<p>My mother has been in assisted living close to 3 years now. She has been hospitalized 5-6 times during that time and a UTI made her sicker than anything else, even a cerebral hemorrhage (stroke)! She became so ill, so quickly. She was hospitalized, unable to feed herself, walk or even transfer from chair to chair. She will be 95 soon and we call her The Phoenix, as she keeps rising from the ashes of one medical issue after another.</p>
<p>We have tried a daily prophylactic antibiotic, but she still developed another UTI. The only drug the last bug she grew out was sensitive to was an IV antibiotic. I was hoping that maybe after the course of IV antibiotics, maybe she would go a while without developing another infection, but the nurse at the assisted living center told me today her urine smells suspicious and they were sending a sample to be tested lovely! I am so grateful her living facility is 90 seconds from my home as I am over there 4-5 times a week.</p>
<p>They were not equipped to deal with a combative, violent Alzheimers patient, so we ended up committing him to a geri-psych hospital. He continued to spiral downhill, in and out of lucidity, refusing to eat. He developed pneumonia so we said enough, he does not want to live.</p>
<p>I moved him to a hospice near my home and he passed away. 11 days total from Alzheimers unit entrance to the end. (This all happened last October.)</p>
<p>I can not say enough good things about the geri-psych hospital and hospice.</p>
<p>dentmom4- Sorry that road was so rough and condolences on the loss of your father. </p>
<p>Sounds like you made all the difference by being there and getting him to the right place with people who knew what would work. It also helps when you know what your relative would want going into the process. </p>
<p>MidwestParent- 90 seconds is the best. Those UTIs can be so stealth and dangerous. I like the “Phoenix” reference. We have one of those in our family as well. Hope your mother is okay.</p>
<p>My Aunt, (the UTI queen), will be 96 in March, her one sister is 99 today, my mother is 88 and the “baby” sister is 85. I am responsible for 2 out of the 4. I am called in to help my cousins regarding medical issues for the “baby” and I am helping to hire an aide for the “big” sister. The “UTI” queen is now in rehab after a hospitalization for a fall, (it interestingly happened the day after I left for Florida), She had a CVA last June and is a holy terror. We went through 4 agencies and at least 6 aides, one who ran from her house, another I ended up taking care of in the ER due to chest pain and anxiety. Her cardiologist calls her the “Energizer Bunny”. She is going to bury me. The ativan and lexapro don’t seem to make any difference. She is angry, agitated and now paranoid. I thought some of the symptoms were due to the UTI’s or an elecytrolyte imbalance. I requested a psych eval. (I know, you are probably thinking that I could use one too, and you would be correct). She had no will, no POA, no health directive until November. She had a lien on her house due to unpaid taxes, expired IRA uncashed checks, dormant funds that went to the state, 4 years of back taxes not filed, etc, etc. It has been so hard trying to help without the authority to do so. Now that I have authority, I’m the witch. There must be something that can be done to help a combative Alzheimers patient. This is no way to live, they must be frightened. I can also see that this disease magnifies pre existing conditions. Thanks for listening!</p>
<p>The way to get a combative Alzheimer pt under control is medication. My dad spit out the pills. Same if they were crushed in food. The injections sedated him because it took so much to calm him down. It was a vicious circle. He had difficulty swallowing and the aspirated food caused the pneumonia. A blessing in disguise.</p>
<p>He had a very specific medical directive and DNR.</p>
<p>My Aunt has a medical directive now and a DNR. While the psych eval. from the hospital states “not competent”, she is still alert and very much aware of her surroundings. She refused a pacemaker, (she was quite rational in her explanation and I respected her wishes, much to the anger of the hospital cardiologist). She can be quite convincing at times, then becomes agitated, angry, confused and paranoid. It’s this “in between stages” that seems so difficult.</p>
<p>My father has been placed in hospice yesterday, things are not looking good. His body is just shutting down after a good life of 82 years. He was a great father of five children, a wonderful husband to my mom, a great friend to many, and a special granddaddy to my daughter and his other grandchildren. </p>
<p>Do any of you have a special end of life poem or prayer that you could share? </p>
<p>dent4mom - that sounds really tough with your dad, but I understand. My dad had a stroke and dementia and became violent at times. The ativan didn’t work too well and eventually they added Haldol. Apparently, Haldol pills can be given rectally, which was essential, because he was refusing food and pills for a couple weeks. The hospice nurse was very happy with our aide, that she stuck around even though he was so difficult. </p>
<p>ECMotherx2 - the pacemaker decision must have been a tough one. It helps that you knew her before, so that you can tell the difference between the lucid times and the paranoid times. Your situation sounds so difficult. Will you be her POA? Would that make you financially responsible for her?</p>
<p>GA2012Mom - I’m so sorry about your dad… This is SUCH a hard time. Our hospice nurse gave us a great poem. Well, it was great for us because my dad had changed from his stroke and dementia. I don’t know your father’s particular situation, but here is the poem: </p>
<p>What do you see nurses? What do you see?
What are you thinking……… when you’re looking at me?
A crabby old man……………………. not very wise,
Uncertain of habit ………………… with far away eyes?
Who dribbles his food ……………. and makes no reply.
When you say in a loud voice …… “I do wish you’d try!”
Who seems not to notice ………. the things that you do.
And forever is losing ………………… a sock or shoe?
Who, resisting or not ………… lets you do as you will,
With bathing and feeding ………… the long day to fill?
Is that what you’re thinking? …… Is that what you see?
Then open your eyes, nurse …… you’re not looking at me.</p>
<p>I’ll tell you who I am ………… as I sit here so still,
As I do at your bidding, ………. as I eat at your will.
