Can I do any more?

Otiruz

Registered User
Nov 28, 2015
253
0
Kent
I could not even find a title for this thread as I don't know what questions to ask. All I know for certain is that my poor mum is heading towards her final journey. No one can prepare you - they do not teach 'how to deal with parental suffering' in school. Neither are there lessons in 'guilt and how to cope' or 'have I done the right thing for my parent?'. Somehow, no matter how old the 'child' one always feels like the child. I have no siblings. The home have provided great care and is a privately owned demential care specialist home.

Mum's journey has undoubtedly been hurried due to a fall and subsequent fracture of the femur. She was operated on within 13 hours of the fall. The hospital stay was not great and her decline noticeable. She came out with a pain-patch and the home gave me great encouragement that they would facilitate her rehabilitation. I was at the hospital daily but I had my doubts, not because they would not try but because I know my mother and I knew her ability to understand the necessity to avoid becoming chair/bedbound was severely compromised. Quite clearly, her speech, motor skills, and comprehension had nose-dived. Mum now sometimes cannot find her mouth with a fork or even pick it up with a sense of purpose. She is being helped to eat as and when necessary. In hospital she was pouching but we hoped that would improve once she was off the medication. She often has a far aware staring look with her head down. Today I was told they are giving her soft food. Yesterday the doctor visited and recommended taking her off the pain patch. Partly to see if she was a little more cognitive and would eat and drink more readily. Also, I suspect to see if she is able to describe any pain she may have. I feel wretched, sad and thoroughly miserable at her plight. There is absolutely no quality of life and I feel she is almost resentful that she is in this desperate situation.

Everything I try has no impact, songs and music (she was a singer for charity), flowers, the breathing kitten in the bed - and she used to love her cats. A mood lamp, visitors and her favourite foods bring her absolutely no joy. Even stoking her hand does not receive a welcome response. I feel guilty for living my life and for being helpless to do anything for her. I have read lots of other people's journeys and wonder how, as a carer people cope? I really enjoy visiting the home and usually go twice a week. They have all sorts of great activities but nothing my mum can engage with now. It is not a nursing home, although when I first visited to see what it was like, I was advised that they have never asked a resident's family to remove a resident once they are at end of life. I know, since my mum has been there, that residents have passed away or gone into hospital. I do not want my mum to end her days in hospital but Im frightened to bring her home with me in case I can't cope - so therein partly lies the guilt I suppose. I've been candid with the owner of the home, and she with me in that mum's prognosis now is pretty poor. She believe's mum has had a series of tia's since the fall, which I agree and this has exacerbated her condition. I think my question is - can I do anymore and if so what?
 

CraftyJ

Registered User
Jan 31, 2014
35
0
Bedfordshire
Otiruz

So sorry to hear of how things are with your mum. Situation very different to that of mine, but the main thing I can say, which everyone tells me.... dont feel guilty!! You sound like you have done everything you can, and really can do no more. I agree that we dont get care advise for when parents or family get old - we have to learn the hard way. You get all the info for when children are born, but not for when parents are near death.

Doesnt your mums care home offer end of life care if it reaches a point where the hospital know no more can be done? That way your mum will be receive more individual hands on care and some dignity.

Do you have a DNR on your mum? Perhaps you need a good talk with hospital and doctors and see how the land lies and hope the owner of the care home will help you too. My mum has been in care for 3 years and there is no way she is ever going into hospital now, whatever happened. All the staff and her GP are aware of that too.

Just want to send you lots of positive vibes and make sure you take care of yourself. Sometimes, nature has a way of solving our problems, one way or the other. If your mum is nearing the end, then just ensure she is somewhere where you feel happy for her to spend her last days and if it means its too stressful for you to have her at home, im sure the care home can assist. Wishing you well and keep us posted as to how things go. Take care x
 

LadyA

Registered User
Oct 19, 2009
13,730
0
Ireland
@Otiruz i am sorry things are so hard at the moment. Reaching the point where we know our loved one is nearing the end of their journey is very difficult.

I honestly don't think you can do anything more than you are doing for your mum right now. You are giving her reassurance, she's as comfortable and well cared for as possible.

I will say though - don't ever feel guilty for going ahead and living the life she gave you.

And do keep posting here if it helps. You're never alone on TP.
 

Otiruz

Registered User
Nov 28, 2015
253
0
Kent
Thank you so much Crafty J and LadyA.
Otiruz

So sorry to hear of how things are with your mum. Situation very different to that of mine, but the main thing I can say, which everyone tells me.... dont feel guilty!! You sound like you have done everything you can, and really can do no more. I agree that we dont get care advise for when parents or family get old - we have to learn the hard way. You get all the info for when children are born, but not for when parents are near death.

Doesnt your mums care home offer end of life care if it reaches a point where the hospital know no more can be done? That way your mum will be receive more individual hands on care and some dignity.

