So sorry, Snowball.
So sorry, @snowball. A very emotional time.
@MaineLonghorn, I am sorry. But please don’t overestimate your mom’s abilities. I realize how difficult all of this is at the same time, with your dad still in rehab and your sister so busy with him, but it sounds like she will need help at home until they can move.
Thanks @oldmom4896. You are right. I will be seeing Dad shortly and will talk to him about Mom. If I tell him her equivalent age, that might help him realize the severity of the situation.
@snowball, the situation is not the same, but my mother had bowel obstruction (caused by previous diverticulitis) and no doubt part of her colon was dying during the weeks of obstruction (she looked like she was having triplets). They had her on a nasogastric tube and pitchers of green bile filled up quickly.
If your Dad has the inguinal hernia and the tissue is dying, does her run into the same thing? Or rupture with peritonitis?
The reason I ask is that I called hospice to take my mother to their residence to die. We all agreed on that. The hospice nurse came to the hospital, and we found out that with a situation like this, hospice would also do a nasogastric tube and most likely surgery with a tube to vent the gas and bile.
In other words, colostomy surgery was actually our only option. We were told by everyone that dying that way is NOT an option. The pain is too bad.
I have no idea if this is parallel.
My mother’s cardiologist would not have approved surgery but I called his nurse practitioner and explained that the only options were surgery or a horrible death. We had a long talk. As a result, the cardiologist approved the surgery.
I wonder if you could talk to the cardiologist and get support for surgery. You can still say no breathing tubes (outside of surgery) etc…
So sorry, @snowball, at this difficult time for your family.
@mainelonghorn,
While I’ve not heard dementia stages equated to chronological age, it might also be helpful for your dad to understand that mom may look capable in one area, but be very incapable in another. Safety is a primary issue. She may not be able to handle the multi step process of operating the washer and dryer (Ive seen folks try to put detergent int he dryer…) she may think she can cook but may leave the burners on if she gets distracted. If dad has trouble understanding the aspects of her impaired function, you might was to consider, if you haven’t already, having a neuropsychological evaluation to better discern her strengths, weaknesses and level of function in different capacities. Good luck.
The Elderly Are Getting Complex Surgeries. Often It Doesn’t End Well.
Complication rates are high among the oldest patients. Now a surgeons’ group will propose standards for hospitals operating on the elderly.
https://www.nytimes.com/2019/06/07/health/elderly-surgery-complications.html
^^notwithstanding, my dad had surgery to relieve spinal stenosis when he was 89. It was delayed for a year by futile attempts to find other ways to relieve his pain, none of which worked. The surgery did the job, and he had two pain-free years thereafter,
And of course we have the situation with @compmom’s mom who would have had a horrible, painful death without surgery.
@MaineLonghorn I am echoing what others have said. But mainly, don’t get in a tussle with your mom about tasks such as the laundry. If you can work with her to do the laundry, she won’t remember how to do it the next day, or even 30 minutes later. Trying to get her to do the laundry will only frustrate both of you. I do fear your mom may not qualify for admission to their retirement community (if it’s a CCRC) so be careful of the evaluations your get. Might there be a less lovely unit they can move into sooner? Also, remember at the move, your mom will need 3-6 months of adjustment to the new surroundings.
How much could present stress be contributing to ML’s mom’s evaluation? If it’s the Mini Mental Status, I wonder. Any prior signs?
Again, if the surgery is necessary to avoid a painful death, talk to the cardiologist who may adjust his recommendation.
So at 4:00am this morning my father becomes chatty Cathy! He said they needed to remove the brick (sandbag) from his groin. It actually weights 5 lbs., so it is heavy to him. He then saw my mother in her robe as told her to go home and get some sleep. My mother told him who had come by or called earlier, and he wanted to know how my daughter was feeling. When the nurse came in, he answered all her questions correctly-name, date of birth, where he was, the president, etc…
They have reduced the amount of oxygen he is receiving as his pulse ox is good. The speech therapist came by to see if they could try some foods with him as he says he is hungry. The concern with aspiration is still there, so he will have a swallow study tomorrow; it was too late today by the time she got here. Tonight she said he could try a liquid diet which was suppose to be potato soup, but tomato was sent. She specifically said he could not have tomato doe to the acid. Food services is going to send up the correct soup, but that remains to be seen! I did help him with some ice cream; he took about 6 infant sized bites. Because of his Parkinson’s, it was mentioned that his muscles might be loose and he may not notice if something goes down the wrong way. While most of us here would cough it up, he may not realize it has gone the wrong way. Plus, he coughs so much any way, he might choke while coughing.