I’m a small child of Ten ……. with a father and mother,
Brothers and sisters …………… who love one another.
A young boy of Sixteen ………… with wings on his feet.
Dreaming that soon now …………… a lover he’ll meet.
A groom soon at Twenty ………… my heart gives a leap.
Remembering, the vows ………… that I promised to keep.
At Twenty-Five, now …………… I have young of my own.
Who need me to guide ………… and a secure happy home.
A man of Thirty ……………… my young now grow fast,
Bound to each other ………. with ties that should last.
At Forty, my young sons ……… have grown and are gone,
But my woman’s beside me ………. so see! I don’t mourn.
At Fifty, once more, ……… babies play ’round my knee,
Again, we know children …………. my loved one and me.</p>
<p>Dark days are upon me …………… my wife is now dead.
I look at the future …………… I shudder with dread.
For my young are all rearing ……… young of their own.
And I think of the years … and the love that I’ve known.
I’m now an old man ……………… and nature is cruel.
Tis jest to make old age …………… look like a fool.
The body, it crumbles ………… grace and vigor depart.
There is now a stone ………… where I once had a heart.</p>
<p>But inside this old carcass …. a young guy still dwells,
And now and again …………… my battered heart swells.
I remember the joys ……………… I remember the pain.
And I’m loving and living …………… life over again.
I think of the years …. all too few …… gone too fast.
And accept the stark fact ……… that nothing can last.
So open your eyes, people ……………… open and see.
Not a crabby old man. Look closer …… See …… ME!!</p>
<p>GA2012MOM, there’s a beautiful old Gaelic blessing which I was recently reminded of when it was posted in another thread. </p>
<p>May the road rise up to meet you.
May the wind be always at your back.
May the sun shine warm upon your face,
The rains fall soft upon your fields,
And until we meet again,
May God hold you in the palm of His hand.</p>
<p>Thinking of you, GA2012MOM. Here is a poem and a “fragment” that focus on this time. </p>
<p>Do not stand at my grave and weep,
I am not there. I do not sleep.
I am a thousand winds that blow.
I am the diamond glints on snow.
I am the sunlight on ripened grain,
I am the gentle autumn rain.
When you awaken in the morning’s hush,
I am the swift uplifting rush
Of quiet birds in circled flight.
I am the soft stars that shine at night.
Do not stand at my grave and cry;
I am not there, I did not die.</p>
<p>-Mary Frye, American poet (1904 - 2004) </p>
<p>And did you get what
you wanted from this life, even so?
I did.
And what did you want?
To call myself beloved, to feel myself
beloved on the earth.
― Raymond Carver</p>
<p>I hope that your dad and your family will find hospice a blessing, GA2012MOM. So sorry to hear your news. This poem/prayer by Sylvia Kamens and Rabbi Jack Reimer has comforted me:</p>
<p>At the rising of the sun and at its going down, we remember them.
At the blowing of the wind and the chill of winter, we remember them.
At the opening of the buds and in the rebirth of spring, we remember them.
At the blueness of the skies and in the warmth of summer, we remember them.
At the rustling of the leaves and in the beauty of the autumn, we remember them.
At the beginning of the year and when it ends, we remember them.
As long as we live, they too will live; for they are now a part of us, as we remember them.
When we are weary and in need of strength, we remember them.
When we are lost and sick at heart, we remember them.
When we have joy we crave to share, we remember them.
When we have decisions that are difficult to make, we remember them.
When we have achievements that are based on theirs, we remember them.
As long as we live, they too will live; for they are now a part of us, as we remember them.</p>
<p>GAmom, a hug and prayer for you. My3/8, I am the POA for my aunt and will be her executor when she passes. The POA has a fiduciary responsibility on behalf of the person, I am responsible for bills, banking, taxes, etc. from her finances. I am not liable for accounts, debt, etc. from my own finances. The pacemaker was a difficult decision. I am a nurse, I know the benefits and the risks not having the device implanted. My aunt was and still is quite clear, (and vocal), about her wishes. It certainly made it a little easier for me, but was still difficult.</p>
<p>Apparently she didnt have a stroke or heart attack or UTI. She has pneumonia. She is out of ICU but in a room 3 doors away from ICU. She has opened her eyes and can talk but is saying nonsensical things… she’s making an apple pie, the grocer near her is moving to wisconsin, my grandfather like to have vanilla ice cream in his freezer.</p>
<p>She is off oxygen but can’t swallow anything. I gave the doctor permission to insert a flexitube so they can feed her.</p>
<p>I guess only time will tell how far she will bounce back. My sister and brother are over the moon, so I have spent the weekend trying to keep their hopes positive but not to expect too much too soon.</p>
<p>Thank you all for your thoughts and prayers.</p>
<p>Wow, pretty scary that pneumonia can have such a huge effect on your mom’s mental health status! Sure hopd she continues to improve–does sound like the things she says are pretty random. Take care of YOURSELF too!</p>
<p>Well, I learn so much for you all here. I had no idea about UTIs and the elderly. My daughter is an ER nurse, so I told her about what I’d read here and asked her about it. She said that as soon as they hear that the (older) person has showed increased signs of dementia/confusion, they automatically check for a UTI. Evidently they are quite common in the elderly and can seriously harm their health due to the ripple effect of the symptoms. </p>
<p>She said that the challenge can be in getting the urine sample. Imagine you are confused/in dementia and suddenly someone you don’t know is spreading your legs wide apart and touching you ‘down there’. Yeah, you may not react too docily in that situation. Oh my. That had not occurred to me.</p>