Mom and Sadie Health Reports

Lake Superior Sunset

Lake Superior Sunset

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 Mom has become withdrawn and doesn’t want to talk.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.

About Unconfirmed Bachelorette

Unconfirmed Bachelorette, a/k/a Ella, is a 50-something-year-old lawyer who wishes fervently she could retire from the practice of law and write full time. Never-married-childfree Ella resides in Austin, Texas with her three fluffy black rescue cats.
This entry was posted in Alzheimer's, Cats, CKD Cat, Dementia, Elderly Parents, Subcutaneous Fluids and tagged , , , , , , , , , , , , , , , , , . Bookmark the permalink.

47 Responses to Mom and Sadie Health Reports

  1. franhunne4u says:

    Ah, another stubborn one – my tom refuses his heart medication, too. Even though they promise it tastes well for dogs and cats … Haha …

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  2. franhunne4u says:

    Cannot say much about your mother. I know it is hard to see her this way, particularly when she has been a stronger force. The end of life is not pretty for most. And that is even worse for the survivors. I think of you. Good that alcohol is just an after thought.

    Liked by 1 person

  3. leggypeggy says:

    There’s a lot going on in your life. Hope you are looking after yourself too, beyond staying off the booze.

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  4. foguth says:

    Old age is difficult enough when one is healthy. This past week, we’ve been having a similar situation with Daryl, who is 70-something – urinary issues, bowel obstruction, which required surgery and that unearthed complications… the situation remains in limbo, so I believe I have a hint about the feelings you are dealing with.
    I pray for the best possible outcome.

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  5. Writing for Ghosts says:

    You have a lot going on and you see to bear it all with grace and humor. You may disagree with that, but both traits emanate from your writing. Sending out prayer and good vibes to you, the cats, and your mom. In the words of Ram Dass, “We’re all just walking each other home.”

    Liked by 1 person

  6. gertmcqueen says:

    your ‘after thought’ is a good one. hope you continue keeping your own strength up. it IS time to get your mom into hospice care, don’t wait any longer, she will have much better care and attention, in the meanwhile…you take care of yourself as well

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  7. cindy knoke says:

    So difficult. You have my empathy as does your mother. Hospice, especially the non-profit ones, can be a wonderful relief. I remember arguing with my mother in law’s care providers who resisted it for her. They wanted the money. She got hospice and it was a God send~

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    • Thank you, Cindy. Hospice was wonderful with my father. They were non-profit, and I expect we’ll use the same organization with mom. I recall when we were trying to get my dad moved over from the nursing home to the hospice wing of the facility, the nursing home tried very hard to keep us from moving him. As you said, they wanted the money. The level of care with hospice was amazing.

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  8. josie416 says:

    The one thing I would recommend re: your mom is to have her meds checked. Sometimes a simple medication like a bladder control med can make a person with dementia suddenly much worse. Run her meds through Google and look for possible side effects. (Or get a second medical opinion on them). Other than that, I just tell you that my heart is with you.

    Liked by 2 people

    • Josie, excellent recommendation. We are weaning her off the antidepressant to see if that makes a difference. We think she has another UTI. She fell this morning and was back in the emergency room. All x-rays and ct scan of head negative. They gave her an IV antibiotic and sent her back to assisted living with an RX. Round and round we go. Poor mom. Thank you!

      Liked by 1 person

  9. I totally sympathize with you. By the time I got mom into Hospice, she lived less than 2 days. I was more successful with dad in that he was cared for in an inpatient hospice for just over a week. The care was wonderfully compassionate. The doctors were present all dqy weekdays and on call at other times. The nurses to patient ration was 2 nurses per patient, and in addition they had othere techs, perhaps CNAs who helped reposition dad every 2 hours to prevent bedsores. They gave him medication whenever he seemed to be in pain or agitated as by the last week he could no longer communicate.

    Most of all, it was a feeling of total support for me, the primary caregiver, as well as my children who sat with me in dad’s room every day until he passed. I could have stayed on the day bed in his room overnight, but I was confident in the wonderful care he was getting and I needed to sleep in my own bed. They even had a kitchen and playroom and laundry facilities for the families to use. There was freshly made soup brought in twice a day for th families as well as the patients. It was so very supportive I can’t thank them enough for all that compassion and care during our most difficult time.

    I strongly encourage you to follow up on your questions about hospice. Facilities differ, so ask about whatever is available in your area.

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    • If I knew then what I know now, I expect my dad could have gotten into hospice care weeks earlier. Your experience with your dad and inpatient hospice sounds much like my own. The level of compassion and the dignity with which they treated him made his passing a special and spiritual time. The night before he died, the nurse gave him a shave when I told her he never would have been so scruffy if he’d had any say about it. I’m going to call the facility we used directly and ask questions. Thank you for sharing your experience. Getting the word out is important!

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  10. Sorry to hear about your mum. I can sympathise, my mum seems to be heading a similar way. Old age can be such a tough place.

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  11. Karen says:

    My sympathy on your mom’s condition. I’m still muddling along with my 95 yr old mother who is slipping a little more as time goes on. She’s in her own home right next door, but it’s a gamble and she, too, is stubborn. The one thing I have going for me is her interest in painting; she loves to create art. I am not sure what I will do in the future as she fails more; so far I’m taking it one day at a time which probably isn’t the wisest course of action, but it’s the one I’m in for now. I am her only caretaker; some days I dread waking up, even though I realize how selfish that sounds.

