I am a "Long distance" caregiver for my 90 y.o. mom...that is I make phone calls for her, inform everyone when she has a health issue or other emergency, check on her via phone and Facebook, etc. I'm also her "sounding board" for when things (or ppl) bother her. Mom is currently independent and lives by herself, but I will be retiring next year to care for her full time.
Last week, mom had a heart attack that required her to be airlifted to a hospital (she went to one in an ambulance but they didn't have the facilities she needed) to have a stent put in one of her arteries. She's also developed a couple other issues. One is she has a "bubble" of some kind either near her stomach or somewhere else - they're not sure of what; and the other is she has Colon Cancer (early stages). It was there before the attack. There's a large mass in her colon that needs to be removed, as she's losing blood, and with this Coronavirus they've pushed back the surgery to remove it at least twice. The cancer has been there for some time too.
For the last few months, she's been saying how she's on borrowed time, she's "a whisper away from heaven," she could die any day, etc. With this recent heart attack, she's been saying it more often. I'm well aware that she isn't doing well, but she has friends and family that want to keep in touch. She has a (93 y.o.) boyfriend whom she sees regularly and I know he'd be heartbroken to hear her talk this way. I've offered to come and help her, but she keeps saying things like, "well I might not be here tomorrow" and the stuff mentioned above.
She DOES have other people nearby who are ready to help, but with her constant talk of dying, I don't know what to think or do. She has depression but can't take meds bc she takes a slew of other medications for diabetes, heart, blood pressure, etc. as well as Iron pills and Vitamin D3. Is some of this talk stemming from depression, or does she know something I don't?
*Not sure where this should go, so feel free to move.
PS - I have done some caregiving for mom in the past, and am well aware of what I'll be facing. I helped my mom & dad care for their parents many years ago.
With that said, my brother retired back near me and also would mention how he felt physically and had heart problems prior, too. I think he had 2 stints 10 years before and complained that "My heart isn't working right, I'm afraid it's going to give out." He passed away two years ago the night before Easter. I thank God for what time we had to be there for each other. It was his heart and he passed very suddenly. Edited to add this because we know when the mechanics aren't working right, aches and pains that shouldn't be there but, life is precious and just be sure you love unconditionally.
BE SURE that you are with her prior to the surgery. The anes. Dr. will come in an evaluate her. Be mindful that they may refuse to perform anesthesia on her. People don't know this, but it's the anes. Dr. who 'makes the call' (My DIL is an anes. Dr and she said she has turned down MANY cases she felt would not have good outcomes-that is part and parcel of her job.
At age 90, she is really being a trouper about this all. Just the HA and the ensuing drama is more than I could handle, emotionally. DH had 2 HA's 2 years ago and he sunk deep, deep into a depression that has not fully lifted. You may want to deal with her obvious depression before you move towards surgery, so she has 'on board' an antidepressant.
I would be surprised if she weren't depressed. My mom is turning 90 in a couple of weeks. She talks about dying all the time. And how she is not going to do it. So weird, b/c all my life she would tell me how sorry I'd be when she died. At this rate she will outlive me. She's already outlived one of her children.
You are a good daughter and willing to take on a huge job. I wish you the best. Dealing with depressed elders is hard (I know, my kids have to deal with me!)
I know what I'm getting into...I really do...mom & my late dad had to care for her parents before this, and I helped (whenever possible) with that, so I have a pretty good of what can happen. They were both in their 90s when we cared for them.
My mom is in need of surgery and her doctor weighed the benefits vs risk of having anesthesia at her age. The decision was to not have surgery. I happen to know the chief of anesthesiology at a major Boston hospital so asked him for advice. He confirmed that anesthesia on the elderly can have dramatic effects and so should be part of the decision. You may want to talk with her Oncologist about this before moving forward. Just so you are informed. As others said a psych consult with a geriatric psychiatrist is a great idea. Mom May be depressed or worried given the HA or she may just know that she is soon departing. Either way say all you would like to now. Enjoy those special memories of life together when you chat - whatever will make you both happy. I think my mom is also feeling this way and notice she tells me she loves me with such determination like she wants to make sure I really hear her heart.
With increasing health issues, she needs a healthcare proxy - now! They need to know IN DETAIL how much medical attention she wants. Any surgery at 90+ is risky, and someone may need to know if she wants to be kept alive if she'll be in bed for years, if only her heart is working but not her brain, if she's going to have breathing and eating tubes stuck in her and constantly tended to, and LOTS more. A living will would be a good start for anyone facing surgery, but the one-page thing people get leaves out MANY hard questions.
That's all I can add to Lealonnie 's excellent answer. Best of luck on this journey!
Wonderful responses
From what I understand, the colon surgery is still scheduled. She’s having it June 10th. I don’t think she had much anesthesia when she had the stent put in her heart, as she said they didn’t knock her out. Wouldn’t the hospital have told her surgeon and the doctors about the effects of the anesthesia?
It does something to your chemicals, then you have the reaction to anesthesia and it is a perfect breeding ground for depression and talk of dying.