Do you have a DNR on your mum? Perhaps you need a good talk with hospital and doctors and see how the land lies and hope the owner of the care home will help you too. My mum has been in care for 3 years and there is no way she is ever going into hospital now, whatever happened. All the staff and her GP are aware of that too.

Just want to send you lots of positive vibes and make sure you take care of yourself. Sometimes, nature has a way of solving our problems, one way or the other. If your mum is nearing the end, then just ensure she is somewhere where you feel happy for her to spend her last days and if it means its too stressful for you to have her at home, im sure the care home can assist. Wishing you well and keep us posted as to how things go. Take care x
I have POA for health and welfare. Who do I speak to for DNR - would it be the home? I have no contact now with the hospital but the home have a visiting local doctor so I suppose I should discuss these things with her. I have seen her with mum for previous health issues. I know mum does not want any interventions or life-lengthening procedures - nasal feeding or peg. We discussed this years ago, before she was diagnosed with mixed dementia. However, when it comes to it I'm not sure I would be strong enough to do nothing and see her fade - omg just thinking about it is awful.

I think I have avoided talking to the home specifically about end of life care because it's so upsetting. I realise they are used to this but somehow, no matter what, I have always gone into the home in an upbeat positive fashion. If not for my mum, then for the other residents. I have cried outside in the car when no one is around because it is distressing. I have come to really love being among the residents, talking, doing my best to understand them, helping where I can, taking in magazines or books, telling jokes, having an impromptu sing-song or help with feeding. Sometimes just sitting holding a resident's hand (and usually my mum's too). Because I don't work there, when I am there I have the time to spend and I take my cues from the carer's in engaging with the residents. I am terrified I will just fall apart and a full scale hurricane of emotion will spill out. Perhaps it needs to. I just see so many people lost, sometimes frightened and I know they have all had vibrant lives with careers, loves, families which has all drifted away from them, sometimes, as with families, in the real physical sense. Perhaps it's doing me good to vent all this on here. I've pushed all this emotion down in order to just get on with it, for so long.
 

canary

Registered User
Feb 25, 2014
25,072
0
South coast
Im so sorry @Otiruz
A very similar thing happened to my mum too.She too fell and fractured her hip. She had surgery and intially it looked like she was doing well, but then her dementia progressed massively and she did in fact pass away a few weeks later.
One thing that has occurred to me is that near the end, people with dementia often lose the ability to smile and instead can only grimace. Have you been seeing this?

Please do talk to the care home manager about end stage instructions. I know it is upsetting, but if you dont then your mum would probably be sent to hospital and I did not want that for mum. She was in a care home with a similar set-up to your mums - not a nursing home, but would give end of life care for their residents. I wanted mum to pass away in her care home which she knew and had been happy there, cared for by people who she recognised and were genuinely fond of her, So I had "that" conversation with the manager saying that I didnt want her resuscitated and I didnt want her to go to hospital, but just let nature take its course. This is exactly what happened. When the time came the district nurses organised a syringe driver so that mums passing was pain free and at the end I felt that I done my very best for mum.

Please get rid of the guilt ((((hugs))))
 

Otiruz

Registered User
Nov 28, 2015
253
0
Kent
Im so sorry @Otiruz
A very similar thing happened to my mum too.She too fell and fractured her hip. She had surgery and intially it looked like she was doing well, but then her dementia progressed massively and she did in fact pass away a few weeks later.
One thing that has occurred to me is that near the end, people with dementia often lose the ability to smile and instead can only grimace. Have you been seeing this?

Please do talk to the care home manager about end stage instructions. I know it is upsetting, but if you dont then your mum would probably be sent to hospital and I did not want that for mum. She was in a care home with a similar set-up to your mums - not a nursing home, but would give end of life care for their residents. I wanted mum to pass away in her care home which she knew and had been happy there, cared for by people who she recognised and were genuinely fond of her, So I had "that" conversation with the manager saying that I didnt want her resuscitated and I didnt want her to go to hospital, but just let nature take its course. This is exactly what happened. When the time came the district nurses organised a syringe driver so that mums passing was pain free and at the end I felt that I done my very best for mum.

Please get rid of the guilt ((((hugs))))
Oh canary, I am so grateful to you and the others who have answered me. Yes, there is a definite grimace and no smiling, I think I have sub consciously recognised this as not being a good sign. You and the other very kind TP responders have helped enormously. I will have the conversation. Thank you for sharing and thank you all for helping me to feel brave. God Bless. I will probably keep popping in and out as a way of keeping myself sane.
 

CraftyJ

Registered User
Jan 31, 2014
35
0
Bedfordshire
Otiruz

Im surprised the care home hasn't asked you about DNR. When my mum went there, I had to fill out forms and one of them was about DNR. As I am mums Deputy as she had no capacity at all, i made that decision, as I know mum would absolutely hate living as she is now. Its on her notes and also if ever she was admitted to hospital. I would ensure that your mums GP is fully aware of this too. So many decisions we have to make which are so hard. I put myself in mums shoes - if i were in her situation, would i want to exist like that and also cause so much upset and worry on my family? Having seen what Alzheimers has done to my mum, the answer would be a big NO. My sons and husband know exactly my views already on my future should that happen.

