My Mom's Advanced Heart Failure

[Katsmeow]

This thread is mostly about expressing my frustration at finding it so hard to get clarity on my mom's prognosis. Specifically, how close it is to the end and what to expect. (apologize for the length but a lot has happened the last 2 months). I do have my mom's health care POA and the rehab she is in will talk to me.

My mom is 94 and has advanced heart failure, as well as Type II diabetes and kidney disease. Despite having all these problems for years, she was actually doing pretty well until a couple of months ago. She was living on her own. She has no dementia and was doing everything for herself. Through the years we have asked her to move in with us many, many, many times but she always refused. She liked her independence and said she wouldn't do it until she had to. During all these years, I've lived about 250 miles from her.

A little over a month ago, we sold our house and moved to her area (not so much because of her specifically -- we have other family/friends in the area as well). We are in a short term apartment rental while waiting to close on the house we have under contract.

During the past several years, my mom's heart failure has given her few problems. She had some swelling of her feet and exertion would tire her. She walked slowly, but that was all. The diabetes took most of the effort in her health management.

About 2 months ago, she went to the ER due to shortness of breath. She was hospitalized for several days then went to rehab for 2 weeks. All of this was before we moved here. I saw her in the hospital and rehab a couple of times during visits. About the time we moved here, she was discharged home from rehab. For the first time, she was using oxygen. She had home health care coming 3 times a week.

Two days after she arrived home we went to visit her and found her on the floor in her kitchen. She had gotten dizzy due to low blood sugar and had fallen. She didn't break anything but couldn't get up (too weak). I called 911 and she went back to the ER. They got her blood sugar up but kept her there because she was too weak to get up or to walk. After a few days in the hospital, she went to a different rehab. That was about a month ago. She is still there. They are saying she will be discharged soon (not so much because they think she is ready but they think Medicare will turf her out).

Before she went to the rehab, her regular doctor called me. She said that my mom is in a slowly declining condition. She says it isn't a fast decline. It could become fast if she got an infection or something else happened. She didn't think my mom would get back to where she was before she was hospitalized. But, she felt she might be able to improve enough in rehab to come live with me. If not, she would need to go to a nursing home.

I asked her where she saw this all going. She was somewhat helpful. She said she hated the question because it is so difficult to know for sure. She did say that if my mom didn't improve then hospice was an option. She also said that she wasn't sure if my mom could handle "aggressive physical therapy" and that she might need or want palliative care. She said that if my mom went to rehab the doctor there could order palliative care if she wanted it. She did feel my mom might improve to be mobile enough to live with us but she didn't think my mom should live at home. She eventually more or less said that she expected my mom to live 6 months to a year although it could be less if she got an infection or something else occurred. And, it could potentially be more if she improved.

I don't know if any of this was discussed with my mom. i don't think it was (I think the part about her living situation was but not the prognosis/hospice/palliative care part). My mom does know that her heart failure isn't curable.

That conversation was at least helpful. Since then, it has been frustrating to try to figure out her current prognosis. She started out doing fairly well at rehab. She did therapy and went from being able to walk 10 feet to walking 160 feet (with the walker). On the other hand, she has had almost no appetite and refuses to eat meat (her doctor had said one of the reasons she wasn't getting stronger was because of not eating enough protein). Also, she still has a lot of swelling. She has gained 6 pounds which is clearly all fluid as she is barely eating.

About 2 weeks in, she got a mild case of pneumonia. On the one hand, it was a very mild case and she was recovered from it. On the other hand, since she got it she has become much weaker. Before the pneumonia she was spending most of the day sitting up in a recliner. Now, she stays in bed the entire day except when she goes to therapy or the bathroom.

She still wanted, though, to go home. The facility did a home evaluation today and recommended against her going home alone. She finally acquiesced to moving in with us "until she gets stronger." It is fairly clear she won't get stronger. She actually moves fairly well with her walker when she gets up. But, she has a lot of trouble getting up. Also, sometimes she can't get her feet up on the bed (not enough strength). Other days she can.

I can't seem to get any clear information about, well, where this is going with her. I mean, I know that she won't survive this. But, I'm not sure if the 6 months to a year is still operative or if she is declining more rapidly. And, I'm not sure how to find out. There are a couple of nurse practitioners who come by each day and check her. There is supposedly a physician who sometimes comes by but I haven't seen him. Whenever a nurse practitioner has come by my mom is always there. I honestly don't think she realizes how dire her situation really is.

