Mom (96) in hospice for low sodium. She lost 25lbs in two months and sleeps all day, but heart and breathing are fine. Is hospice a mistake?

My father's heart, breathing and vital signs were perfectly fine until a few hours before he passed and then they plunged quickly. He had a brain tumor. Your mother has low sodium bc her systems are shutting down, I'm sure that's what you were told. My sister in law passed recently with low sodium from kidney and liver failure, but ultimately Covid killed her. She was 64. Your mother is 96 and has lost a lot of weight and is sleeping all day, which is another sign of impending death. If you were to take her off hospice and get her treated, what would her prognosis be, realistically, at 96 and in the condition she's in?

I think there comes a time when it's good to allow nature to take its course. To stop taking heroic measures to extend an ill and tired elders life and allow them to pass in peace. It's what I'd want for myself, rather than more tests, poking and prodding.

I'm sorry you're going thru such a thing and questioning comfort care for your dear mom at this juncture. My mother is 95 next month with serious health issues and advanced dementia so I'll be where you're at soon. May God give you peace to accept His decision as to when it's her time to go home, as peacefully and effortlessly as humanly possible.

Your mother is 96. I am 80 and do not any longer want a lot of treatment for ANYTHING. That is to say, I have made my wishes expressed, and have expressed that I am read to go, and what things I will accept or not accept. The treatment for low sodium is an easy one; but low sodium can result for many reasons, anything to a major system malfunction to the minor result from administration of diuretics which wash out many essential electrolytes.
Only your Mom's MD can discuss with you her systems and whether her organs are heading for failure, heart, lungs and kidneys. And only your Mom throughout her life can have let YOU know what she want to do about end of life care. I myself am very accepting that a long life ends, inevitably in death. I wish that time to be peaceful and without a whole lot of treatment.
Time to have discussion with your Mom's physician who will have ordered Hospice care, and with Hospice itself. They know your Mom and her individual case. It sounds she has wasting now, and is approaching the end of her life. For myself I would be wanting her comfort now.
I am uncertain what you mean by "Why are her heart and pulse and breathing fine". If there is no fluid build up in the lungs they will function so long as they function, and the heart will pump until the pump fails. That is to say our systems function until they do not.
The person who is POA, next of kin, or otherwise designated makes decisions regarding treatment if the person is unable. Otherwise the doctor, who knows the patient and will (hopefully) have discussed end of life care with that patient, makes decisions in best interest of that patient.
Your Mom is an individual. Her case is as individual as a thumbprint. Discuss your feelings with her MD/and with hospice. Discuss also what you mean by "treatment" and what their prognosis is for your Mom if these treatments are done. I must say that, at 96, I am hoping you are not talking those treatments that honestly end more an end of life torture than a "treatment" (dialysis, tube feedings and et al).

I would venture to say she is making some of those choices with her eating and sleeping. At her age she has that choice. My mother has been put on palliative care twice in this past year only to be removed from it as she rebounded. That seemed to be what she managed. I literally have had two lengthy conversations at the hospital with individuals in charge of dealing with helping family come to terms with end of life. My children have made across the country visits to say goodbye.

She somehow changed course and began to thrive (to a degree) and was taken off palliative care. She is 91 and cannot walk but is not ready apparently to move on. Her vitals have been good.

I feel your mother is doing what she can at the point of life she is at. She is being treated if not necessarily how you feel you might prefer. I suggest living and visiting with her as she is. I don't want to offend you but what age would you want her to reach. To reach 96 is many more years than many do. I hope you find peace with her and her remaining time.

I would bet Mom's pulse, heart and breathing are fine because she's taking medications to make them fine. If she wasn't on the meds, it'd be a whole other story.

My mother started hospice January 1 this year, and in July, I asked the nurse why we were still giving her all these medications when several clearly were no longer doing what they were supposed to do. She said she'd been waiting for me to notice that, and it was specifically about the diuretic she was taking for leg swelling. Her legs remained enormous and swollen in spite of the Lasix, her heart and breathing were mostly fine, but up a bit one day and down a bit another with no rhyme or reason. Her BP was fine -- low as it had been her whole life -- but she was clearly declining overall.

I made the tough decision to take her off most of her medications and let nature take its course. Once the diuretics were gone, her leg swelling disappeared (go figure), and once her heart and BP meds were gone, things remained about the same as well for a couple of weeks. Slowly, though, things started changing, and her heart rate would go up quite a bit one day, then be lower the next. The nurse told me her heart wasn't pumping normally but rather fluttering, and that's why the rate was so high.

It was about three weeks after we stopped the meds that she passed in her sleep, and there's not a day I wonder if I should have made that decision sooner. She was being kept alive by all those blasted drugs but with no real quality of life, and she probably would have died several months sooner if I'd recognized the decline better.

You need to come to the realization that your mom is likely dying. Hospice is the right place to be, and no, they aren't going to hurry her exit along, so don't worry about that. It's vital that she's comfortable, and that's what hospice is there for.

It is confusing, no doubt. It's no fun watching someone wasting away. But, unfortunately, that's often the way it goes for the elderly.

I doubt that hospice is a mistake, given her age and her issues. Hospice must have evaluated your mom and determined that switching to comfort care for her was a viable option.

While it's hard, maybe it's time to accept the fact that her time here on earth is limited and you should try to be kind to yourself too.

My dad's STRONG heart continued to beat for 5 full minutes after he stopped breathing. His breathing was shallow, but he did breathe on his own until he began the active phase of dying. Slow, shallow breaths.

He was on Hospice, so the Morphine and Valium kept him calm and allowed us to have a peaceful, beautiful passing for him.

Your mom is 96. 96. For what purpose are you trying to keep her alive?

I have been in the “is hospice a mistake” boat so many times. I think what caused me so much confusion was the 6-month qualification rule along with lack of clear prognosis along with months-long periods of clinical stability. Since my 90 yr old mom has been in hospice, though, and even before, she has clearly been in decline. And also had multiple acute incidents from which she’s recovered, but may not have, had hospice not been available to treat. Most importantly, she has been clear about never wanting to go to a hospital ever again.

It took the last acute incident for me to fully accept that hospice had not been a mistake. Ironically, I was able to better grasp the value of hospice when they alerted me to the seriousness of the situation, and pointed out the ER option. I asked my mother to verify for the nth time that she did not want to go to the hospital for treatment of any kind. I thought I’d been ready for her to pass, but I guess I hadn’t been, not fully. HTH.

Her body is scavenging her muscles to keep her vital organs - heart, brain, lungs,,, - going. However, she can not hold on forever if she isn't eating enough or drinking enough. Hospice is the right choice if the desire is to keep her comfortable and not try to "cure" her health issues.

When my father went on hospice the nurse asked about his meds and made recommendations. We took him off most of his meds leaving only the ones that would keep him comfortable. Prescriptions were provided for heavy pain killers, but he never needed them. He was on hospice for about six months before he died.

I found the hospice people we dealt with to be helpful and would respond to questions. They took such good care of dad and allowed him to die on his terms.

My mom's vitals-- heart and breathing were fine until about 20 minutes before she died.

The big question is WHY is her sodium low? Are her kidney's failing?