I don't think mom will ever walk again, or will she?

Hi Weary, So sorry about Mom. I think Mom has had a lot happen to her in a short time. Pneumonia is serious in the elderly as is a broken hip. Her going under for the surgery can have longterm effects. Both the Pneumonia and the anesthetic will effect her dementia. She just has a lot going on. I agree, I would get a Hospice consult. If they feel its not needed at this point, see if you can get in home therapy.

Enjoy your Holiday with your family.

Weary, consider asking for a hospice evaluation.

It seems possible that mom's latest fall might have also involved a stroke. Even if an initial CAT scan or MRI was done at the time and showed nothing, our experience was that sometimes evidence of a strokes shows up later.

Do you have a wheelchair for mom?

weary,

I read your initial post and your kind response to others in the group.

I came back to your post because I wrote out a response last evening, soon after you'd posted and twice, my PC crashed. Here goes.

I feel that it's still fairly early days for her mentation to improve after the UTI and she's still in a whirl after so many medical events in a short period of time; she hasn't had time to adjust and the cognitive bandwidth is limited with dementia, as you know. Doubtless, your mom is depressed and she may be willingly giving up, she may also be fearful of positional changes, esp trying to walk due to the hip (maybe some lingering pain), advancing diabetic neuropathy, and the impacts of the antibiotics (ABX) which cause dizziness in some people. It may be too soon to know if this bedridden status is her new normal.

Hopefully, your mom is still willing to drink a lot of fluids to flush her body of bacterial die off and is also eating adequately for healing that hip. If her willingness to consume nutrition is declining, that's a sign of her having made a deep. inner decision to let go and withdraw herself from this ole' life.

I was encouraging my 88 yr old Mom, in a MC unit, to accept her glaucoma eye drops 'so she could retain her vision and be able to see clearly.' She once responded by saying: "I don't want to see clearly." And that was that for me; she has chosen to diminish her physical functions because quality of life is not what she needs to keep her engaged. She's still walking and I watch her diminishing muscle memory and muscle mass loss and I worry about her first serious fall; I know it's inevitable.

All we can do is love them as they are and honor their willfulness because it's their choice, their life. That withdrawal is a deeply embedded decision and there's no encouraging them out of it.

My Mom is deeply depressed, has lived with most all of her life and it's understandably worsened with her many life losses and the advancing dementia. She lives for my and my family's visits and our daily phone calls; we share deep and abiding love and family bonds, as I'm sure you and your mom do.

I'm not a proponent of medicating the elderly unless for pain or mildly for anxiety. Instead, I keep up with having labs drawn for Mom and supply her with high grade supplements, what I can get the APN (Dr. in charge is a dweeb) to order for her. Our family uses daily liquid MTV/ mineral called Passion 4 Life and I also provide food-sourced vita D3, B12, bio-available magnesium, psyllium husk for binding metabolic toxins in the gut, and a spendy probiotic. The one we use is MegaSpore and it's so strong that it has to started slow - as it knocks out bad gut bacteria - and worked up to a daily capsule. (A'zon sourced.) I'm a believer in the gut-brain axis for alleviating depression and it allows me the sense of doing something for her.

I'm sorry that your mom has experienced such rapid decline and there's no knowing if she'll come out of it and try again. I trust that you fully understand her wishes if not prolonging life is her choice and won't have to make the independent decision on a feeding tube, etc. I have Mom's Advance Directives and deep discussions on late life and end of life care so, I know what decision I'll make when that time comes.

I wish you all the best moving forward, and please make the holiday season one of celebration of the many good years you and your mom have known.

After dad broke his hip at 90, it was repaired in the hospital (not replaced), and he went to rehab but made little progress in walking again. He too went into a wheelchair afterward and never really walked again, but stayed OUT of bed. He did pass 10 months later; turned out, he had a brain tumor that was causing his issues and inability to walk, and that's what led to his death. It showed up on an MRI when he'd fallen and broken his hip originally b/c he'd also hit his head so they did a head MRI too.

Home hospice sounds like a good idea Weary. Sending you a hug and a prayer for strength & peace as you walk this journey with mom.

