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She is in stage 4 Che with kidney failure. She can't walk now and is having to use a catheter due to no urine output. She is being treated for a UTI also.

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I’m so sorry that you are going through this. It’s hard to watch our parents declining.

The hospice nurses are really wonderful. Please speak to them about your concerns with your mother’s condition.

Wishing you peace during this difficult time
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Yes, this should be a question for the RN. She should be available 24/7. Not sure if a drain will be used, this is usually done in a hospital and with Hospice there are no longer any Hospital visits. Maybe a diuretic can be used but Morphine now to ease breathing and pain.
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Why aren’t you asking her doctor? What makes you think anyone here can guess?
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Deanna, they have many medications in hospice to help with pain, breathlessness, nausea and restlessness. I am so very sorry for your coming loss. There's just nothing to do when the heart fails and medications no longer work. I am so thankful you are getting Hospice care on board and I wish you and your Mom the best, and rest and peace for your Mom.
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ElizabethAR37 Jul 2023
Totally agree. You have years of experience and knowledge behind your input which I do not, but I would certainly hope that Hospice would provide complete symptomatic relief were I in that situation. (These wishes are reflected in writing: a POLST, healthcare directive and a personal letter.)
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She is in hospice and yes, it is Chf . We have her in respite care but she will be transported home in 2 days. She is nauseous and vomiting. She is completely bedridden now.
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TeethGrinder65 Jul 2023
I hope the hospice care will make her more comfortable, Deanna. Ask your hospice person for signs of how long she has. The nurses are very experienced with this and can help you know what's around the corner. They should be giving her meds for the nausea and morphine to ease the pain of breathing. Diuretics can help with that, too. Hang in there.
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She is actively dying if she is not going for medical help. Her breathing will get more shallow as her lungs fill up. Perhaps she is feeling short of breath. This falls into the category of feeling distress and discomfort. The hospice treatment is usually morphine to keep her calm. Morphine is also used in acute CHF along with diuretics but she is not putting out urine
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As no doctor treating your dear mom will begin to make a guess on this one, given she is his/her patient, Deanna, I don't think it reasonable to expect that we will make a guess here on Forum.
I am a retired cardiac/telemety RN. I haven't a clue what to tell you.

Your Mom's doctor will have a lot of info for you if you are POA for your mom. He can tell you ejection fractions for the heart which indicate how efficient a pump it currently is. If she is in kidney failure secondarily to heart failure makes a difference-- as well as she could be in heart failure secondarily to kidney failure.
These two systems are necessary for life.
I assume you meant to write CHF and not CHE? Am I correct? If so CHF read out is "congestive heart failure". The pump is failing. The pump is essential to life.

Peripheral edema legs, abdomen and etc will indicate failure of the right side of the heart. The more worrisome is the left side, which is allowing fluid to gather in the lungs. Shortness of breath and crackles in the lung are the indicators here, the inability to lay back to rest.

There are many medications to help this, but they become fewer as you go along exhausting the options, and the modes of administration (by mouth or by IV). The mainstays are diuretics that eliminate fluid; at the same time they do this they also wash out crucial electrolytes, sodium and potassium et al, that are needed for life.

Your Mom may be in end of life stages now if you have been told stage IV. If you are her POA it is time to talk with the doctor about hospice support for her comfort if she doesn't wish to fight for life to the very last moment.
If she does wish to go on fighting to the last, she should at least have palliative care where comfort is addressed but she can still avail herself of treatment.

I am so sorry. No one here can guess what will happen nor when. But you understand the facts in your mom's dire diagnosis if you are in touch with her doctors; they are your best information source as each patient is as individual as his or her own thumbprint.

I so wish you the best. I am glad she has your love and support. That is crucial now. We aren't built to last, Deanna. Not forever. I wish it were otherwise for your sake.
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If she is under medical care they can address this, If she is under hospice you can talk to her Rns about it, but diuretics may help, or a drain
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