We all have to be brave and no doubt are. From what Ive seen from TP in such a short time is the support and care from "strangers". Means so much. Take care x
 

yak55

Registered User
Jun 15, 2015
616
0
Thank you so much Crafty J and LadyA.

I have POA for health and welfare. Who do I speak to for DNR - would it be the home? I have no contact now with the hospital but the home have a visiting local doctor so I suppose I should discuss these things with her. I have seen her with mum for previous health issues. I know mum does not want any interventions or life-lengthening procedures - nasal feeding or peg. We discussed this years ago, before she was diagnosed with mixed dementia. However, when it comes to it I'm not sure I would be strong enough to do nothing and see her fade - omg just thinking about it is awful.

I think I have avoided talking to the home specifically about end of life care because it's so upsetting. I realise they are used to this but somehow, no matter what, I have always gone into the home in an upbeat positive fashion. If not for my mum, then for the other residents. I have cried outside in the car when no one is around because it is distressing. I have come to really love being among the residents, talking, doing my best to understand them, helping where I can, taking in magazines or books, telling jokes, having an impromptu sing-song or help with feeding. Sometimes just sitting holding a resident's hand (and usually my mum's too). Because I don't work there, when I am there I have the time to spend and I take my cues from the carer's in engaging with the residents. I am terrified I will just fall apart and a full scale hurricane of emotion will spill out. Perhaps it needs to. I just see so many people lost, sometimes frightened and I know they have all had vibrant lives with careers, loves, families which has all drifted away from them, sometimes, as with families, in the real physical sense. Perhaps it's doing me good to vent all this on here. I've pushed all this emotion down in order to just get on with it, for so long.
Talk to your GP regarding the DNAR x
 

Otiruz

Registered User
Nov 28, 2015
253
0
Kent
Thank you yak55 and CraftyJ. As I said to a friend today, I have to put my 'big girl pants' on and get this difficult conversation underway. I think because the care home is registered as 'residential' and not 'nursing' it possibly is why this isn't made formal. At the beginning (and obviously as mum was not nearing the final hurdle) - I was relieved to find a home which filled the criteria for 'care'. I had seen 7 or 8 and was shocked at some. The conversation I had with a senior member of staff at that time when I brought up the end of life scenario gave me confidence that they do not turn residents away. I think I need to book a private appointment with her visiting GP to clarify that she feels mum's needs can and will be met by the home.
Thank you again.
 

yak55

Registered User
Jun 15, 2015
616
0
Thank you yak55 and CraftyJ. As I said to a friend today, I have to put my 'big girl pants' on and get this difficult conversation underway. I think because the care home is registered as 'residential' and not 'nursing' it possibly is why this isn't made formal. At the beginning (and obviously as mum was not nearing the final hurdle) - I was relieved to find a home which filled the criteria for 'care'. I had seen 7 or 8 and was shocked at some. The conversation I had with a senior member of staff at that time when I brought up the end of life scenario gave me confidence that they do not turn residents away. I think I need to book a private appointment with her visiting GP to clarify that she feels mum's needs can and will be met by the home.
Thank you again.
Good luck x
 

Babymare01

Registered User
Apr 22, 2015
315
0
It is such a difficult conversation. I had the conversations re DNR/ End of life with both mums doctor and the nursing home and whilst yes it broke my heart I actually had a sense of relief after. Relief that we all wanted the same for my mum and all have mums best interests at heart. Also a sense of relief that I have the support of the doctor and NH and wont have to fight to allow mum has peaceful end as possible. So bite the bullet and have a chat with the doctor and home. It may put your mind at rest re the future. Doesn't make it easier but it may help

Hugs of support xx
 

Otiruz

Registered User
Nov 28, 2015
253
0
Kent
It is such a difficult conversation. I had the conversations re DNR/ End of life with both mums doctor and the nursing home and whilst yes it broke my heart I actually had a sense of relief after. Relief that we all wanted the same for my mum and all have mums best interests at heart. Also a sense of relief that I have the support of the doctor and NH and wont have to fight to allow mum has peaceful end as possible. So bite the bullet and have a chat with the doctor and home. It may put your mind at rest re the future. Doesn't make it easier but it may help

Hugs of support xx
Thank you Babymare01, all of the support Ive received on this subject is really helping. I think it is my own feelings of inadequacy which I have to put to one side for the sake of making the pathway clear for my beloved mum.
 

canary

Registered User
Feb 25, 2014
25,072
0
South coast
I think that feelings of inadequacy are par for the course @Otiruz Dementia is too big for us and we often veer off into unknown territory and have to deal with difficult/taboo subjects.

Take your courage in both hands. It will be OK - imagine that we are all standing beside you.