Yesterday, I called my mom on the phone and she asked me to call back later. She told me later that she had been too weak to talk to me. She says everything tires her even brushing her teeth. That was the day she agreed to temporarily move in with us.

I am uncertain whether palliative care should be considered at this point. Basically I don't want my mom to be made uncomfortable with attempts at therapy or trying to get her to eat if she is beyond the point of any of it helping her. At the same time, I don't want to assume that she is beyond that point if she isn't. I know she is starting to get very tired.

If she was being treated by her regular doctor (who has seen her for the last few years) I would talk to her. But, in the rehab situation with someone who does a cursory check each day (and it varies who does it each day) it is harder to find out information. I do have the number of the nursing director. She came in my mom's room once to talk about her discharge plans (at that time my mom was still wanting to go home alone). So, I could call her.

In a sense I'm not really sure what to ask. I guess I want to know what is expected to happen and when and see if that affects what my mom should be doing going forward. But, I'm having a hard time figuring out who to ask (if anyone). I had that good conversation with her doctor which did help, but since then there has been nothing so I don't know if that timeline is still operative.

I remember when my dad died. He was in the hospital for months before he died. In retrospect, it is obvious that he was dying. But, it was never discussed at the time. He was never in hospice. When he went from being treated to being dead 3 days later, it was a big shock. Looking back on it, I think that could have all been handled much better but he was on that treadmill of treatment and I don't think anything else was every even discussed.

 

[swakyaby]

Katsmeow,
I’m so sorry you are going through this. These are very tough times, heartbreaking, and full of uncertainty. I think your mom’s primary care doctor explained as much as she could, in as sensitive a manner as family need to hear. When someone is in a slow decline, it’s often unpredictable how much longer she has. She’ll seem to be doing fair, then suddenly becomes weak or dizzy or disoriented, and declines further. The weakness and fatigue is often a sign of worsening congestive heart failure, if things like infection or low blood sugar have been ruled out. Her doctor probably brought up palliative care, and hospice as a prelude to the discussion of DNR (do not resuscitate). It’s hard to know just how long an ailing family member has; it’s probably one of the most difficult discussions primary care doctors have with family members because of its uncertainty. It does sound like she has less than a year in her current state. But life is funny in that the will to live upsets all predictions. I’m sorry that I’m kind of rambling; I keep thinking of my own experience with my departed father. I have no answers; but I do understand your pain.

 

[MichaelB]

katsmeow, sorry to hear about this. It is a very difficult situation.

You might consider asking a for an assessment by a hospice physician. Their determination of eligibility should help address your questions about the course of your mother’s health. It might also give you a clearer idea of what the next steps could be with her care.

 

[Bamaman]

Times can be so difficult when a parent or loved one is in the final stages of life. We went through what you're experiencing with my mother and later with my aunt.

Mom was in a high line retirement community with 24/7 helpers watching over her. My sister essentially gave up 5 years of her life managing her healthcare, and she is yet to recover mentally from the ordeal.

My mother's sister was first in assisted living and later in full nursing home care. She was well taken care of and actually happier there than she had been in years. She had dementia the last 8 years of life but was otherwise healthy until the very end. We lost her 3 months shy of 100.

It sounds as if your mother would be better served being in full nursing home care. We as their children naturally think that we can better care for them at home, but that is seldom the case. End of life care is best left to the professionals that are equipped to handle such situations.

Just rest assured that you have been a good daughter and well cared for your mother. Don't forget that someone must also go in and break down loved one's households and liquidate possessions which can be overwhelming physically and mentally. You need to save your strength for that ordeal.

 

[braumeister]

You might consider asking a for an assessment by a hospice physician. Their determination of eligibility should help address your questions about the course of your mother’s health. It might also give you a clearer idea of what the next steps could be with her care.

+1
This could be very helpful.

 

[Scrapr]

+1
This could be very helpful.

agreed. My FIL died at home last year. Congestive heart failure. The hospice was fantastic. It took a very hard push to get him in the hospice program. But once there they were caring and empathetic. They have a counselor for the family too. Leo was in some serious pain and they helped a lot to manage that. There are some pamplets by Barbara Karnes that are very helpful on end of life

Dad is in memory care and on hospice now too. I don't have any opinion on nursing home vs at home. Just that when Leo was at home we were able to grieve his death over about 2 weeks and say our good byes

Good luck and God bless

 

[MRG]

There are some pamplets by Barbara Karnes that are very helpful on end of life.

