Expert: Paula Damgaard - 2/3/2010

Question
QUESTION: My grandmother is 92 and I am her primary caregiver.  She appears to be in the very last stages of AD.  Recently she has started holding saliva in her mouth and refusing to swallow her ensure. She does not smile as often and her responses are few and far between.  She used to hold to a bar and stand while being cleaned up in the bathroom.  Now she refuses to stand at all.  This is all changes that have happened within a week.  Is there something I can do or should be doing differently to accommodate these changes?  She is my heart and I am struggling to hold on to her.

ANSWER: Hope,

If these things happened like you say in one weeks time, then my first guess would be that she has some kind of infection, usually a urinary tract infection.  A simple urine test would answer that.

If not, then she may be trying to tell you that she has had enough.  I truly believe that they know somehow when they have had enough.  It is very important for us to remember what their wishes would be if they could talk to us.  Would they really want us to do everything possible to keep us alive or would they prefer to let go?  I think it is our duty as caregivers to give them as much Quality of life rather than Quantity.  It is not an easy thing to do for sure, but at some point we really aren't keeping them alive for them we are selfishly doing it for ourselves.

Take care of yourself and remember that she loves you too!  

Paula

---------- FOLLOW-UP ----------

QUESTION: Follow-up but not a question.  Thanks for your helpful response!!! Obviously, she was ready to journey on because she peacefully passed away. I believe she fought a great fight and was really fatigued!  I am truly grateful for the time we had together.  I pray for everyone experiencing AD and urge everyone to seek out support!

Answer
Hope, I am sorry for your loss, but am sure that she is in a much better place now!  This disease is not fun and is so hard on the caregivers.  She has a lot to thank you for.  Now take care of yourself and doing something you have been putting off!  

Paula