Yep, now that he's been dead for fifty years, I imagine there is a strong resemblance.
Phoenix, I'm just catching up on your mother's situation. Sorry things have deteriorated for her. I hope you're feeling better and let me know if there's anything I can help clarify on her transfusion needs.
JPB- Apparently, from what I have read, her deteriorating kidneys may be the cause of her anemia.
I spoke with the woman from the assisited living center who is the head of the medications. She has been around for 15 years, is sharp as a tack, and just about runs the place.
She was very concerned that I consented to have my mother taken to the hospital in the first place, as she understands what a day in an E.R. can do to someone who is very elderly and confused. A number of people have mentioned that oral iron pills might have alleviated some of her symptoms withut causing her the trauma of being in the hospital.
Sometimes, I think that I am working at cross purposes. She is 97+. Her cognitive abilities are declining more rapidly, and she sometimes states that she wants to die.
I really need to think this through. At this point in time, was transfusing her really in her best interests? To what end? To prolong a dreary, confused life perhaps a few more months, or maybe even a few days?
Am I just stretching out the inevitable? Am I really being good to my mother, or just adding to her misery? I really don't know.
There are days when she seems content, even happy. I really don't know the answer to this, and right now, apparently "the ball is in my court". Since I don't believe in a god, it seems perverse that I am expected to play one.
Phoenix--
The End of Life Whipsaw is guaranteed to be guilt-producing. Your mother is dying in style.
There is no one right answer to how much intervention is best. I'm sure it's a very difficult position for you -- is she able to discuss her wishes on future interventions? It might help if she can be part of the decision-making. As an aside, my BIL passed away last week, seven weeks after deciding on no further interventions. It was very difficult for my sister, but she knew it was his decision and didn't feel like she was playing 'god'. Whatever you decide, don't let those who would choose differently make you feel guilty. It bothers me somewhat to hear that the woman in charge of the meds seems to be second guessing you.
Your mother's anemia might have contributed to her recent level of confusion. Red cells carry oxygen to all organs, including the brain. When her anemia reached a certain point, she probably didn't have enough oxygen-carrying capacity to support her congnative abilities - however limited they may be. The transfusion probably gave her a much quicker boost in treating her anemia than iron pills would have, but it wouldn't have had any positive effect on her kidney disease or other issues. The fact that she has circulating red cell antibodies complicates things. Depending on which specific antibodies she has developed, the availability of compatible blood might become limited. Some antibodies are easy to crossmatch around, others are not.
It's unfortunate that she had to be transported to the hospital for the transfusions. Even if her residence center offered in-home transfusion service, they might balk at providing it for someone with atypical antibodies. I'm familiar with some visiting nurses and home-health groups that have done transfusions in certain circumstances. You might want to investigate if your VNA offers such a service. There are those who consider in-home transfusion no greater intervention than oxygen support.
Whatever you decide, Phoenix, will be the right decision. Regardless of which way you go.
JPB- I don't know if you read an earlier post, but a doctor at the hospital said that with her kidney condition could live 6 months to a year. Egads, she was put on hospice over a year ago, and she is still percolating.
I am not upset about the gal who questioned the wisdom of sending her to the hospital. I think that she had a really good point. If you saw my mother after her day in the emergency room, you would know what I mean.
I don't think that my mother really knows what she wants. Thirty years ago, I suspected that she was committing slow suicide, but boy, was I wrong. She was always very histrionic. I remember one time, some years ago, when she cried that she wanted to die. I looked her straight in the eye and said, "Whatever turns you on". That snapped her out of that one, quick. Her affect changed immediately, as if I had turned off a light switch. She had had a history of depression, and had been on and off on anti-depressives for years.
I think that from now on, I will take a more non-proactive course. I don't think that there is any point in prolonging the inevitable, and don't want to put my mother through any more trauma.
Mental decline and dependency
You sound as though you've got it right. The trauma for your mother with continued medical procedures and interventions seems to me worse for her than a further shortening of her already shortening life.
This is a difficult difficult decision to make, but I truly feel that the caring act is in stepping back and doing as little as possible, consistent with her comfort.
I have been directly involved in making this decision twice - for my grandmother, and for my sister. It wasn't easy, but it was plain that there was nothing left for either of them in this life.
My thoughts are with you.
Forgive me if you stated this before, Phoenix, but have you signed a "Do Not Resuscitate" order for your mother?
Mental decline and dependency
When I had to place my mother in a nursing home I signed a DNR form. Unfortunately, the law in Massachusetts requires that anyone named in a will must also sign. This meant tracking down 11 grandchildren - one of them at sea with the Merchant Marine - and getting their signatures.
They had totally disapproved of my decision to place my mother in a nursing home, but I - and the court - overruled their objections. They finally had the good sense to see that the DNR form was important for my mother's welfare and everyone's peace of mind.
At the time all this took place, Living Wills and Health Care Proxies were barely poking up over the radar. I don't know if my mother would - in her right mind - have signed such documents, but considering her own mother's death and my sister's, I believe she would. However that's something we'll never know.
Just popping in to say my thoughts are with you, Phoenix. You have some very thoughtful posts here regarding you mother and her treatment.
I do hope you can take to heart the "Whatever you do, you shouldn't feel guilty," that someone posted. You are there doing your best. Nothing to feel guilty about when you are trying to do your best in these circumstances.
I'm glad to hear that. Sorry to be so nosy, but I just went through this with my brother who died last July. Even though he had suffered, severe, irreparable brain damage, his daughter could not bring herself to sign the DNR. When the time came that his heart was failing, the nursing home sent him to the hospital. Fortunately, the whole family was there to help T. make the hard decision to let her dad go. We all assured her that he would have wanted it that way.
My mom is the same age as your mother, Phoenix. I'm lucky that she is still in good health for her age. She just finally agreed to get hearing aids and it's made a big difference in her quality of life. She was beginning to shut off from the world. Now maybe my mother-in-law will consider them
My brother died when he was 26. He was riding in his girlfriend's car and they were on the way to her apartment when he looked up and saw a truck coming right at them. His girlfriend apparently wasn't very attentive and didn't see the truck right away. Anyway, my brother reached over and grabbed the steering wheel and tried to get the car over to the other lane (there was a guard rail on the right, ruling out that option) and he managed to get the car only far enough to the point where his side was hit head on.
He stayed alive for three days with almost every bone in his body broken and was, not surprisingly, comatose. He never did regain consciousness and I still remember with clarity the moment he flat-lined and we all knew he was gone, but my mother refused to accept it. She fell onto his chest and began to hug him and told the doctor, "He's still alive! He's breathing! Can't you see?"
We all knew, as I'm sure my mother did, that it was merely the oxygen machine still carrying on its relentless pumping, and we peeled my mother off and tried our best to console her.
It was a god damned gut-wrenching moment and I shall carry it to my grave.
And that son of a bitch that killed him was drunk on his ass.
I'm not sure why I put that story on this thread. I guess Swimpy mentioning her brother triggered something.
