My mom (93) with advanced Vascular Dementia. How do I know when the end is near?
The past few months she has become much more sedentary; she usually would walk, now not so much. She is on Seroquel and Buspirone for mood/behavior issues because she gets so agitated and excited. Very irritable. Now she is calm, smiles, but sleeps off and on in the recliner most days and through the night. She is incontinent now, rarely can go to the bathroom anymore. She struggles to feed herself, and doesn't say much. When she does talk, it's a few words but no real conversation. She is confused often, and when she tries to make a conversation these days she struggles with words and non words come out instead. Like her brain knows but she can't get it out right. She hasn't even gotten dressed out of nightgown and robe in about a week. Again, she is 93, with advanced (stage 6 I'm guessing?) vascular dementia. She was not this bad a month ago, and 2 months ago she was even a little better than last month. Seems like a pretty rapid decline to me. Also she was on those 2 pills now for 2 months so I don't think it's that. She has a cough, and she feels clammy at times but when I ask her if anything hurts she says she feels "fine". She drinks 2-3 cups of coffee a day, has a good breakfast, light dinner. and pie or a muffin. but it's tough to get her to drink water. Just wondering about hospice. It's depressing but I have to be prepared and really trying to keep her home. Thinking about pneumonia too... just don't know what to do, if anything, or let nature continue taking its course. She has a DNR in place and I am POA. Thoughts?
The end point to VaD is often a heart attack or stroke. We don't have a good way to predict it. It seems to me that people with VaD can be like energizer bunnies with weak batteries. They keep going even when it looks like they're ready to stop.
Huge hugs coming your way. I know what you're going through.
My mom will often recover from declines, but never fully back to where she once was. The process has been excruciatingly slow and unpredictable, but the one saving grace is that I usually have time to adjust to each little decline before another one crops up. When our nurse was in this month she commented that mom was really pretty healthy, good BP, healthy lungs, good bowel sounds, peeing OK, pain under control. Of course she is also fully incontinent, sleeps 18 hours a day, can't turn herself in bed and recently is having problems standing, no appetite, as well as mostly deaf and blind... but other than that she's mostly healthy ;)
She would be ok one week, then the following week you would think this is it, it's the end of her journey.... then she would bounced back eating more, chatting more.... then it was noticeable that her journey was finally starting to end as she refused to eat or drink, wanted to sleep, and was under the watch of Hospice. Hospice was able to pin point the final hours within 24-48 hours.
Elders will slow down on their eating because they aren't getting the exercise that requires more fuel. Staying hydrated is important only if you can get water into them. My Mom wouldn't drink Ensure or Boost unless it was in a cup of ice.
I do like how the nurse called your mother pretty healthy. Sounds a lot like "fine."