Unsure about keeping Mum in bed now

[catbells]

Mum - in lovely care home - cardio vascular, in latter stages now, needs feeding, speech gone, a few noises, has had infection due to stage 3 pressure ulcer on her ankle, which although is beginning to heal still seeps. The infection has instigated another huge drop in the progression of the the dementia. She is now eating, but is still exhausted. I haven`t seen any progress since she began to eat again. We have a plan in place to allow slow recovery to get her up, no need for dresses etc, in chair for breakfast, then bed rest, repeated for lunch and t-time. But because of the handling involved, hoisting, putting into bed, turning her two hourly, she struggles when breathing when back in bed, the whole process of moving her in and out of bed three times a day and then turning, seems to be exhausting her. When is the right time to ask that she should stay in bed. She has a hospital bed so the back can be raised to feed her, she has a pressure mattress. I acccept now she will not return to how she was 5 weeks ago, and this is perhaps the beginning of the end, would it be more kind to keep her in bed now? Calm and comfortable. She has a gentle baby-like happy, affection demeanour, but she can communicate in her own way when she is uncomfortable or in pain, and mostly she is comfy in bed. I visit her daily and feed her her lunch, so keep a close eye on her and work well with the carers. Carers agenda is naturally to keep residents mobile and socialising as long as is possible Confused, but wanting to do the best for her. She likes people watching, so reluctant to take away her time within the lounge, as for a short while she enjoys watching what is going on, but of course she gets tired quickly and I`d rather her be comfortable in bed, than sitting awkwardly, sleeping in the upright chairs. She doesn`t like recliners, she never has, she likes her feet on the floor, but being in bed is different. Carers say sometimes she doesn`t want to get up, keep pulling the duvet back and waving them away! Like most of us the plan for the end is painfree, calm and comfortable, and we seem to be moving into the final stages now.
Would appreciate you comments
Heather xx

 

[TinaT]

If you think your mother is coming to the end of life then I would make an appointment to speak with her GP and discuss her care with him.

It would seem that the care home is doing the best they can by getting her as much as possible 'back into the swing of things' but as you say this is hard on her physically. Perhaps they may be willing to slow this down a little by taking her into the lounge for just a couple of hours for the first week or so and trying to increase this time if she responds well.

Best wishes
TinaT

 

[Navara]

When elderly people die at home, not necessarily with dementia, they often take to their bed in their final weeks. I clearly remember my granny at 92 taking to bed, using a commode, having a few nosebleeds, then passing away in her sleep.

My mother has been calmer and looking more contented while she's been in bed in hospital for the past month than she did for the previous few months in the care home where she was saying "its all getting too much for me" - ie fitting into the routines of getting up early, going to the dining room for meals, then back into the lounge for 'socialising'.

Why don't we just let nature take its course??

 

[VickyG]

Mum - in lovely care home - cardio vascular, in latter stages now, needs feeding, speech gone, a few noises, has had infection due to stage 3 pressure ulcer on her ankle, which although is beginning to heal still seeps. The infection has instigated another huge drop in the progression of the the dementia. She is now eating, but is still exhausted. I haven`t seen any progress since she began to eat again. We have a plan in place to allow slow recovery to get her up, no need for dresses etc, in chair for breakfast, then bed rest, repeated for lunch and t-time. But because of the handling involved, hoisting, putting into bed, turning her two hourly, she struggles when breathing when back in bed, the whole process of moving her in and out of bed three times a day and then turning, seems to be exhausting her. When is the right time to ask that she should stay in bed. She has a hospital bed so the back can be raised to feed her, she has a pressure mattress. I acccept now she will not return to how she was 5 weeks ago, and this is perhaps the beginning of the end, would it be more kind to keep her in bed now? Calm and comfortable. She has a gentle baby-like happy, affection demeanour, but she can communicate in her own way when she is uncomfortable or in pain, and mostly she is comfy in bed. I visit her daily and feed her her lunch, so keep a close eye on her and work well with the carers. Carers agenda is naturally to keep residents mobile and socialising as long as is possible Confused, but wanting to do the best for her. She likes people watching, so reluctant to take away her time within the lounge, as for a short while she enjoys watching what is going on, but of course she gets tired quickly and I`d rather her be comfortable in bed, than sitting awkwardly, sleeping in the upright chairs. She doesn`t like recliners, she never has, she likes her feet on the floor, but being in bed is different. Carers say sometimes she doesn`t want to get up, keep pulling the duvet back and waving them away! Like most of us the plan for the end is painfree, calm and comfortable, and we seem to be moving into the final stages now.
Would appreciate you comments
Heather xx

