Advice needed - should Mum be moved to hospital for IV rehydration?

Discussion in 'I care for a person with dementia' started by Blackcat20, Jun 8, 2014.

  1. Blackcat20

    Blackcat20 Registered User

    Dec 4, 2012
    32
    York
    I would be really grateful for advice - my 91-year old Mum is currently very ill in her NH, having had the norovirus two weeks ago and now a bad UTI. Her GP had been out twice, and says she is severely dehydrated. She is being treated with liquid antibiotics for the UTI, and also a sub-cutaneous drip for hydration (because I did not want to move her from the NH, which cannot do the IV type). I've just been told by the nurse that the drip is not working because Mum does have enough muscle - they have put it in at four different sites and want to try another one, but they don't think it would work. They think the IV one would probably work. I have now been asked again if I want her to be moved to hospital (it is about 2 minutes away, so the actual journey is not long, although the disruption would doubtless be bad for Mum). Prior to this, Mum was at a low/moderate stage of AD (she could still read and write, was mobile, could knit and did not have any problem recognising people or expressing herself, although she had no sense of day or time). Now she no longer eating, although she is drinking and when asked says she want to get well again.

    There is no other close family as I am an only child, and the other family which do exist are complete invisibles. This means I am having to make the decision on my own, and so I would be grateful for advice. Should we try to move Mum? The NH has a lot of agency staff and so Mum is in any case having to be cared for by constantly different people, so it is not really that she is in the hands of familiar carers (although the care is good, I think). I don't want to disturb her, but I am torn apart by the thought that if I don't try everything to help her, I will not be able to get rid of the guilt. When my father was in a similar position a few years ago (although with cancer not AD) my Mum made the decision to have him taken to hospital.

    I know that many posters on here have been in the horrible position of making this kind of decision, and so if anyone has any thoughts to offer, it would be much appreciated.
     
  2. FifiMo

    FifiMo Registered User

    Feb 10, 2010
    4,710
    Wiltshire
    If I was in your position then I would consider your mum's quality of life and from what you say, despite her age, she was still very much active and able to do things such as read and write and communicate etc. If a few days in hospital would rehydrate her which often deals with things like UTIs etc too as they can be more prevalent if a person is dehydrated, then I would consider the hospital option.

    Not wanting to distress you or anything but lack of fluids is not compatible with life and to be given the best chance she should be rehydrated sooner rather than later before the kidney function deteriorates and things like that.

    We always told the care home that we didn't want my mother hospitalised but one night there was an agency nurse on duty who didn't know her and saw her deteriorate quickly so she sent her to hospital. Oh how we were furious but on reflection, you couldn't have faulted the hospital and I have to say that treatment there is instant - rather than a care home having to contact a Dr then get a prescription which all takes time. Dr said give her this and a nurse was there administering it immediately. So, for all our misgivings, there were certainly advantages to the hospital setting.

    As I've said, this is just my view and I am sure that others will share their views too. Unfortunately you will still be left in the position of having to decide, so, weigh up the pros and the cons and then decide what you think is for the best. As long as your decision has your mum's best interests at heart, then it will never be wrong :).

    Fiona
     
  3. sistermillicent

    sistermillicent Registered User

    Jan 30, 2009
    2,949
    You have asked for opinions and so i will give you mine but it does not mean it is right or that you have to take any account of it. How little I know of your life and your mum's life, it hardly seems right that I should do this but here I am anyway.
    I would let her be taken to hospital. I agree with Fifimo that your mum seemed to have a decent quality of life before this and that she wants to get better. Also having just had the norovirus myself i know how very ill it makes you feel and it leaves you dehydrated even when you think you have had loads and loads to drink when it is all finished.
    But this is my opinion based only on what you have written here.
    All the best x
     
  4. jawuk

    jawuk Registered User

    It seems that your Mum had a fairly good quality of life and you say she has expressed a wish to recover. It sounds as if the most sure way to assist her is not to oppose her admittance to hospital for rehydration particularly as it is so very close to where she is cared for, imho.
     
