About six weeks ago, my 90 year old great aunt (whom I've cared for since her husband died last year) was admitted to the local hospital suffering from severe nausea/ vomiting/ weakness. Doctors quickly diagnosed gallstones and infected gall bladder. After debating and running tests for several days, surgeons decided there was no way they could operate; my aunt has a bad heart and almost died from anesthesia for a minor procedure (lower GI series; they had a very difficult time waking her up....blood pressure fell to 70/30).
To complicate matters, my great aunt has now been diagnosed with terminal cancer in her intestines (since leaving the hospital). Also, she hasn't eaten (more than a few bites at most) in more than five weeks....weight has fallen from 105 lb to 87 lb in the past month.
At the time she was being discharged (three weeks ago today), all of my aunt's doctors.....her MD, the cardiologist, the gastro (stomach/ liver), pulmonary specialist, and urologist all recommended a hospice for my aunt.
At the time, I opted in favor of a local skilled nursing/ rehab center.....hoping for a miracle. I now realize the doctors were correct. In addition to all her illnesses, my great aunt is also totally blind (from diabetes). Since entering the nursing home, she has fallen twice, and the last fall (Friday a.m.) was serious....requiring 15 stitches in her forehead and a trip to the ER (I'm amazed she didn't fracture her skull).
Here's my dilemma: my great aunt still has some mental faculties; knows me....except she is suffering delusions (doctors explanation); can't seem to understand she is dying; thinks sometimes she's at home or still in the hospital. That's a major reason she keeps falling....thinks she's well, and tries to get out of bed and reach the bathroom (even though she's wearing diapers); says "I'm 90 yrs old and am as well as ever" (also says she's eating everything on her plate; when the reality is she is eating virtually nothing).
While my heart says hospice care in the nursing home is best for her, I have a couple reservations. First, my grandmother is concerned the hospice folks will "starve" my great aunt to death. I've tried to reassure grandma not only is that illegal, but something I'd never allow. I don't want my great aunt to die before God calls her home....but also don't wish to see her used as a guinea pig (feeding tube, dialysis, heart/lung machine etc); especially since her own living will states clearly at the time doctors deem her condition as terminal, she wants all forms of life extending/ support to be stopped.
I'm also scared to death unless hospice care is brought in soon (providing adequate medication to properly sedate/ provide pain relief to my great aunt and stop her from getting out of bed), she's going to fall and fracture a hip or pelvis. If this occurs, there's no way surgeons will attempt to operate....not on a 90 year old diabetic with a bad heart. My great aunt would lie and suffer horribly until either infection or pneumonia ended her life (which happened to a good friend of mine's grandfather last year
I could have listened to the doctors three weeks ago and admitted aunt Millie directly from hospital to hospice....but I listened to my conscience; wasn't ready to give up....I wanted to give her a second chance. I now feel badly, because if I had done what doctors recommended then.....she wouldn't have fallen and wouldn't be upset by being badgered by nurses to eat everyday (when doctors say she CANNOT eat; is too sick) or forced to take physical therapy (when she is too weak to even stand up?). This is a lady I love dearly; is more like my grandmother to me than a great aunt.
What I'm asking.....do any of you have past/ current experiences with terminally ill loved ones recieving hospice care, especially in a nursing home enviroment? (or work/ have dealt with hospices). Any information and advice will be greatly appreciated (as will your prayers for us).
Sincerely,
Perry
