Expert: Alanna Shaikh - 11/3/2008

Question
Hello,
My mother-in-law,84 years old,  was diagnosed with Alzheimer about 6 years ago. My daughter, myself, and two ladies in the community cared for her in her home until we could no longer do it due to her declining status. She is now incontinent of urine,sometimes able to feed herself, sometimes knows us and others times not. She is in a wheelchair now and over the last month she has become very slouched in the chair and her head droops.  She is taken to PT everyday but it does not seem to be helping.  She also now is having moderate edema in her feet.  I noticed yesterday she seems to be holding salvia in her mouth and not swallowing it.  She has declined rapidly in the last 4 month since being placed in a Memory Care Unit. We feel guilt for not being able to provide the care she needs at home.  I married her only child and he passed away with cancer 11 years ago.  I remarried but am her POA and responsible for the care she receives.  Any suggestions regarding the poor posture, edema, and most concerning is her inability to hold her head up. Do you expect her time left is short?

Answer
Dear Sylvia,

I am sorry. This question is way beyond my level of expertise, and I don't have anything useful to offer. You might want to consider joining the Washington University of St. Louis Alzheimer's email list - http://alzheimer.wustl.edu/adrc2/alzheimerlist/Subscribe.htm - and posting your question there. You could also post this question to the other advisors on Alzheimer's at AllExperts.

I do want to say that you've shown amazing devotion and care to your mother-in-law. She's extremely lucky to have you. You should not feel guilty that you couldn't provide home care. In my opinion, it's nearly impossible to provide good end-of-life care in the home.

Best,
Alanna