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Hello,
So my mom had a stroke a few weeks ago, she has been doing a bit better. She is responsive, she smiles when I talk to her and mumbles back to try to answer. But currently she's getting more fluid in her lungs and is obviously having trouble breathing because of it. Should I somehow get the fluid pumped out so she can breathe better? (the dr's comment is always about "quality of life") Currently they give her some morphine to help her relax and then her breathing isn't as hard, but I don't think that's the answer. Has anyone had this experience? (I think she WILL die sooner than later at this rate, but its not a nice/natural way to go...).

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Aspiration pneumonia is what took my mom in the end, it had got to the point where it was her own saliva that was pooling in her throat and lungs so although they did suction periodically there was really little else that could be done. I don't agree that it is a such a terrible way to die given that endings almost never look like those presented by Hollywood. Morphine helps, don't resist using it.
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Something you can do is to ensure that she doesn't lay flat on her back.    We were told that my father should use  a pillow behind him to prop him up.  

When my father was in palliative care, then segued into hospice, there was a suction machine at his bedside.  It was used by the nurses when they checked on him and the secretions to ensure he wasn't choking.    Eventually he was only able to sip something like 1/2 tsp. of water, and even then it was difficult to avoid some choking.

He also wore a Scopolamine patch; I didn't have any way of determining though if it was helpful in reducing secretions.
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Hello,
Just wanted to thank everyone of you that took the time to respond to my question. I really appreciate the insight you've given me to know how to handle this situation. God bless you !!
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There are products that will thicken liquids so they will be less likely to be aspirated. It is possible to aspirate solid foods but less likely. (I stopped giving my Husband "slippery" foods like peaches, nectarines, as they can slide the wrong way)
The thickening products do not change the taste jut the texture. If she is on Hospice they should give you a product like that.
It is possible that she also has an excess of phlegm, saliva and other secretions. If that is the case a swab to wipe the inside of the mouth. Turning her on her side will also allow the secretions to run out of the mouth.
When my Husband was on Hospice they ordered a medication (off label use) that would help dry secretions. The medication was Atropine an eye drop.
Talk with the Hospice Nurse before giving anything like Benadryl or other OTC medications for "runny nose, watery eyes...
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I believe Hospice does not treat, but gives comfort. I pull my wife off Hospice for that very reason over 2 years ago and she is still going strong. For fluid overload I stay in close contact with her cardio to adjust her meds as needed and blood work as needed.

Every time she is hospitalized, the hospitalist pushes me to put her back on hospice but I refuse mainly because she has frequent UTI's which are EBSL (extended spectrum beta-lactamase), which require cultures to treat properly. Hospice will "treat" with antibiotics, but will not culture to find the best antibiotic which is IMO, not treating at all.

Hospice is a great resource if someone is truly near "end of life" but if they have frequent illnesses that can end their lives without proper treatment , then no.

My wife has had at least 5 cases of EBSLs that without culturing WOULD have killed her due to sepsis. Also several episodes of pneumonia and other CHF fluid overloads that would have shortened her life. So, at least 9 times in the past 2+ years that she probably died if I had kept her on Hospice.
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MJ1929 Jul 2021
This is completely false. Hospice absolutely does treat. What they don't do is try to cure incurable issues or send patients to the hospital.

If you want to send your loved one to the hospital, you can take them off hospice, then put them back on when they come out again -- or not -- but hospice doesn't hasten people's deaths. Hospice allows the more natural course to be taken, minimizes suffering from unnecessary treatments, and focuses on quality of life rather than quantity.
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Is your mom under hospice care? If so, they're job is to only keep her comfortable and as pain free as possible.
If you feel you should be doing more for her, you can always request they take an X-ray of moms chest, as it sounds like she may have aspiration pneumonia. And if in fact she does, they can treat it with antibiotics.
My husband developed aspiration pneumonia in Nov. 2108, and it almost killed him. After being in ICU, and then the pulmonary floor, he returned home after 2 1/2 weeks, completely bedridden, where he lived until Sept. 2020.
And of course during my husbands dying process, his lungs filled up with fluid as well, and hospice gave me patches to put behind his ears to try and help, along with some drops to put under his tongue as well. None of it really helped, and it was actually horrific to listen to my husband gurgle all that crud for days and days.
I believe that you should do whatever you feel you need to do to help your mom at this point. And if she doesn't have her final wishes written down anywhere, then you can ask her what she wants. Hopefully she can at least respond with a nod or shake of her head.
Praying God's blessing over you and your mom, and asking Him to give you wisdom and discernment in this situation.
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How old is your mom? My mom had a massive stroke at 71 - it took her about 4/6 months to slowly learn to strengthen her swallow and then about 7 full months before she could eat a normal diet - she went from purée (with thick it packets) then to mechanical soft - and every few weeks she moved up (with a speech pathologist) until she was cleared for anything she wanted. My mom slept 90% for the first 2/3 months so it took her longer to regain her swallow. My mothers stroke was extremely large but she didn’t have any health issues previous to her stroke so once she gained strength and let the brain heal she was able to start therapies.
She had to be as a 45 degree angle to sleep - she was on a peg tube for food and water until her swallow was strong enough - (we used thick it packets for all thin liquids - even soups and smoothies) until her swallow and Cognition was stronger.
Her stroke was 1/2019 and she eats with no issues since late June 2019 (though I always cut things smaller still to this day). Though it took my mom longer than most she did fully regain her swallow.
I am unsure of your moms age or other health issues - or if she was given a swallow study and assigned a specific diet and or oral speech exercises before being released from the hospital? Try to make sure she is fully upright while eating and does not lay back for awhile afterwards. You can try thick it packs - or request a swallow study. I do not know the terms of hospice in regard to this or your moms condition but wanted to share my experience with the above - sending you good wishes.
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