I would acknowledge that she feels like she may be dying soon, none of us knows when our time is up. Encourage her to make the most of every day. For you, please know that she is 90 and she has lived a long time, she could be getting near her end.
You have to decide if you should go see her now or wait. Only you know how you will deal with this if she does die.
Believe me, I am well aware that Mom could pass any day now (Nothing personal towards you). In the past she’s said this is why she and her boyfriend like to go out and do things. They both know their days are numbered. I’m happy for her she can do that. If she should pass away, I know she will be in a better place and much happier. And I will be happy for her.
Some people do have a premonition that they're dying.........their soul seems to know ahead of time. Others just talk to hear themselves talk and to garner sympathy or reactions from loved ones, such as my mother is doing.
I don't know if your mother's soul 'knows' it's getting ready to transition. I don't think anyone can answer that question for you, my friend.
I do think a hospice evaluation is a good idea since she does have a lot of serious health issues going on right now. Hospice also has chaplains who can speak to her about the whole transition process, if that's what she'd like to do. If she's nearing the end of her time here on earth, I don't imagine a 'happy pill' is the answer for her either. But, like BarbBrooklyn said, a psych consult may not be a bad idea. Elders take TONS of meds and adding an anti depressant into the mix, if appropriate, doesn't always present a problem. At the very least, some anti-anxiety medication if you feel that her talk of death is arising from anxiety over her declining health (and who could blame her?)
Wishing you the best of luck in this difficult situation. Whatever lies ahead for your mom, I wish her no pain, discomfort or anxiety of any kind.
She comes from a family with good genes - raised on a farm - and her siblings and parents had long lives. Her mom died at nearly 101 and dad at nearly 100, brothers died at 98, a few years apart. Her health (IMO) isn't as good as theirs though.
I do think she is having anxiety issues, as we all are, partly due to the Coronavirus, as well as having her Colon cancer surgery postponed at least twice in the last few months. I know that's been bothering her. Fortunately, she, most of my family, and I are Christians and are praying. She's been saying she has to "keep living" for me and for her boyfriend. We've both told her to not feel that way, and if she wants to give up, that's ok. After all, with her heart issues, we wouldn't want to be to blame for her having a 3rd heart attack. (Hope that makes some sense.)
Also, has anyone considered a hospice evaluation?
((((Hugs))))))
She actually had chest pains last Sunday, but wouldn't go to the ER. When they kept returning last Tuesday (April 28) she finally went. Talk about stubborn!
I will have to look into hospice, altho I'm not sure if she's at that point yet. This is why I wonder if some of this talk of dying is stemming from depression...
You have promised to care for her but to what extent? How far away do you live? What will be the consequences if you need to take an early retirement to help her? Are you thinking she is a candidate for cancer surgery (if that's an option)? Anesthesia at her age is a bigger risk. If not surgery, would chemo or radiation be her only other options? If so, will the effects on her body and mind be worth it? Were you going to move to where she lives to care for her? Her prognosis and what (if any) treatment is chosen, may answer a lot of these questions.
Most importantly, she needs to have all her legal ducks in a row. I'm hoping you are her durable PoA and the she has a Living Will and has designated you as her medical representatives with her medical team. And a Last Will. It would be advisable for you to make a trip there prior to her health going into further decline, so she can show you where all her important paperwork is located, and to tie up anything that is in doubt. Go there during a weekday so that if you need to see an attorney or talk to social workers or her doctors you'll be able to. Others will soon post good insights for you. Let us know how it goes and come back if you have more questions to ask or just want the support of those who have been in your shoes. Blessings!
I'm 55 now, and have enough years in to retire now. My pension wouldn't be much, but the plan has always been for mom and I to split the bills. (Of course this is all providing she's alive when I do.) My oldest brother is PoA, and I know she has a Last Will but not sure about a Living Will. I might also be her Medical representative, will have to check on that.
I live about 4 1/2 hours from mom. I visit in the warmer months. We've discussed my caring for her for a few years now...the plan is for me to move into her home, and then buy a house for myself, and have her move in. This is bc I have family who is dead set against my living on her property with her. (Long story.) I want to wait before buying a house when there IF POSSIBLE. It won't be a problem for me to move down there, as I've discussed this many times with her and the family. Even if I moved there and she passed away, I would stay in the area bc I have many relatives and friends I've met/made over the years. I'm single with 3 cats, so no worries. I have told her I might be able to retire sooner if necessary (and that's another story, too. LOL)
Considering her health issues, all her doctors say she's in pretty good health for her age. Her surgeon, the one who will perform surgery to remove the mass in her colon, has said she can have it...but that was before this HA. She had heart issues before, and he was aware of it so that helps. She's already said she doesn't want chemo or radiation, and I don't blame her. She's going to her Primary dr. this week, and will be seeing her cardiologist soon. The Colon Cancer diagnosis was in November 2019 and a treatment plan was laid out before the HA. Not sure now if it will change.
Hopefully, when this Coronavirus nonsense settles more, I can visit for a few days and see if she & I can get all of this straightened out.