Good luck and God bless

+1
Some of her stuff really helped and documented the process.

I'm sorry what your family is going through. My DM passed of CHF. She was OK until a respiratory infection caused her end.

 

[ERD50]

katsmeow, sorry to hear about this. It is a very difficult situation.

You might consider asking a for an assessment by a hospice physician. Their determination of eligibility should help address your questions about the course of your mother’s health. It might also give you a clearer idea of what the next steps could be with her care.

Agree to this as well. The path is just not all that predictable, I imagine the doctor is telling you what she can. But the hospice people are routinely seeing this carried out to the end, so their assessment could be valuable.

A word on hospice providers - our families have had good and terrible experiences. With my Mom, the hospital was 'pushing' the organization that DW's family had a bad experience with, but I figured each separate group could be different. But when we talked with them, we got the same feeling that they were incompetent at everything, including communication.

So I talked to the head nurse at DM's assisted living place, and the nurse had a definite positive opinion of a different hospice group. We met with that hospice group, and it was night and day - easy to talk to, they explained what they would/could do, and they made sure it got done.

I'm sure this varies by location, so ask around, and I suspect some hospitals sort of default to a particular group, and that group may or may not be best. Try asking at some Assisted Living facilities.

Good luck with everything, I know how hard this can be - you see some progress and comfort one day, then they are back in the ER the next.

It's tough on everyone, take care of yourself as well.

-ERD50

 

[braumeister]

You might look to see if there is a palliative care nurse available to talk to. I found one who was a great help to me for my mom, including some good unbiased opinions about available hospice resources.

 

[Bestwifeever]

Since you seem to have a good relationship and respect your mother's regular doctor, I would call her and tell her your concerns and what has been going on medically with your mother and ask if she thinks her prognosis of two months ago (? can't tell where on your timeline you were told this: "She eventually more or less said that she expected my mom to live 6 months to a year although it could be less if she got an infection or something else occurred. And, it could potentially be more if she improved.") is still valid. She might advise you about hospice and palliative care vs other treatment.

 

[JoeWras]

I'm so sorry. My Dad passed from heart failure. We got so little information about this until hospice got involved.

The doctors just wanted to keep putting him in the hospital on lasix. It became madness. Dad finally said enough. And then hospice helped us get him out so he could come home, and have a few days and then slip away.

I'll never forget the most cold-hearted thing I ever heard from a medical professional when we took him out of the care of the hospital resident. He said: "I am a doctor of the living, not death." He implied we were taking him to hospice for a euthanasia.

Sure doc. Let's keep him living a few more months in your hell hole hooked up to a lasix drip. Right...

Hospice was of our choosing and not the hospital's. They were wonderful.

 

[ERD50]

...

I'll never forget the most cold-hearted thing I ever heard from a medical professional when we took him out of the care of the hospital resident. He said: "I am a doctor of the living, not death." He implied we were taking him to hospice for a euthanasia.

Sure doc. Let's keep him living a few more months in your hell hole hooked up to a lasix drip. Right...

Hospice was of our choosing and not the hospital's. They were wonderful.

When we were in the process of arranging hospice care for my FIL, it seemed that all the many doctors made sure they got in another chargeable visit. I recall the "kidney doctor" stopping in and telling us about how well his kidneys were doing at that stage. We were all thinking, "what difference does it make, he is dying, don't you have better things to do?". It sure seemed like a money grab to us.

-ERD50

 

[JoeWras]

It sure seemed like a money grab to us.

-ERD50

+1

 

[HFWR]

I'll never forget the most cold-hearted thing I ever heard from a medical professional when we took him out of the care of the hospital resident. He said: "I am a doctor of the living, not death." He implied we were taking him to hospice for a euthanasia.

At that point I’d have shoved his stethoscope up his ...

 

[LOL!]

My mom died of congestive heart failure in her sleep at home. She had been in and out of hospital a couple of times and knew the end was near. She was sharp as a tack to the end, too, and had already gotten rid of all her junk and distributed to her kids any items that were wanted by them.

There was nothing anybody could do except try to make her comfortable the last couple of months of her life.

 

[Moemg]

So sorry for your troubles . We can never predict when our parent swill die especially when they are on a slow decline . My Mom was just like your Mom 's situation .She would have good days and bad days . Eventually a severe pain landed her in the hospital and she passed away a week later . We did have palliative care and then hospice for six months before she died . They were great. Two weeks before my Mom died she went to a St. Paddy's day party so you can never predict when someone will die .

