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My 78 year old mother suffered a stroke in March followed by a broken hip in April and then entered a nursing home in which she has just laid down and given up on life. Her dementia is such that the doctor consider's her no longer able to conduct her own affiars. She refuses to get out of the bed or to do anything with PT. She's now sleeping more than usual, basically has to be helped to eat a meal, does not talk as much as usual and today I was not even sure she knew me and anyone else. I got the impression that she is withdrawing into herself.

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When a person stops eating, it is often because the body is shutting down and can't process the food. That, of course, is a sign she is dying. Withdrawing into herself could be another sign.

She has been through a great deal of trauma and could have lost the will to fight anymore. My mother used to say to me, "Can't you just give me a little black pill?" She was so tired of pain and misery, even though we did everything we could to make life better. Of course, all I could say was, "No, I can't do that, but we will see if more can be done for your comfort."

I do believe she lost her will to live after my dad died, but it took five months for the physical effects to take over. She did get so she couldn't eat at all and then it was mostly about pain management and physical and psychological comfort. Dying is often a drawn out process. My heart goes out to you, as you are the one who must witness this process.

If the doctors think anything can be done to help her, listen to them and weigh the options. Will a procedure cause her more pain and misery, but prolong her life three days? These are choices we must make. What would she have wanted if she could make these decisions. You are savvy and concerned.

Please keep us posted. This is a hard way to spend this holiday season. I know. I experienced three Christmas season deaths. But it's not easy any time. Knowing my loved ones were finally out of pain was my comfort.

Take care,
Carol
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Have you considered asking for hospice care? The hospice people I had for mom were so compassionate, and also very knowledgeable. Not only can they help your mom with medications and measures to keep her comfortable, but they can help YOU.

Sometimes letting go can be so difficult for us, the ones "left behind". I truly believe that we need to make an extraordinary effort to get around or past our own feelings and needs, and do what we can to help the dying person to let go. As caregivers during the aging process we've done so much to help our parents, and this is the last and best thing we can and should do for them. I lost mom just before Thanksgiving and the feelings are still raw, but I still firmly believe that allowing her to go in peace was the best gift I could have given her.

So think about hospice. They'll be able to help you understand the stages of dying, support you, and help your mom. May you find peace in this process. I will pray for you and your mom.
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I agree. Thanks txmaggie! I should have mentioned that. Hospice care allowed both of my parents pain relief and a peaceful passing.

Hospice is also, generally, very savvy about what signs are about the dying process and what notes a need to intervene with the process so the patient is more comfortable. Some people go on and off hopsice several times, as they actually improve under the care.
Carol
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Good question, Crowemagnum. What does her physician say?

Doc told my husband just last week that his dad is "failing to thrive." He's losing tons of weight, falling (and hallucinating), sleeping a lot, and sometimes can barely keep his eyes open when we visit, try to wake him, or try to talk with him. He seems to be losing his hearing, as well. When he is ambulatory, his gait is much slower, and he seems to be so feeble. He taught his grandson to play chess last year, and was still beating him at chess not too many months ago. Now he doesn't even play. Last night, when I gave him a hug at supper, he yelled, "Don't take my out of this hospital; I like it here!" (He's been telling us for four years he wants to escape.) He's 90.

txmaggie, thanks for the Hospice suggestion. Doc said we can call Hospice if we want, but they won't do much more than he's getting already at the nursing home. Is that true? I thought about calling anyway, but is it selfish to wish for more support for us?

My dad is only 77, but is losing more communication skills, both verbal and auditory. He doesn't seem to understand what we say to him, and can't complete a recognizable sentence when speaking. He's sleeping more, and eating less, often refusing meals. He falls asleep wherever he can recline, or in a chair. Sometimes he lets us feed him, but only a bite or two. Advanced Stage Alzheimer's seems to be stealing him swiftly. Right now it's got his sparkle, with barely a twinge of spark now and then. There's still a smile, but only for brief seconds. I've asked for a med review, and he's had some labs done. They ruled out UTI, but have found nothing else, nor changed his meds. The Ativan they give him helps with aggitation, but makes him drowsy. I miss my contented dad. So discouraging! :(
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Hospice can do a lot more than the nursing home SecretSister. At least a good hospice can. They work together with the staff at the center, so your dad would get more one-on-one care. They also monitor pain and can give pain relief out of the range of the care facility.

