My 90 year old mother stopped eating, drinking very little.

[christina 17]

Hi

My 90 year old mother went into a care home in September, just 10 mins drive away from me after living with me for the last 3 years.
After going there for respite twice, after a talk with her social worker, she decided she wanted to stay there for the rest of her days. She said she knew I was getting older and also having to foster my eldest granddaughter, she felt she should now, then, be with people nearer her own age. It upset me greatly but I sort of came to terms with mum moving into the care home, but she has not been too happy there, getting upset when other residents would call out and staff not attending quick enough and I have been frustrated in the staff not getting mum's swollen legs raised and other less urgent problems.

My mother had a stroke 7 years ago with speech difficulty in expressing herself, but with perseverance, staff and myself could work out more or less what she needed. Sometimes though, she would give up explaining, if she wasn't understood easily. She also suffers from Rheumatoid arthritis, Osteo arthritis, incontinence (bladder and bowel) and heart failure.
My mother has often spoken of wanting to die and saying 'this is it now' whenever she has had any infection, in the last year.
Last week my mother developed 'Bronchitis' , this was diagnosed by the surgery's nurse practitioner, who prescribed antibiotics and steroids. The antibiotics got extended a few more days longer.
Mum has stated on many a time last week, that she didn't expect to be alive the next day and it was time now to go.

Mum was confused on many days last week, which was not a surprise, due to her having an infection, she refused all meals but on and off has had fluids but not nearly enough and it is very apparent that she has lost weight and is dehydrated.
The Care home manager has already said to me earlier this week that unless mum improves her fluid intake, she will need a nursing assessment and may need to move to a nursing home as only they can put up Intravenous fluids.

I understand this, but she might refuse having a drip up, and also she might refuse to being moved.
Since Monday, Mum has not really communicated much, just said yes or no to fluids and then sleeps the rest of the time.
I would welcome any opinions especially as I don't know of any recommended nursing homes near where I live, including having looked up the CSSIW (in North Wales) reports but I don't want to slow down any nursing care input for my mum.
Any advice would be very welcome

Christina

[Maxwell_1602]

Hi Christina

It is possible that your mother may still have a chest infection or possibly a urine infection particularly if she is dehydrated. Have you queried why they have not called the doctor in to check? I would have thought that would be the first step before looking to move her into a nursing home. The doctor may want to admit her to hospital for a few days which may be the best option at the moment.
Have you been in to visit and does she communicate with you?

I certainly cannot give you medical advice but I saw the same thing with my mother (also aged 90).
Wishing you all the best and do hope your mother gets stronger really soon.

[bowlingbun]

When my mum was very ill, I googled "Signs of Dying". Such a difficult thing to do, but I'm so glad I did, I just wished I'd done it years ago when my dad, and my in laws, were very ill. Maybe it's time you took this brave step? There is a lot of information written in a very kindly way by people with a lot of expertise. For example, if the body isn't feeling very well, it may instinctively know how much fluid it can process, and will only take in what it can manage. Mum may pull through (I've had bronchitis since Christmas and still don't feel well) but it may be a battle that mum's body cannot manage to win.
What mum needs now, most of all, is love and support.

[jenny lucas]

I'm afraid I agree that you may, perhaps, have to face up to this is your mum finally 'calling time' on herself. Now, it may not be at all, and it may be that a couple of days in hospital, or on a drip (I believe you need a nurse 'on call' when someone is on a drip)(ie, in case something goes amiss with the needle, which is potentially dangerous), and she'll pull right back up again.

But, if she doesn't, or refuses hospitalisation or being moved to a nursing home, then you may have to take that dreadful step and accept that she's 'had enough'.

You say she is not drinking enough, but I take she still CAN drink, but is just not up to it. The difference I believe is important, as one of the 'signs of dying' that BB mentions is the loss of the swallowing reflex. This means that it becomes dangerous to introduce liquids orally, by mouth, as the person has become incapable of stopping liquid going not down the gullet/oesophagus into the stomach, but instead, down the trachea in the lungs - and then choking. That's why at that point, fluids will only be administered by drip anyway, or not at all, depending on prognosis.

IF (and it really is only 'if') this is the end approaching for your mum's long life, then I hope that her passing is easeful, and peaceful, with you and her loved ones at her side 'waving her off'.

Facing the end of life for someone we love is a terrible thing, and a great ordeal, but we owe it to the person we are saying goodbye to that it is as untraumatic as possible, including our own reaction to it.

With kindest wishes at this worrying time, Jenny

[christina 17]

Thank you Maxwell, Bowlingbun and Jenny.

Maxwell, the Doctor's surgery always ask the nurse practitioner to examine the care home residents, they can prescribe medication and will only call a Dr out if they are not happy in their diagnosis and treatment themselves.
The nurse practitioner has said for the staff to encourage fluids and for follow up nursing assessment if fluids are not taken adequately.