 

[W2R]

Katsmeow, I am truly sorry to read that you are going through this. TBH I do not know what advantages or disadvantages would ensue from putting her in hospice or not at such an advanced age. Others will have more to say about that.

Right now, IMO, it is very important to spend time with your mother, say everything to her you need to say, and appreciate these last few months or years that she may have left. This is probably more important than getting an accurate prediction of when she will pass away.

My suggestion is to make sure that when she is gone, you will not be thinking, "oh, I wish I had told her (…)", or "oh, I should have asked her about (…)" or "did she really understand that I forgave her for (…) and love her so much", or whatever. Or at least not as much.

Also, spending a lot of time with her will help you to know if she is comfortable, happy, and at peace at this time in her life. That may help to guide you in decisions concerning her care.

 

[MBAustin]

Since you seem to have a good relationship and respect your mother's regular doctor, I would call her and tell her your concerns and what has been going on medically with your mother and ask if she thinks her prognosis of two months ago (? can't tell where on your timeline you were told this: "She eventually more or less said that she expected my mom to live 6 months to a year although it could be less if she got an infection or something else occurred. And, it could potentially be more if she improved.") is still valid. She might advise you about hospice and palliative care vs other treatment.

I think this is a good next step. I would also ask her for recommendations for a palliative care or hospice evaluation.

It's also important to have a conversation with your mother (ideally with a trusted medical professional present) about what she wants. Are there events coming up that she wants to be around for (a wedding or graduation, etc.)? Are there things she still wants to accomplish (even if it's finishing a knitting project)? Or is she interested in spending the time she has left comfortable and at home with you?

If you haven't read it, get Being Mortal by Atul Gawande - it is not a difficult read and addresses these issues very well.

I was fortunate that when my mother developed breathing problems after having been in a nursing home for a couple of months, she made it very clear what her wishes were. When her doctor asked "Should we take you to the hospital to check this out?" she sat up in bed and said firmly "Hell, no!". So we called hospice and she died comfortably 3 days later.

Blessings on you and your family in this difficult time.

 

[ExFlyBoy5]

I can certainly sympathize with you. My Mom died in 2013 after being enrolled in "at home" hospice (dementia and COPD) and now my Dad (at the age of 90) I am afraid is getting close to needing the same care (also has COPD).

I would definitely consider getting a hospice provider involved, as they can do an evaluation in a relatively short order...and if she doesn't quite meet the Medicare requirements today, when she does get to that point, it will much easier to get her enrolled and get the benefit that will help her AND YOU. This was the case with my Mom...when initially referred, she didn't quite qualify, but they were able to help out in the palliative sense. Within a couple of months, she did qualify and at that point, it was all "turn key".

Just this AM, I had to go over to my Dad's (he's about 10 minutes away and lives by himself..and yes, he refuses to move in with us) when he hadn't gotten up at his normal time and wasn't answering the phone. He was indeed still sound asleep in his bed (the latest he's been in bed in 50+ years as far was we could tell) but was OK. Needless to say, it was a stressful morning.

I also feel your pain dealing with the MD's. Dad has a pulmonolgist, a cardiologist and a GP...and he has been chasing his tail for months. It's aggravating as hell, especially with conflicting (and often WRONG) information.

If you haven't read it, get Being Mortal by Atul Gawande - it is not a difficult read and addresses these issues very well.

He also did a PBS Frontline show on this book. It's somewhat depressing, but does an EXCELLENT job of showing how physicians are terrible at dealing with end-of-life situations.

https://www.pbs.org/wgbh/frontline/film/being-mortal/

 

[braumeister]

It's somewhat depressing, but does an EXCELLENT job of showing how physicians are terrible at dealing with end-of-life situations.

Lots of horror stories out there, which make you appreciate the good ones all the more.

When my mom was at the end, her memory care unit sent her to the ER when she was found unresponsive. They called me at the same time, and I got to the ER about 30 minutes after she did. I feared the worst when I talked with the attending ER physician.

He put his hand on my shoulder and said "I've already checked her chart and I saw that she has a DNR order. Unless you want us to, we won't do anything but keep her comfortable and pain free. Does that make sense to you?"

I could have hugged the guy. Mom died peacefully two days later. The hospital wasn't especially crowded, so they gave her a private room so I could visit, and the morphine she needed. The nurses were really great.

 

[Katsmeow]

Thanks, everyone.

