk around enough. then you lose mobility.

also in facilities, sometimes there are infections spreading.

i hope your mother bounces back!!

you’re an amazing daughter. super loving.

and you needed a break. of course!

what else could you do?

poor you; you didn’t even get a chance to have a break. the “break” lasted less than 48 hours…
(it wasn’t a break. you had to continue to worry, solve problems).

many of us are in such impossible situations. we want to help. we also must rescue our own life.

i wish for your life, OP, to be rescued too. your mother, i’m sure, of course also wants you to have a real break. everyone needs/deserves a real break.
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Your mother is on hospice care thought to have less than 6 months to live. THIS is why she's declined recently, not due to anything 'horrible' you did to her.

Give yourself some grace here and realize that 24/7 caregiving is too much for one person to manage. Respite is recommended for ALL full time caregivers, period. Insisting you 'caused' this natural decline in your mother is not only wrong, it's causing you undue heartache and guilt as a result.

Realize that your mother will pass when God is ready to take her, and nothing you or anyone else does will prevent that from happening as part of the cycle of life.

The best thing you can do is stop crying, start eating again, and allow yourself to enjoy your time with mom now. It can be another year she has on Earth, so don't count her out quite yet, ok? We've seen elders rally ALL the time around here. Your mother is no exception.

Best of luck.
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CareGiver2Mom, don't feel guilty that you "think" you had set this whole thing in motion. It is no different than one day you are feel great and the next day you are down and out with a summer cold. It just happens. There is no way of preventing it. All of this is new to us, so we believe we are doing the best.

Please note at 100 lbs your Mom is what called "dead weight". At that weight, your Mom's bones could be easily fractured.

Really yellow urine could mean that Mom isn't getting enough water. Don't give her any water with ice as that could upset her stomach. Give her room temperature. For myself, it is so much better to drink :)
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