[LexLu]

Listed below is the latest info about my 96.5 year old grandma. Note -- she is seeing the doctor and nurses in her home tomorrow... (my Uncle is her caregiver and he is just wonderful with her). We are all worried because she is refusing to eat. I saw her today... She is really out of it... Her hands are freezing... But she wants to be cold? We kept putting a blanket on her and even gloves and she kept taking them off... I think food doesn't taste good to her anymore? Another note: she has alzheimers (we believe)... She is also very pleasant. Always the sweetest... Never complains. It's amazing to me. She doesn't take any medications besides eye drops to prevent macular degeneration progression.

This is the email my uncle sent to me (please offer any advice):


Refusal to eat [exceptions: black raspberry ice cream, plain water, some juices]

2. Nothing tastes palatable [favorite foods are routinely refused; no hunger pangs exhibited]

3. Swallowing difficulties [several seconds required to swallow ordinary water]

4. Very low blood pressure [possibly triggered by dehydration] -- B.P. Reading is 94 / 70

5. Constipation or irregular bowel movements [no B.M. For ten days; no abdominal discomfort]

6. Drowsiness and listlessness during daylight hours [inclination to nap, although roused easily]

7. Sparse urine production [very strong odor noted; normal color and clarity; no apparent discomfort]

8. B ody temperature of 97.3 degrees

[J_9]

If you haven't gotten her to a hospital already, you should. That B/P reading alone is enough to be concerned about.

[LexLu]

She's always had this low BP though... for some reason... even when she was hospitalized 2 years ago (broken wrists - she was a passenger in a sever car accident --- hit by armored car)... I remember the same BP issue.

I think I'm really asking for help mostly about the eating... this is the thing that's so unusual.

[J_9]

Since it appears that she has had a change of mental status (incoherent, your word), it is important that she get treated as soon as possible.

[Wondergirl]

If I were your grandmother, I wouldn't want to be forced to eat or drink anything. I remember when I was very sick several years ago, food and water were the last things on my mind--and I wasn't hungry or thirsty. I just wanted to sleep. IVs revived me enough for me to begin eating. My mil is 92.5 and has been very sick several times lately with the same behavior. Her son managed to coax her to eat and convince her to accept a saline IV that revived her.

Since your grandmother has so little going in, that's why there's almost nothing coming out. If she's comfortable and not in pain, I'd just let things continue as they are. Be sure she gets the ice cream she enjoys, and tell her how much you love her.

[J_9]

Personally, I would not let her continue as is WG. I've seen too many downhill slides while working in the ER. She needs to be treated tonight for her dehydration. Elderly people are as fragile as newborns when it comes to dehydration. Mental status change is a very serious indication that medical intervention is necessary.

[Fr_Chuck]

Do you have home care nurses coming in on a daily basis, it sounds like she needs more professional care.

[LexLu]

There is team of nurses evaluating her tomorrow... they specialize in elderly care and the first priority is this eating issue.

[J_9]

I hope everything goes well with you tomorrow. As a nurse myself, I hold a high regard for home health nurses, but I also know that a change in mental status can be cause for extreme concern and should be treated promptly.

[LexLu]

Thank you very much for your help. I was so worried earlier today... She is very old... and she has always been my favorite grandma. She is a SAINT. When my other grandma passed (about 7 years ago) I will never forget how she was so angry and difficult for years before she passed... she was just angry... That miserable experience with my mother's mother is so different from my (almost) 97year old (father's mother) grandma (I will call her "Jane") now... I am just amazed by how my grandma "Jane" is such a force to live. She survived breast cancer in the late 70's (before I was born)... she raised children alone (widow)... she also became a doctor in the 80's after her husband died to support her children. I want to write a book about her.

[LexLu]

I am out of the state she lives in... so I'm grateful to get to visit with her today... but from what I observed --- she is very well cared for. She regularly sees a doc who does home visits. She lives in her home and her son (my uncle) takes very very good care of her. We should all be so lucky to have our children help us in this time. I don't think she would be here if she wasn't in her house. She never married again (after being widowed)... she was so independent... and I used to love (and also ask for extra visits) to go with her on the weekends when I was young... and when I was 10 and 11... I think I still stayed with her on new years eve (we watched the ball drop on TV together) up to age 15-16 even!. We would play rummy Q... or scrabble...

[J_9]

She sounds like a wonderful woman. I hope it all goes well. Please keep us posted.

[LexLu]

She has been evaluated today and the decision to give her in home hospice care has been made. It's very sad to me... but I want her to be comfortable and I'm happy I will get another visit with her before the end.

Thank you for your replies :)

[Wondergirl]

If I were 97 and homebound or especially bedbound, the last thing I would want is to be taken to a hospital and subjected to IVs and oxygen while lying in an uncomfortable bed and surrounded by strangers. My preference would be to die at home in my own bed and surrounded by loved ones and my cats.

My heart goes out to you, Lexlu, and to your beloved grandmother. May her last days be pain free and comfortable with loved ones at her bedside.

[J_9]

How is Grandma? You all are in my thoughts during this rough time.

[jammy23]

Write that book but she really sounds like she needs to be in a hospital.