I did call and talk to the nursing director to see what her take was on all this. She agrees my mom is declining. She says that my mom is not motivated to do very much. She does go to therapy and works there but mostly stays in bed the rest of the time. She says that one reason my mom has so much fluid on her legs is because she doesn't move around much. She feels moving around is the only thing that at the this point would help with the fluid.

I did tell her what my mom's outside doctor had said a month ago. She said that she didn't feel that right now my mom needed hospice. She doesn't feel her decline is that rapid. That said, she doesn't think my mom is getting back to where she was. She also said that we should expect more bouts of pneumonia due to fluid on her lungs.

Then, at a later point in the conversation I mentioned my mom saying that she feels tired all the time and that even brushing her teeth tires her. She then said that hospice could help with that, even if my mom was not totally at end of life stage. She said she could give me names of hospice providers who could evaluate her and that they could help given my mom's diagnosis.

I told her that I don't think this has been suggested to my mom at all and that mom still basically thinks she will get back to where she was a few months ago. I don't think that she would take kindly at all to me mentioning her having an evaluation for either hospice or palliative care. I think my mom would see that as me giving up.

On the one hand my mother does have an advanced directive. And, I know she feels very fatigued and isn't highly motivated to try to move around much. And, she won't eat protein even though she has been told that it will help her with her strength. She gives every sign of simply being tired of the fight and not having it in her to continue it. And, honestly, I can understand that. If you are exhausted and every movement is an ordeal and food tastes like straw (which is what she says) then I can see just not wanting to do any of it, particularly if you know that what you have isn't curable.

At the same, though, my mom has always been one to like to avoid facts she doesn't like. You can tell her X which is a verifiable fact. She will says she understands. But, then she will do something that requires the fact to be Y. That is, she doesn't like X being a fact so she will ignore it for what she wants the fact to be.

So - my mom wants to believe that she can get back to where she was living alone and driving her car. I am not sure she can face up to that not being possible. I think that doing a hospice evaluation would be difficult for her to accept. Yes, I know that people can be hospice and live for a long time -- DH's mom lived 8 years after first entering hospice. But, I think my mom wouldn't see it that way and would resent me if I even raised the subject.

A few years ago her sister was in the hospital having developed poor health over a period of a few months. When the hospital basically said she was going to die soon, she immediately entered hospice and died a few days later. But, I don't think my mom ever understand she did it. I think part of it is that my mom doesn't like to think of death (she is exceedingly fearful of pain) and so doesn't want to do anything that would cause her to think about it even if it would reduce the possibility of pain.

Oh-- about the book Being Mortal. I have read that book and it is a wonderful book.

 

[ExFlyBoy5]

Thanks, everyone.

I did call and talk to the nursing director to see what her take was on all this. She agrees my mom is declining. She says that my mom is not motivated to do very much. She does go to therapy and works there but mostly stays in bed the rest of the time. She says that one reason my mom has so much fluid on her legs is because she doesn't move around much. She feels moving around is the only thing that at the this point would help with the fluid.

I did tell her what my mom's outside doctor had said a month ago. She said that she didn't feel that right now my mom needed hospice. She doesn't feel her decline is that rapid. That said, she doesn't think my mom is getting back to where she was. She also said that we should expect more bouts of pneumonia due to fluid on her lungs.

Then, at a later point in the conversation I mentioned my mom saying that she feels tired all the time and that even brushing her teeth tires her. She then said that hospice could help with that, even if my mom was not totally at end of life stage. She said she could give me names of hospice providers who could evaluate her and that they could help given my mom's diagnosis.

I told her that I don't think this has been suggested to my mom at all and that mom still basically thinks she will get back to where she was a few months ago. I don't think that she would take kindly at all to me mentioning her having an evaluation for either hospice or palliative care. I think my mom would see that as me giving up.

On the one hand my mother does have an advanced directive. And, I know she feels very fatigued and isn't highly motivated to try to move around much. And, she won't eat protein even though she has been told that it will help her with her strength. She gives every sign of simply being tired of the fight and not having it in her to continue it. And, honestly, I can understand that. If you are exhausted and every movement is an ordeal and food tastes like straw (which is what she says) then I can see just not wanting to do any of it, particularly if you know that what you have isn't curable.

At the same, though, my mom has always been one to like to avoid facts she doesn't like. You can tell her X which is a verifiable fact. She will says she understands. But, then she will do something that requires the fact to be Y. That is, she doesn't like X being a fact so she will ignore it for what she wants the fact to be.

