Did I do the right thing?
Mom's been see-sawing with her congestive heart failure between dehydration and fluid overload for a year. I've learned to recognize it and adjust her meds. Two weeks ago, she was on fluid overload, so I did what the doctor did last time: doubled up on her diuretics for three days. And even though she wasn't "unswollen" (her legs/feet are the first to show), I stopped the doubling. In a day or so, she was "normal." I talked to the doctor shortly after, and he said I did exactly what he would have prescribed. "Good job."
Three or four days later? She was starting to get dehydrated. I waited a day or so to see if she'd stabilize. She didn't. So, for the last seven days, I've cut her diuretic in half. (One day, to only 25%.) I talked to the doctor today, and he said to hold her diuretics 'til Monday and eat bananas and raisins.
I asked, "Do you think mom is ready for Hospice?" He said, "If she's see-sawing back-and-forth so rapidly, she may be." He's having the hospice center he works with call to make an appointment to evaluate mom.
I'm a pragmatist. For myself? If in my right mind? I'd have been on Hospice long ago. When I'm making the decision for mom? It's a completely different story.
Mom has Congestive Heart Failure, mild (not so mild some days) Parkinson's Disease and moderate dementia. She's gotten so she doesn't remember to put one foot in front of the other half the time when I walk her with a gait belt. Or...she doesn't remember to push her walker.
Still? She has some good days. Fortunately, she isn't aware of the shape she's in, and, of course, I never remind her.
Am I doing the right thing?
It is what it is. I'm not sure what her interpretation of the word would be. She's a lil' country girl. That's also a good point. I think if you asked mom, "Do you want to go the hospital if you get sick? Do you want extraordinary measures taken if you stop breathing?" And some other kinds of questions like these describing the care? She might simply say, "I don't want to die." Who does?
What is your mother's current understanding of hospice? Will she consider that it means she is dying? Since she doesn't want to hear that message, would she be receptive to hearing a different description that is also true, but less direct?
I've brought her back from the edge twice: once when she first came to live with us when she was over-medicated thanks to once-every-six-month doctor visits and her dementia. The second time in the nursing home when I demanded they hold her diuretics until I'd spoken with her doctor. (They refused to hold them until I made it clear they were in trouble if they didn't.)
To what end, I ask myself. She's since had a 3" x 5" open wound for a couple months waiting for a skin graft. I don't have to tell you how painful the twice daily dressings were for her. Then a painful donor site. Then a broken hip.
Life is hard. Death is harder. I guess . . .
I'm sorry you lost your daughter. I didn't know that. My late husband lost his 2-year-old son to SIDS. We married 15 years later. He never got over it. Ever.
Pam, mom always told me, "Don't ever tell me if I'm going to die. I don't want to know." I'm sure she still feels that way. How do you respond to me knowing her wishes? I don't want to short-stop Hospice and yet . . .
Pam is right... Hospice takes over and everything goes through them. That alone scared me with my dad. In the long/very short run it was the right thing and they helped us out so much.
You'll know what to do...