I think my mother has moved into the next phase of dementia. The end phase.
Mom has had repeated infections over the past year: multiple urinary tract infections, and more recently, MRSA. The MRSA hospitalization over the Thanksgiving holiday appears to have taken a lot out of her. Mom has become withdrawn and doesn’t want to talk. Caregivers have reported that she rarely speaks. When she’s asked questions, her responses, when she gives them, mostly are limited to, “Yes,” “No,” or “I don’t know.” But if I ask her about her cat, I usually get something more; something along the lines of, “He’s right here, he’s sleeping.” Often when I call, like today, she doesn’t answer the phone. She rarely calls me any more, and when she does generally she’s agitated and confused. She refuses bathing. She refuses to go down to meals. She’s losing weight. Her pants are falling down. I’ve ordered pants and pull-up diapers in a smaller size.
Last week, the occupational therapist called to tell me she found mom sitting in her chair and had had a bowel movement. She was a mess. But she did not appear to realize it. She didn’t push her button for assistance. She didn’t seem to understand how the call button worked. The therapist got mom into the shower to get her cleaned up, but mom had trouble following instructions. She wasn’t able to focus; to take instructions in.
Of course I’ve plugged all of these symptoms into a google search. The hits are along the lines of: Late-Stage Dementia, End-Stage Dementia, Palliative Care. I think we’re getting to the point where mom might qualify for, and benefit from, hospice. I hesitate to bring it up with my sister, however. The last time I mentioned hospice, it was for my father, and he died within six days of being moved into the hospice wing of the nursing home. I don’t think death is imminent with my mother. But I do think it could be within six months, and so she might qualify for hospice. I spoke with her physician assistant last week, and learned mom will be getting a complete Medicare physical in the coming weeks. When that’s scheduled, I’ll ask them to consider whether hospice is appropriate when they examine her.
Meanwhile, Sadie, the chronic-kidney-disease kitty, continues to hold her own. Some days she eats better than others. Always she refuses to be pilled, whether it’s an antacid, anti-nausea medication, or appetite stimulant. I’ve chewed a piece of the antacid, and to me, it has no taste. How Sadie knows I’ve crushed it up and put it in yogurt, or put a tiny little chunk in a piece of cheese, is beyond me. Last night, I gave Sally a similar tiny piece of cheese to show Sadie the cheese was a sought-after delicacy. Sally scarfed it down. Sadie was unmoved.
I continue to give Sadie daily subcutaneous fluids. Unlike with pills, Sadie is a very good girl with fluids. I do them every evening at around the same time. When she sees me leaving the kitchen with the warmed fluid bag, she follows me upstairs and jumps up onto her spot on her sheepskin by the window. Everyone knows when fluid time is. Everyone gets treats. When Sophie sees me come into the bedroom with the fluid bag, she jumps up from her nap and licks her lips. Sally winds herself around my legs meowing. I give everyone their pile of Greenies, including Sadie’s on her sheepskin. Once Sadie starts munching on her treats, I insert the needle and let the fluid flow. She’s usually still having snacks when we reach her 100 ml dose and doesn’t notice when I remove the needle. Yesterday, she’d had enough and got restless before we finished, so I opted to let it go at that, rather than forcing her to be still and take the last little bit. Hopefully she won’t do a repeat tonight. Tomorrow we have a checkup with the vet. Here are her numbers from when she was first diagnosed (and feeling very poorly) and after one week of fluids:
BUN 50 — 49
Creatinine 4.9 — 4.0
As of tomorrow, she’ll have been on the fluids for three weeks. I’m crossing my fingers for a Creatinine reduction to somewhere in the low 3s.
Oh yeah, I almost forgot: I’ve been off booze for well over a year now. It’s nice that it’s an afterthought.