So - my mom wants to believe that she can get back to where she was living alone and driving her car. I am not sure she can face up to that not being possible. I think that doing a hospice evaluation would be difficult for her to accept. Yes, I know that people can be hospice and live for a long time -- DH's mom lived 8 years after first entering hospice. But, I think my mom wouldn't see it that way and would resent me if I even raised the subject.

A few years ago her sister was in the hospital having developed poor health over a period of a few months. When the hospital basically said she was going to die soon, she immediately entered hospice and died a few days later. But, I don't think my mom ever understand she did it. I think part of it is that my mom doesn't like to think of death (she is exceedingly fearful of pain) and so doesn't want to do anything that would cause her to think about it even if it would reduce the possibility of pain.

Oh-- about the book Being Mortal. I have read that book and it is a wonderful book.

Some physicians are hesitant to call in a hospice referral because of the medicare requirement of "a terminal illness that would expected to run the normal course within 6 months"...and 6 months is key. There are lots and lots and lots of scientific articles out there that deal with this. In recent years, hospices have been getting "in trouble" for admitting patients that were clinically suitable. If a provider has a patient for 2 months, it will be less profitable for them than if it runs the full 6 (or longer) months...as the initial set up costs more than just the "maintenance" aspect of it. Accordingly, the government has fined some of the providers.

I will say that in my Mom's case, the hospice was very, VERY good at how they explained the services and really downplayed the "end" aspect of it. I think the part that sold her (outside of the dementia causing confusion, but that wasn't the admitting condition) was the she could be "released" from hospice and that it isn't necessarily a death sentence.

https://www.crossroadshospice.com/a...ligibility-criteria/congestive-heart-failure/

In doing research for my Dad's prognosis (which is very difficult in COPD, even in the end-stage), I found that these folks break down the clinical side of it pretty well. I don't know anything about the *specific* provider, but nonetheless, they do a good job explaining it.

I will add one more thought...an advanced directive is NOT a DNR. This is something that is important to discuss with the primary physician. I will use my Dad as an example: He too has an advanced directive and doesn't' want feeding tubes, intubation, etc., etc...and his ultimate goal is to die in the home. Well, this is all good if he were admitted to the hospital with something dire. HOWEVER...and this is distinction. Had I gone into Dad's house this morning and instead of being able to wake him up, he was unconscious, I would have had to call 911. If the emergency responders determined his condition needed CPR, intubation, or "the paddles", they would HAVE to perform this on him...no matter what his advanced directive says. *If* he was in hospice, I instead would call them and they would send out an RN to deal with it...and keep him comfortable. There would be no crisis...there would be no invasive procedures. And with hospice, there comes the DNR.

In closing, hospice isn't a bad thing. Unfortunately, it's still a novel concept to many MDs and accordingly, people suffer needlessly. The average time spent in hospice is weeks instead of months, and in many cases (specifically long-suffering diseases such as COPD and CHF) this is just unacceptable. In my Mom's case, it was a God send. Her last year was tough...really tough, but the care she got was fantastic and she really enjoyed the daily visits from the CNA and social workers. And because they did SO MUCH, my Dad (who was in his 80s at the time) was able to finally rest some...something he hadn't got to do in a very long time. They (hospice providers) really became part of the family, and 5 years later, they still come to visit my Dad.

 

[bmcgonig]

Lots of horror stories out there, which make you appreciate the good ones all the more.

When my mom was at the end, her memory care unit sent her to the ER when she was found unresponsive. They called me at the same time, and I got to the ER about 30 minutes after she did. I feared the worst when I talked with the attending ER physician.

He put his hand on my shoulder and said "I've already checked her chart and I saw that she has a DNR order. Unless you want us to, we won't do anything but keep her comfortable and pain free. Does that make sense to you?"

I could have hugged the guy. Mom died peacefully two days later. The hospital wasn't especially crowded, so they gave her a private room so I could visit, and the morphine she needed. The nurses were really great.

That's a great story..

 

[Moemg]

We knew my Mom would be upset if she knew she was on hospice . She was on palliative care at the time so we made the decision to not tell her . She was very hard of hearing so she assumed she was still on palliative care and was happy with all the extras they were supplying .

 

[iloveyoga]

I am sorry about your mother, she is lucky to have you. When my FIL was very ill and the hospital wanted to discharge him, there was a social worker that we talked to. She was very helpful, and that started our road to hospice. We honestly did not know what to do.