My mom is 91. She has CHF. In 2013, stroke with sequelae of vascular dementia, some aphasia. Broken hip in Aug 2013, walks with a walker. In nh since sept 2013. Fell in June; while in hospital, heart rate could not be maintained, so we asked her if she'd agree to a pacemaker and she said yes. Since then, she's had an almost constant pneumonia/pleural effusion. Several rounds of antibiotics did not clear the pneumonia. She fell on thursday at the nh; in the er, her o2 sat dropped and they wanted to intubate. She has a dnr and dni.She was put on a bi-pap. They tapped her chest and got a litre and a half of fluid which came back okay from culture, still waiting path report. Had sepsis with a white count of 19000. Better ttodat 13,500. She has a compression fracture of her spine (one doc says old, one doc says new). In addition to her bp and heart meds she's on antidepressants and anti anxiety meds. And now morphine qid for pain plus lidocaine pain. Her legs are contracted because she hasn't been walking much at nh due to shortness of breath (due to pleural effusion). When do you say enough and stop transporting to hospital? Sorry if I'm rambling, I haven't had a lot of sleep! A couple of weeks ago my brother and I asked th he hospice question of the nh folks at our care meeting...they seemed shocked.
I formally put her on palliative care a month ago. (Really, she's been on that for quite some time since I've turned down many procedures and tests for her over the last two years.)
In my opinion, from what you've said here, it's time to ask her doctor if he thinks it's appropriate and go with his recommendation. I think we both have a good idea what he'll say...
I'm sorry, Ba8alou.
NH is jail . it might be the only care available for most people and the best care available but its still jail if you cant leave ..
And Bob, yes, maybe NH is jail. But if my mom were in my 900 sq ft apt in Brooklyn with hubby and me, she wouldn't be able to leave THAT either. As I've posted elsewhere, my grandma lived with us for many years after a broken hip and eventually died of gangrene, after pneumonia, being bedridden, poor circulation, etc. We made a very conscious choice to have mom cared for by professionals and it's been what it's been...better than everyone resenting grandma. Better that mom has autonomy to make choices about meals, when and how she gets bathed, activities when she wants to go. And when yesterday she thought her toe was gangrenous, I pulled in a wound care specialist to say it wasn't. That was a good feeling.
i try to be an asset to NH staff when im there . they are in charge , i just want to contribute in small ways .