When I got to the care home yesterday evening at 5.30pm, I had a shock as Mum was up in the sitting room in her recliner chair. But she was tired and the manager said that she had willingly had drinks and soup during the day but that she was desperate to get back to bed and they were going to take her soon.
I only stayed a short time as I knew while'st I was sitting there, they wouldn't take her to bed.
I have normally been going to the care home afternoon and evening, but did a full day at work yesterday instead of half a day.
When I phoned the care home today, the manager said that although Mum managed to walk back to her bedroom most of the way yesterday evening, the last few feet her legs buckled and they had to let her go to the floor and use the hoist with 4 staff.
The manager has said that Mum is exhausted today and doesn't want to move and she thinks to let mum stay in bed a couple of days. I really think that Mum having been in bed ill for 8 days, it was too much for her to walk there and back to her chair in the sitting room and to be up for 7 hours. The manager said that she would have refused if she really couldn't manage!! But the manager had also said that Mum needed a lot of persuading to go to the sitting room and told her that it might be more comfortable being in the chair for a change.

Mum refused to go to hospital earlier in the year when she had low SAT's, was breathless and a high temperature, the ambulance said as Mum had mental capacity it was her choice, called a GP and he diagnosed a urine infection after I got a sample off Mum. Mum refused the medicine for 24 hours then finally took it and recovered - hence I don't think she will go to hospital.
I have looked up the signs of dying, sadly, as it did occur to me that this might be the beginning of the end.
But I am not sure what the care home staff think.
A district nurse came in today to do an assessment for mum to have a more suitable mattress for in case mum does stay in bed more permanently.
I do think that Mum has had enough and I was accepting this until I found that Mum was out of bed yesterday but I think that Mum will now be set back as it would have been traumatic for her having to use the hoist as she hates it.
Thank you all for your advice.

[bowlingbun]

Christina, in the last year of my mum's life she was up and down like a yo-yo. I'd visit and think she was so poorly I hoped the end would come quickly, then the next day she would be eating her food and chatting as normal. It is a real roller coaster ride for relatives.
It's really important during this time that you look after yourself, don't end up visiting so much that you are constantly exhausted and neglecting your own life. Be kind to yourself.
Visiting regularly can be tedious, after a while it's easy to run out of conversation, so maybe think of something you could do for mum when you are there.
My mum always loved the flowers in her garden, so I would take her fresh flowers on most visits. Staff said they always known I'd been in by the flowers. So even when I wasn't with mum, she had a little reminder of me. Mum loved watching me change the flowers, give them a drink, arrange them etc., something we'd always done together.
Someone else on the forum said that when her mum was poorly, she would massage her hands and arms with lotion.

[christina 17]

Thank you all for your input of advice and support.

My mother has recovered from the bronchitis but she has lost a great deal of weight.
She is now eating and drinking small amounts and the manager is keeping a check on intake.
Mum hardly gets out of bed as her legs give way, but once a week the staff manage to get Mum to the sitting room but she dislikes being moved out of bed, highly dislikes wheelchair and hoist and also the stand alone equipment.
When she has been out of bed for some of the day, she is so totally exhausted, she then sleeps the rest of the day.

Lucky enough her pressure areas must be alright.
Apparently a nurse did come in and do a general assessment for going into a nursing home 2 weeks ago but I have not heard anymore about it.


My mother just looks out of the window or goes to sleep. I did bring in her TV and she occasionally glances at it.
I think she is totally exhausted and I know that this may or may not last any length of time.
Christina

[bowlingbun]

Has mum got her recliner at the home?

[christina 17]

Yes, BB, Mum's recliner is in the sitting room area still.

2 days ago the manager said they could stand mum up to take her in wheelchair to the sitting room but later when they brought her back to the bedroom the staff couldn't get mum to stand, she refused. She refused hoist etc eventually it took 3 staff including a strong male support worker, to get mum into bed as they persuaded mum to hold onto bed rail and eventually got her in bed.
The manager said that the staff said that they can no longer take the risk of getting mum out of bed if she can no longer weight bear. She said one member of staff went off sick last week with a painful back, although not due to handling my mum.
The manager said that in view of the staff's health and well being, my mother is now to be kept in bed all the time. The staff cannot take any risks.
I asked about her pressure areas and she said mum's pressure areas were good and that if there was deterioration then they would get a special mattress in (Mum is already in a profiling bed.

Christina

[bowlingbun]

Mum should not be in bed all the time, for transferring she should now be hoisted. Why not ask for mum's recliner to be moved to her bedroom so she can be moved easily to a sitting up position? My mum found her recliner much more comfortable than her bed. Two days before she died, she was still happily sitting in it. (Mum preferred to stay in her room.)