    So sorry for your struggles with your dear cat; I lost both of my elderly dogs last year and they, too, were incredibly reluctant to take their medicine. I miss them both very much, but like you, I knew I’d done the best I could for them. I hope the vet check went well!

    And congratulations on one year. That is Amazing. 🙂

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    • Your mother is 95, in her own home, and creating art? The environment and creativity surely do her well. Being her only caretaker must be overwhelming. Struggling with a feeling of selfishness seems universal. But seeing as you are caring for your mother, selfish is an unearned label. I expect many of us are ambivalent about our roles as caretakers. As difficult as that is to admit, I believe it is normal.

      Oh, I’m so sorry you lost your dogs. And here I was thinking dogs were easier to give medication to. It is comforting to know we gave them the best care we could, with giant heaps of love on top.

      Thank you, Karen!

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  12. Time and the Bottle says:

    My cat has been throwing up a lot lately. I am starting to worry. But he is eating and drinking and terrorizing the dogs. So he has not change his routine. Maybe he is overeating. We shall see.
    I truly hope the results will come back much better. Fingures crossed.

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  13. I cannot tell your if it is better, with your mom I mean, in this way or if it is better what happened to my father, who died suddenly for myocardial infarction. The previous minute he was here and the next minute he was dead. I can only say: enjoy every second with your mother! And do not htink she does not understand!
    A big kiss to your cats ❤
    Ciao
    Sid

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  14. Sadie makes me smile…still very much in control of what will and won’t happen. Cats. Fluids make everyone feel better.
    When your mom loses the swallowing reflex/ability you will have to make decisions on how much care. Here, that’s when hospice tends to be recommended. I am so happy you’ve bought new pants for her – so many do not see the need. The shrinking of the frame and the mind seems worse when the person is swamped in clothes that no longer fit.
    You’re doing good, kid. Hang in there. Soft paw pats to Sadie, Sally and Sophie

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    • Sadie is a one-in-a-million cat. We’re still playing games with the pills. She usually wins. But with the fluids, when she sees me warming the bag, she starts mooching about. When I make may way upstairs to her IV pole, she sprints up after me and jumps up onto her window seat where I administer them. I’m astonished every time she does it. She has to know it makes her feel good.

      When my mom loses the swallowing reflex, it will no doubt be time for hospice. I’m not sure if they’ll certify her for home (assisted living) care before then. I’m still investigating. I do know that there will be no feeding tubes, or anything of that nature. We agonized over that decision with my dad, and ultimately decided against. I was so relieved my mom eventually agreed to forgo that with my dad. And it gave my mother an opportunity to make her own wishes known. So we’re clear on that. She was very excited about the new pants. She got them over the weekend and called me multiple times on Saturday to tell me she’d received them. She kept forgetting she’d already called, so it was a little like ground hog day. Each time she called, I’d act as if it was the first time, refraining from telling her she’d already called and told me. Thanks, Phil. I’m getting better at this.

      Liked by 1 person

      • Had to laugh. It was definitely groundhog day here. Those pants are important and how nice she calls ( even if you have to pretend each time – that’s part if it. Only thing important is that they are happy – and retain dignity.) So glad you have a clear path. It’s easier on everyone. They ought to certify for home/assisted living with recent changes. You’re doin’ great, kid!

        Liked by 1 person

        • Yes, she’s had a string of good days, including making phone calls. I enjoy pretending and figuring out the response she most needs. Reality and truth aren’t paramount considerations at this point. Whatever weird nonsensical conversation she wants to have, we have. Sometimes many times. Instead of getting anxious and agitated about it, I treat it as a challenge to respond in a way that won’t upset her. You are exactly right about what’s important! Thank you!

          Liked by 1 person

  15. Kim G says:

    Hola Ella! Wow, you really are going through a LOT. And dealing with all that while remaining not only sober, but with alcohol as an afterthought means MEGA kudos for you. What with your job, your mother, and Sadie, that’s a lot to deal with. So I tremendously admire your stamina and grace under pressure. Don’t lose sight of how far you’ve come.

    Does this mean your antidepressant is now fully kicked in? Because if it hasn’t, then you’re going to be truly amazing when it does.

    Saludos y kudos,

    Kim G
    DF, México
    Where the lotus keep getting tastier.

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    • Hola, Kim! I think not drinking is making it all easier to deal with. And I suspect the antidepressant works better without the booze in the way. Over the past few weeks they do seem to have kicked in. I’m not sure whether they’ve reached full efficacy. I’ve been taking your advice and getting in some lovely walks. You’re right, I have come a long way. And now I’m craving lotus.

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  16. OMC, there is a lot going on in your life and not happy events either. mom and I feel for you as gramma had dementia but not to the extent of your mom. This is very hard to see as it doesn’t seem like your mom anymore. How is Sadie doing after the vet visit? Guess I should read the next blog and maybe find out.

    Shoko and mom JeaN

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  17. My but it sounds good and good for them. I wonder if we have it in Canada. I must look at the pet stores. Thanks my friend.

    Liked by 1 person

  18. No go in Canada..oh well, maybe in time.

    Shoko

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