Mom re-broke her other hip and is now on Hospice
Back in November I posted that my mom had broken her OTHER hip... she broke her right hip in September and then broke her left hip in November. Well last week she fell again and re-broke her left hip and broke her left elbow. Actually, she broke her femur around the place where the "post" of the partial hip replacement was inserted. It was a very bad break.
My mom had let us know that she would not want extraordinary measures several years ago, even before her dementia. And then more recently, she had a moment of clarity and told me that she knew where she was in life and when the end came ("and I think it'll be sooner than you may think") she was OK with it, and to just let her go.
As with the first break on the left hip, I asked the ortho what would happen if we didn't do anything and he said that we needed to do the surgery so that she wouldn't be in excruciating pain. He said that she needed 2 units of blood, but that was "no big deal" in that anyone who had that break would need it to. So I said OK. Well then she was transferred to the MICU. The next day was supposed to be her surgery but the surgeon came in and said that her hematocrit was too low and that she needed 2 more units of blood. So we said OK. At that point she was "basically comatose." (that's what the surgeon told someone the next day.... never put it to me that way at the time). Anyway, after the transfusion, she had an amazing turnaround and was talking and joking (she still had dementia, but she was communicative). So we went forward with the surgery.
But my brother and I, who are both POAs, talked during the surgery and decided that we had probably screwed it up and through our ignorance of what was going on, had disobeyed Mom's wishes. We felt sick about it.
So yesterday, when the hospitalist came by to talk to me about her condition for the surgery for her elbow that is scheduled for Wednesday, it turned out that she received 3 more units of blood during the surgery, making 7 total, but her numbers had gone down again significantly overnight. And she needed more blood. And she needed platelets possibly, and her albumin was down, and this and that.
So I asked him about not doing anything. And he said there's a difference between not prolonging death and not extending life. He said that we were not at the "not prolonging death" stage. So I asked "what if we know that she would not want us to extend her life this way?" and he and I talked more about it and he said he would call in Hospice. I told him that she does not want artificial nutrition or hydration, and he said OK. I asked him what sort of time frame were we looking at, and he said 1 to 2 weeks, but rarely it could last a little longer. He said it was OK to give her whatever food she wanted orally and water, too, if she asked for them.
So the Hospice nurse talked to my brother and me last night and she said that since she had taken some food and water, it would be longer because Mom would go on a week or two after not having any food or water.
The only food she's had was about maybe 3 or 4 ounces of apple sauce to take her oral meds, 4 or 5 small spoonfuls of cream of chicken soup and 2 small spoonfuls of vanilla yogurt, and maybe a couple of ounces of water.
What do y'all think? Who's right... hospitalist or hospice nurse? My stomach hurts... we don't want this to be all protracted for Mom! Her elbow is still broken! but the first time she complained of pain was last night after we moved her off of MICU to another room where she will stay in inpatient hospice for 5 days. She has been denying pain the whole time otherwise!
Lord have mercy. This is so hard. I know she told us her wishes in an attempt to make things easier on us, but, well, it didn't work. This is HARD.