  5. geordie

    geordie Registered User

    May 11, 2010
    108
    it sounds like your Mum has the potential to benefit from hospital care - could you possibly stay with her to minimise any distress/disorientation she may experience.
    We have recently had to use hospital care and i was v pleasantly surprised at how dementia friendly it had become since a couple of years ago.
    hope your mum makes a good recovery.
     
  6. starryuk

    starryuk Registered User

    Nov 8, 2012
    1,300
    If it were my mum and she still had the quality of life you describe, I would take her to hospital. The couple of times Mum went in for something like this, it was amazing how quickly the IV fluids and ABs perked her up. We only stayed a couple of days. I found the staff very happy to have me there with her most of the day and I felt better being there to make sure she was ok.
     
  7. Blackcat20

    Blackcat20 Registered User

    Dec 4, 2012
    32
    York
    Thank you so much for your replies

    Thank you so much for your really helpful advice - it has made me feel less alone in taking this decision. I have just been up to the NH again to give Mum her antibiotics, and when I put on some Scottish music (she originally comes from the Outer Hebrides) her little feet came out from under the covers and started dancing away, and she started to sing along. I don't think that she is ready to give up yet. If she gets through tonight OK (the night staff will try to to give her liquids orally, as I have been doing all day) then I will ask for her to be admitted to hospital. Thank you so much for taking the time to reply and for sharing your experiences.
     
  8. Blackcat20

    Blackcat20 Registered User

    Dec 4, 2012
    32
    York
    Update - Mum now in hospital and on an IV drip

    Just an update, particularly for those who gave me their valuable advice yesterday. When the GP came out again today she said that there was nothing more that the NH could do for Mum, and so we agreed that she would be taken to the hospital for the IV drip and antibiotics. Some of the NH staff thought that she should not go to hospital, and I was just talking about this with the manager when the ambulance people arrived. By this stage I was worried that they would think we were wasting their time, but they were absolutely fantastic - they did various tests on my Mum and said that they thought she should have a chance to have the IV hydration. One of them said "why should she be deprived of what is quite a simple therapy just because she is 91 and has dementia"? She was fine during the short journey, and they managed to get her admitted straight to a ward where she was put on the IV drip and antibiotics at once. The doctor who examined her said that he thought she should have a "good chance of recovery", and all of the hospital staff were lovely with her. So we will wait and see, but whatever happens I feel that it was the right thing to at least try to give my little Mum the chance to get better. Thank you for all your help.
     
  9. starryuk

    starryuk Registered User

    Nov 8, 2012
    1,300
    I am so pleased things have gone well so far and the ambulance man spoke wisely I think, don't you?

    Keeping my fingers (and toes) crossed for your mum.

    xx
     
  10. cragmaid

    cragmaid Registered User

    Oct 18, 2010
    7,942
    North East England
    Whatever the outome, I think that your choice was right for you both. I wish a speedy re-hydration with no added problems for Mum.:D
     
  11. FifiMo

    FifiMo Registered User

    Feb 10, 2010
    4,710
    Wiltshire
    Thank you for the update and good news that your mum is now receiving treatment. I hope that she gets back on form quickly. Get the Scottish Music in there and let her enjoy herself too! Bless.

    Fiona
     
  12. Blackcat20

    Blackcat20 Registered User

    Dec 4, 2012
    32
    York
    Further update on Mum - the change is unbelievable!

    This is just another quick update to say that the IV hydration and ABs are already working wonders with with my little Mum - first thing in hospital this morning she asked for a newspaper and chocolate buttons (!), and this afternoon she was up sitting in her chair and had already got back to walking a few steps with the physio. This is such a change from Sunday, when she was lying in the NH barely responsive to anything, not talking, eating or drinking, and it really looked as if she was at death's door. I cannot believe how fast the IV drips have taken effect, and I am really glad that we moved her to hospital.
     
  13. Jessbow

    Jessbow Registered User

    Glad you made the right choice.
     
  14. FifiMo

    FifiMo Registered User

    Feb 10, 2010
    4,710
    Wiltshire
    Aww that is fantastic news. So glad she is starting to feel better. You must be mightily relieved too after all the worry.

    Fiona
     
  15. starryuk

    starryuk Registered User

    Nov 8, 2012
    1,300
    I am delighted for your mum and you. Great news indeed.
     

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