Expert: Paula Damgaard - 9/11/2006

Question
Hi Paula,

Thank you so much for this informative site.....At least 4-5 years ago, my sister and I started to notice our grandmother, who was living by herself at this time, forgetting things.  It progressed more and more over time (when we would take her out weekly, she couldn't remember if she turned the oven and coffee pot off, candle flames burned out, etc.) then she fell 1 1/2 years ago.  She fractured her hip and needed assistance with bathing, dressing, shopping and meals.   It went downhill from there.  She ended up back in the hospital from severe dehydration and then we ended up having to place her in a nursing home.  Upon placement in a nursing home, they diagnosed her with dementia.  My sister and I live near her and my father and her other son live out of state.  My sister and I have POA and also a DNR on file.  Her memory has gotten really bad, she can't remember my name or my sisters most of the time.  She confuses me alot with other people, sometimes thinks I'm still in school (been out 20+years), talks about deceased relatives, has hallucinations occassionally,  sleeps alot and in the fetal position, has fallen several times (suppose to use walker) since at the nursing home and recently ended up back in hospital with severe dehydration/UTI and weighed only 73lbs (years ago maintained 113-116 lbs).  Last Friday she weighed in at 80.8 lbs.  They are giving her options for her meals (to get her to eat) and the only thing she'll eat (if anything) is desserts and fruit.  They do give her Ensure daily.  She usually takes a few bites and then she says she's full.  She is diabetic and on several meds.  She wears depends daily (for the last few weeks-lots of accidents). It sounds like she may be stage 6 or early 7?  Is this what it sounds like to you? I am considering contacting Hospice.  Thanks, Cheryl  

Answer
Hi Cheryl,  Contact Hospice.  Whether she is in stage 6 or 2 doesn't really matter.  What matters is whether or not you think she has a good quality of life.  If you believe that your grandmother would never want to be the way she is now, then Hospice is the answer.  That will keep her out of the hospitals and allow her to die peacefully.  For an elderly person to get an infection and not have it treated is a painless way to die.  Pnuemonia used to be the old person's friend cause it allowed them to die so peacefully.  Now everyone has the idea that every infection should be treated so that people can "live forever"!  They forget that people are supposed to die.  

I hope this isn't a hard decision for you.  It sounds as though you and your sister have done everything you could to take care of her, and she would be proud.  Please let me know how you are doing.  Paula