I have seen hospice at work, and my experiences were very positive. I know that is what I would want under the circumstances.
Carol
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The doctor has not said anything to me, but yesterday's visit and a recent phone call were just different. This will be her first Christmas of not being in her house and understandably is very upsetting. Yet, she does realize that she's not able to enjoy Christmas at home, but there is very little about life right now that she does enjoy and what at this point does she have left to live for. My gut tells me that she's hanging on possibly for me to complete solving her four years of past due taxes, but I might be wrong.
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You know her best, and you'll be there for her this Christmas, right? Surely that's got to bring her some joy. Sounds like she is blessed to have you looking after her interests. Hope things work out for you and her to have a good Christmas, even though she's not at home. Like the saying goes, "home is where the heart is," can you "bring Christmas to her"?
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Thank you, Carol. Went to FIL's quarterly review today, and asked the question. They said the doctor didn't give dad a written diagnosis of "failing to thrive," and that he seems better the past couple of days. He went to the Christmas party last night, and stayed for the whole thing, enjoying the kids, and was ambulatory and eating lunch today when we visited, so...perhaps Hospice is premature. Doc did say she wouldn't guess at a time line... I may look into our Hopice here for future needs, though. Perhaps more information will help discern the signs. Thanks, everyone for your suggestions, and input, Carol.
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I do agree with Carol and Txmaggie on this, as I also went through this situation. I personally did find HOSPICE to be of a great support-not only to the person in need, but for all the family as well. I personally feel that when the patient's body is shutting down, this is something we have to respect..especially after exhausting all options. This is very difficult to say the least, but if we believe in the 'here after'-they are perhaps going to a better place. Getting back to Hospice, from my experience, I definately would not hesitate to use their services-they are very well trained, and can offer support during this 'dark time' of the caregiving journey.

Best,

Hapfra
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Hmmmmm. Where did Carol and txmaggie's posts go?
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A good hospice would help perhaps... wish that my parents had signed up for us before my mom died but they refused, being the reserved types that they are. In the case of my FIL, his 3 boys knew more than the hospice volunteer - he was turning blue by the time she arrived - hours late and she wanted to push the paperwork! NOT a good experience, but I think it's just the one bad apple in the barrell. My father-in-law had given up on life.. I think that you just know the time is coming in most instances.
Prayers up for all dealing with this - especially right now!
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hospice care! I am not sure about them. Don't they put them to sleep like a dog. My friend was suffering with cancer. Her insurance and money ran out so she couldn't go back to the hospital. That is a fact.
When hospice came in they told us they will not let her go past 9:30am. That told me they drug them enough so they just die. Would I call them to help, I don't think so. I can give proof about this too.
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What about alzheimers/dementia patients are they accepted to be in hospices? Since Alzheimers is a slow process it seems...leading to death.
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I don't know what all they do. But they do say they help them go through death. Can you tell me what that means? If that isn't helping death I will eat your hat.

I want to be awake when my time comes and not under drugs. When I had my heart attack I was in the hospital. I heard angels singing. Wouldn't want to miss that. My lungs were filling up with water. They rushed me to another hospital and put the stents in. I told God I didn't want to die right now that I had other things I wanted to finish. It sure was the Lord who keep me here.
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thought that dr did that and was put in jail for doing that . kevoc forgot how to spell his name .
i wont be callin hospices unless i know my dad is on his way out .
i do know they changes meds and control over everything , im not ready to do that .
its a diffrent story if theyre suffering and is in alot of pain yes maybe a hospices be a good thing , as long as dad is not sufferin in pain then imnot going to worry about it ...
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Good for you. We have to think of how we would want it. If they are in pain by all means give them medication but to put them to sleep like a dog. That is just plain murder. Just like they let women get rid of their baby and in some cases it just because the person doesn't want a child. That is murder too and they get aways with it. There is a day coming and we have to give a account to our God. Yes he forgives but my goodness what an awful thing to do. I guess I better shut up.
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Thank all of you for what you have written. My Dad is 89 and he is declining. He is given Ativant for his seizures. But he is not opening his eyes and just today he has developed a fever of 104. I love my Dad and he has been a blessing to me and my 3-Sisters.

And, yes, Hospice is the way to go. My Dad went yesterday and they are making a world of difference in this grievous time. I don't know how long daddy has, but I thank God for Hospice
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I find it hard to send them to hospice, because of what I saw and what hospice said when they came in to care for my friend. They said we will not let her go past 9:30.

Are they druging them so much that they die? I would really like to know. You can give them medication to stop any pain they have at home. I took care of my dad who died from cancer. He had the medication to help with the pain. So why don't they do that now. Why speed up the death. Is that what they do? Why did they make that remark when they came in to take care of my friend. I was told they do it in NH by someone who worked there.
Come on guys this is MURDER
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hi Reba your love and cherishness of life is heart felt, and impressive my friend died of cancer, and his family and i prayed that he would let go, and be at peace, for he could no longer talk nor move but he held on, but one day he just left, i believe that, that was his time, he was strong, but the moment, that moment, we will all have one day, comes, it will be. it's not in our hands but His. And my uncle who i loved dearly died not long ago , he also did not want to fight on.He was made comfortable until his moment came, and he to left also , i believe life is set up that way. We have a certain life span, in every case. And i will always miss them dearly.

Fernando
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Both of my parents were in intractable pain before they went under hospice care. Not all hospices are the same, and I've seen a few comments on this forum that has made me wonder about some of them, but my experience with my parents was that once hospice took over, they were more alert and more themselves than before that, because their pain was controlled.

They only had the drugs they needed for pain relief - no more. There was a great deal of family support, kindness, and no "hurrying of the process." When they did die, it was peacefully, with family at their side. It took my mother three days for her heart to quit beating (she had been mottling and showing other death signs for days). No one hurried the process. I watched carefully for signs of distress, and if there were any, medication was given to comfort her. Finally, after those three days, she did die. We all have our time.
Carol
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Sorry, I've been away for the holidays and away from a computer.