Hi Heather,

The care home, GP and every other person involved in your Mum's care have a 'Duty of Care' to adhere to. And that means, they will do what they deem right to 'enhance' an individuals quality of life. They try and go 'by the book', meaning everyone covers their own backsides, and to a point, quite rightly so as they are liable.
That doesn't mean to say it's always the right thing to do. Clearly, if a person is more comfortable in bed and the whole moving and handling business is too painful / stressful for the person being moved, then as long as the turns are being made as arranged and a pressure mattress / profile bed is in place, then surely that could be more comfy for them.
I get the whole wanting to keep the social aspect / stimulation / interaction in the lounge / dining area going, but at what cost ? Can any of the residents your Mum gets on with come down and say hello in her room ? Or, see if you can pinch a wheelchair for a short while and take her to the lounge to say hello then take her back to her room.
I totally get everything you're saying, I really do. Been there, got the tee shirt.

 

[Tin]

3 really wise posts that say it all, totally agree talk to your mothers gp.

 

[catbells]

Thank you so much for underlining my gut feeling. Love is about letting go, and letting go calmly, everything is in place, so nothing to worry about, just that final touch and the dreaded phone call. I thought I had the call, two weeks ago, she was so poorly, but knew deep down as you do when you are close she wasn`t leaving me yet, but its the closest we`ve been to it, I know her inside out, I see in her eyes when feeding her and she always accepts the spoon I`m not sure if its too much for her, as she can`t always communicate "no more", she looks at me sometimes as if she were saying "do I have to - its too much". Her eyes say everything. I will make sure I see the visiting doctor next Tuesday and speak to her with the senior carers and discuss her future care, meanwhile I will suggest she stays in bed for breakfast and tea and come out into the lounge with me for lunch. I have to do what I have to do for Mum, be strong. I can crumble like a brick wall, out of sight, and when she has left me. Nothing but the best for her which includes ensuring she clam and comfortable, ready to slip away.
Thank you again for your kindness and understanding
Heather xx

 

[Ash148]

Heather, your mum is lucky to have you in her corner, so finely attuned to her needs. Hope the GP and care home will go with what you think is best.

 

[starryuk]

Heather, you are so wise. What a lovely relationship you have with your mum. Yes, your mum is lucky to have you and she, too, deserves credit for her part in turning you into such a perceptive and empathetic lady!

To my mind, you know best what your mum needs and the professionals will agree with you when you speak for her.

 

[Jessbow]

What a close bond you have with your Mum, lovely.

The whole point of a plan is that its a framework, not hard and fast rules that have to be followed, come what may.

What about changing it, to be out of bed for some form of social interaction once a day, be it breakfast, lunch or tea? You say she likes people watching , so what about aim to be up and doing just that, at whatever time is deemed most interesting any particular day? or maybe just for lunch? ( slow relaxed start to the day, the rest of the afternoon to relax?)

You say she doesn't like to be reclined- what about a recliner with a foot rest so her feet don't hang?

Delicate balance, isn't it? You'll get it right for her.

 

[Navara]

I viewed a very expensive nursing home this week (brand new still being set up) where they have some huge chairs made from pressure mattress material which tilt back and have footrests. They are proposing to be able to hoist patients from bed (every room had a built in hoist) onto the chair, which can then be pushed to any point in the home so people that really don't want/are unable to get out of bed can be placed in a lounge/dining area for 'people watching' and meals without being disturbed too much. Absolutely brilliant - but out of reach of most on the financial side I fear.

 

[catbells]

Hello everyone. I have spoken to the manager and lead carer at Mum`s CH. They are very reluctant to keep Mum in bed. WE considered just up at lunch time, but they want to try getting her up first for breakfast, as during conversations we discovered the time between breakfast and lunch 12noon then first one back to bed, same again at tea. She is a fighter. As long as she is eating this will help the healing of the ulcer, which is continuing to improve. We`re going to try this for a week and see if there is any difference, also we`ll all speak with the Dr on Tuesday, so we`ll be around when she comes, to have a further chat. Bedridden patients - permanent bed rest causes loads of other problems Im told, and in his experience speeds up "the end". They aasure me Mum is quite bright after her bed rests, but acknowledge she quickly tires. Feeling better about the situation now. They are all so kind at the home, its over whelming. I`ve off loaded my worries and shed the tears today and they have been brilliant.
Thanks you all too
Heather xx