My mother is in end stage Alzheimer's and has been in a wonderful facility which includes hospice care for the past 8 years. In the last 2 years, any awareness she exhibits is for a split second. She has been hand fed pureed food and liquids for the past year, and was consuming 40% of her meals, although lately she has had a little difficulty swallowing. This past week she has been unable (or unwilling) to swallow food or liquid at all, and we started her on IV fluids 3 days ago to keep her hydrated as it may be temporary. We will not be inserting a feeding tube. I'm reading that continuing hydration makes the patient more uncomfortable and can lead to more complications if their body is indeed trying to shut down. Should we make a decision to remove the IV and let things proceed naturally and at what point should we do so? We assumed we would continue, but are realizing now it is a choice.
IV hydration can be detrimental to someone with dementia if their body is beginning to shut down and the lack of fluid intake is part of that. The fluids can build up and get into the lungs. Someone with advanced dementia can always pull the tube out as well.
I wonder if it was the nursing home or the hospice that put in the IV? I would be surprised if it was the hospice.
Difficulty swallowing can be made much more difficult if the mouth and throat are dry.
Stay in close touch with your hospice nurse, he/she will be able to assess the patient and depending on how close to death she appears to see advise on appropriate treatment. This is the most difficult time for family members so support each other and do what is best for the patients comfort and set aside the desire to keep her longer.
He passed peacefully 45 minutes into the New Year. Those 2 IV's kept him going for a day.