When it became apparent that Mom was giving up, the nursing home staff strongly suggested that we get the hospice staff in to help. There are different hospice organizations. The one the NH used was awesome. They visited with the family and the nurses checked mom over very carefully. They asked what our wishes were. We wanted mom to be kept comfortable. They said they could do that but wanted us to be aware that sedation would probably shorten her remaining time because she wouldn't be eating or drinking as much. (She'd pretty much given up on that anyway). They said it was entirely OUR CHOICE. They said that sometimes sedation made it easier for the children to let go, as their loved one was much less agitated and restless. They said sometimes sedation made it more difficult on the family because of concerns that the person was being overmedicated. At no point did they ever "take a side", suggesting one over the other. They presented all the info, pros and cons, and left the final decision up to the family.

And yes, secretsister, they did a LOT more than the regular nursing home staff. Part of it was financial - they assumed all the costs of all special care. They provided mom with a really nice wheeling, padded, reclining chair, oxygen, meds, etc. Plus, their own providers would go in to help with Mom's bath, the nurses would make visits to check on her. Essentially it boiled down to a lot more personalized care, and extra eyes and hands keeping a watch and doing things for her. And it is NEVER selfish to get hospice for your loved one so you can also get the support. It is a very difficult time and why muddle your way through it alone? Not only that, but hospice organizations offer a year of grief support after your loved one passes, and it really was good to have their help over the holidays.

And yes, Bree, hospice accepts patients with dementia/alszheimers. Mom had hospice at home before she went into the nh and her working diagnosis was dementia. Talk to your doctor.
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carol i am very sorry for your loses, and i meant no harm.
Fernando
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Oh, Fernando, if I sounded like I disgreed with you, I totally agreed with your post. Maybe I didn't word something properly. I, too, feel when the time is come, people will die on their own. I just was saying that there are ways to help them with pain while that happens, though not everyone will travel the same road.

As Txmaggie says, not all hospices are the same, either. So, when I support hospice, I am speaking from my own experience, which was similar to hers.

You did not say anything to offend me. But thanks for the condolences. My parents were ready to go, and finally died peacefully. You are the one now who is suffering, now. I'm sorry you are going through this. Know that our hearts are with you.

Carol
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It also happened to my father in law in florida. They kept him alive and until his other son got there and then they kept giving him shots every two hours until he died. (they said, Oh we can keep him alive until then ) Its the same hospice care anywhere in the USA. That is what they do. Want to hear more I sure can give them to you.
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Fernando, thank you. at the end of life they are not suffering because their body is shuting down on its own. With my friend she was afraid. She was crying for God to help her. All they had to do was medicate and let her sleep. Even if it took a couple of days for her to die. But like I said, hospice wasn't going to let her go past 9:30." and she didn't
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i was thinkin about mom 20 yrs ago , she was dyin of cancer . i rembered they gave her morphine and she still would feel the pain , you could hear her cry and dr would increase her morphine and then she would be quite and comfertabel then u could hear her cry in pain . he would up it again and again till she was gone .
my mom was in a hellva pain that nobody could ever dream of . it was eating her alive . so by all means yes morphine killed her but she was nt hurting , and died in peace . bless her heart .....
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lhardebeck, Yes hon I do know, sorry about your mom, they suffer like nothing else. Cancer is the worse pain a person can have. That is what I was told. My dad had cancer of the sinuses. A big round spot came out in the corner of his eye. It got so big it was pushing his eye out some. But it went through his whole body. After a while he couldn't walk or stand. His bowls stop moving and it had to be dug out but the doctor. I took care of him and it was so hurtful to see him go throught that. All because of smoking. Sad isn't it?
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My dad is fading also and is on Ativan, but it also makes him even more drowsy. He is also on diaylsis and now the n.h. has put him on Risperdol. I wonder if this is too much medication. I know he is on it because he gets agitated and sad :( I'm wondering if it's time to call in Hospice? He seems like we are going to lose him and then he seems to perk up.
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I visited my mother today and the nurse was having to feed her supper. She did not have the strength to even notice the cermanic bunny that I brought her nor did she have any energy to speak. The only thing she said for the whole 40 minutes of my visit was 'when will it be over?" I asked if she meant her back taxes and she said yes. I told her we were working on 2006 and that 2007-2008 should all be done by the end of February. I asked her if she was worried about it and she said no. I told her several times tonight that I loved her as I was getting ready to leave, but she never replied which is not like her at all. She just keeps getting quieter and quieter, sleeps more and more, and has to be hand fed more and more. I'm going to ask the nursing home doctor to check in on her. To me it appears that she's giving up just like her mother did and now even moreso.
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snowbound, call the drug store they will tell you.
Take them out and see if there is a big change. It could be depression along with drugs. They drug them to keep them that way. Also they may not be happy where they are. NH - If I was put in one that is how I would feel, I would want to die. No family around and that would make me depressed
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