((hugs))
This is a place she was going to reach sooner or later even without all the things that have zapped her strength, and I am doubtful that she can ever regain her ability to walk again after so much time has passed. Rather than pushing rehab exercises to keep her walking I would focus instead on her being able to at least bear weight long enough to stand and pivot; this will allow you to get her into a wheelchair, onto the commode/toilet and onto a transfer bench for showers. Just getting her up and moving every day will greatly increase her quality of life and reduce the care burden.

Thank you Sadinroanokeva (Im sad too), ZippyZee, 97yroldmom, Lealonnie1, Fawnby for sharing your thoughts and experiences.....I will draw strength from all you courageous and patient caregivers as this horrible journey worsens. In my diary, I've highlighted the last day mom walked and it just kills me to see that.

Anyway, I will ask the Dr to write a script for home hospice then - the hospital nurse practitioner at the hospital said won't qualify for hospital hospice since mom's vital signs are ok. I'm going to increase aide help for another 2 hoursr/day who will move her from the hospital bed to wheelchair & back. I cannot afford more aide help/facility since Mom won't qualify for Medicare/Medicaid for another 2 years.

Yes bedridden is most likely what is ahead. There is evidence that after a hip break/repair most advanced elderly live less than 5 years. Sad but true. So sorry…perhaps a facility makes sense now.

Sounds like it's nursing home time.

Dementia is not the same in everyone. As much as we would like to see into the future there are always surprises. Overall your mom has been in decline and eventually her time will come.
DH aunt,96, goes back on hospice tomorrow. She has been on rehab since the week after thanksgiving. She has been increasingly bed-bound for the last year. She had speech, ot and pt. Complaining bitterly about each.
Amazingly I received a text from her therapist one day saying she was on the parallel bars with an excellent attitude. Most days she totally refused, said she would get up when she wanted to.
For her, the best part of going back on hospice is her long time CNA (with hospice) will be back. This CNA gets her out of bed for a shower and will then have her up in her wheelchair for a good portion of the day. Lying in bed all day leaves her more susceptible for pneumonia and bedsores. So I’m hoping she will return to that routine of sitting up but after having been separated from her CNA for so long, hard to know.

On the other hand, my 87 yr old uncle, fell in late October. His hospice nurse was visiting when he threw up blood and the nurse encouraged my cousin to take him to the ER. Over the next two months he was in three hospitals, a rehab and then a private care home. Cousin was not able to handle him alone anymore and needed help. She would pick him up and take him to the senior center he enjoyed going to for lunch. He seemed to be doing well. He was sitting holding hands with a lady friend at the senior center on Friday, the 16th. They made a date for her to come play cards on the next Monday. The following day after having a good breakfast and lunch, he was taking a nap. The aide went in to change him and as she was helping him turn over, the aide heard a soft gasp and he was gone.
We can’t help but wonder how long they will live and probably the most accurate answer in the big picture is … not long…but in the moment we have to take one day at a time.

It can be really hard to get a dementia patient to toe the line with PT and/or to realize the importance of staying mobile and out of bed. My mom went into a wheelchair after a hospitalization with pneumonia at which time her dementia worsened as well. It was bad neuropathy that forced her into a wheelchair that I was able to ward off for as long as possible. Once she went into the wheelchair, she refused pt from then on and made excuses for why she was too tired or couldn't do it. Nothing would sway her, either, so we gave up.

I'd say you should insist mom at least get into a wheel chair and use her arms and legs to propel herself around, if such a thing is possible in your home. Keep her out of bed during the day and for meals, etc. The likelihood of her living with dementia for 10 more years is slim, especially if it's vascular dementia which has about a 5 yr life expectancy to it. My mother lasted about 6 yrs after she was diagnosed, but she had dementia a couple yrs before then. Your mother seems to be on a downward spiral lately, which also happens sometimes with dementia, so that can signal her life expectancy is shorter than you realize. Mom was on a pretty steep downward spiral for a year before she passed. I'm not sure if your mom is Medicare approved yet, but if so, look into a hospice evaluation now.

I know how difficult this journey truly is, and the wondering what's coming next is so hard. My heart hurts for all you've been thru and have yet to endure. Stay connected to support, get rest and respite as you can, and stay strong. All the best of luck.

Bribing, cajoling, none of that works. Her dementia keeps her from comprehending or understanding the consequences. I suggest you call hospice and ask for an evaluation, which might give you clues as to what to expect.