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Mom has been in Hospice care for nearly two months and has declined with each passing week. She is now at a point where she is bedridden, yet still insists on getting up and going on the commode. She gets very agitated when we try to persuade her to remain in bed as she is wearing diapers. She does this twice a day, and gets hostile. She is becoming a threat to herself and us as it is very hard to to do this as she is dead weight. Other than these few outbursts, she sleeps continually. She has eaten very little over the past week, and will drink an Ensure once or twice (but not every day). When in this agitated state she will try to spit out her meds. She gets Haldol and Ativan 3X per day, Morphine every three hours. Will Hospice increase her meds to keep her sedated continually or use a catheter to ease her distress? They thought for sure she would pass away last weekend, but she rallied and is now waking up and is very difficult to deal with. She has Vascular Dementia.

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So sorry to hear this Abby. I would speak to the hospice nurse and see what they recommend.
I wonder if transferring to a hospice facility would be a consideration at this point?
I know you are caring for your dad as well so a lot to coordinate for all concerned.
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It will be useless attempt to correct some her problems. She is about to depart from this life at any time.
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funkygrandma59 May 2022
It's NEVER useless to help make a dying person more comfortable, so they can transition more smoothly from this life to the next.
What you said was cold and heartless, and I can't help but pity the person you're caring for or cared for.
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Yes....I asked hospice to catheterize mom when she was a few days into being fully bed ridden. And Ativan and morphine comes in liquid form which can be given in inside the cheek...much easier that way.

God bless.
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I’m really sorry to hear this. A female catheter will take away the urge to physically urinate, but if you can’t get hospice to consent, I’d say to offer mom a bedpan as she can’t get up.
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Dear Abby
feel for you very much with this.
I would try a catheter and bed pan. My dad has a catheter we have tried bed pan but it can be a little uncomfortable if they need some more time.
dad has a butrans patch which is 24 hour releasing pain relief, liquid medication is also good.
sending love
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Grandma1954 May 2022
the only problems with bed pans are they are VERY uncomfortable to get on to and with the thin skin that comes with decline and end of life it is easy to develop skin tears.
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Hospice should provide a Hoyer Lift so that she can safely be moved to the commode.
Normally if a person is confined to bed a Hoyer is not needed as much since she is using disposable briefs (diapers) BUT if she is so instant that she gets agitated then the goal of Hospice is to keep her calm and comfortable and if this is what she wants to do then ordering a Hoyer should not be a problem.
It is worth asking about.
The "problem" with a catheter is that many dementia patients will pull out tubes this is IV's, feeding tubes and catheters.
And even with a catheter if she still feels the urge to urinate even if her bladder is empty she will still want to get up.
Catheters can lead to increased UTI's as well.
Maybe somewhere deep in her brain she still "knows" that getting onto the toilet is "right" and to go in your pants is "wrong" and even through the dementia she is wants to do "right".
((hugs)) peace to both of you.
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Patients who are dying are either unconscious or semi unconscious. They are barely aware or not aware at all of their surrounding. Actually, the idea of inserting a catheter in her bladder on this dying woman is for the benefit of the caregivers only. The patient will care less about having or not having a catheter. Having a catheter inside the bladder can be uncomfortable and it's the quickest wat to introduce gems and cause an UTI. One person in the forum scolded me for thinking with my head instead of my heart. She thinks that all decisions about caregiving need to be done with the heart, not with the brain. Good for her.
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