Now of course we don’t know what to think. The cardiologist didn’t put the order in for palliative care yesterday, but I had the woman’s email from dad’s last stay, so contacted her. We were told the hospitalist had to put the order in before her team could come, so my husband was able to get in touch with his, and he came to see dad this morning. Still waiting for palliative care to come, and even though they do come over the weekend, I am thinking it will be tomorrow as it is 6:00pm. The nurse said they are going to mix his pills in chocolate pudding to help them go down, so we are back to taking medication.
Hernia surgery is still off the table, but the hernia has stayed put for now, and it seems there was a misread on the CT scan, and there is no dying bowel! As long as he is in a bed and not coughing violently, he may be ok with this for a while at least.
So yesterday he was dying, today, while not well, he seems ok. He is still sleeping a good bit, but was alert enough to FaceTime with my son and the baby, and talk to many people on the phone as well as a few visitors. I sent an email to my manager to let her know I would not be a work this week due to my father declining health and possible death last night 
My part time coworker is out for 4 weeks as she had a brain bleed, so me being gone is a huge problem. I wanted her to know early enough so she could pull someone from another clinic to cover my position. Not I feel badly as I could go in tomorrow, or at least I think I can, although I would like to be here for the palliative care physician. I guess if thing still look ok tomorrow, I will go in Tuesday.
We have always joked my dad has 18 lives, and now I guess we have surpassed that and on to possibly 20 
Good news! Can’t believe the error in reading the CT.
One step forward, 3 steps back. Dad failed his swallow study this morning, not that it was a surprise. The recommendation is no feedings, but the Palliative care doctor said we could comfort feed. As they say he will aspirate if he eats, the though is he can have enough to wet his whistle. Again, yesterday he ate maybe a total of two tablespoons of food between the ice cream and soup; that was all he could handle.
Mom originally said she didn’t want a nursing home, so in home hospice was the recommendation. Unfortunately that leaves her alone all day with him unless we hire help and none of us have the money for this long term. The palliative care doc said he is so strong willed and with it, when he is awake, that he could be around for months; not sure I agree with her timing. When she asked my dad what he thought, he said he has 6-12 months left; something he heard when he was in the hospital in April. One minute I think he is done, and then he says something like that!
Trying to figure out if there is a nursing home that would be acceptable to my mother close enough to their home, but everything I am finding is assistive living or memory care, no real nursing homes. Trying to work on the courage to talk to dad and let him know we will all be ok if he is ready to go, but don’t want him to think we want him to go, if that makes any sense. I need his personal cardiologist to come by and talk to mom and dad as they thing he hung the moon, and will value his opinion. If he were to come, it would be a social visit as he doesn’t do hospital rounds any more; he is clinic based only. As it is we get a new doctor from each service everyday and I am losing track of who is who! When the techs come in for his blood sugar or to draw labs, my mother tried to tell them how he is doing, or ask questions about his health I have told her they are just the tech, but she likes to tell everyone.
As of now, they will continue to tune him up the best they can and then boot his from the hospital unless he becomes more critical. On my list this morning was to ask if he needed to go to ICU; guess that is not an option at this point.
@snowball, the social workers at the hospital may be helpful evaluating nursing homes. The nurses too, since they see patients go back and forth between nursing home and hospital. My daughter works as a patient care technician (nurses’s aide) (in support of her upcoming medical school application) and she could tell you A LOT about nursing homes near where she works.
Yep, I just talked with the hospitalist and he is going to ask for the social worker to come talk to us. He was checking back in before he left for the day. I hate that each doctor tells us something different; I do realize they are all different specialties, but it gets confusing. I would love to sit in one room with all of them, ask question and get answers. That way, when one is different than another, we can hash it out! So the hospitalist said if he doesn’t eat, he will die due to dehydration; this is assuming his heart doesn’t give out before then. His thought is dad has weeks, not months, which would be my thought, although days would be my guess.
@snowball. ask the SW to coordinate a family patient care conference with all the specialties.
@snowball the general rule of thumb is someone will live about a week without food or fluid. Longer, maybe 2-3 weeks if you are getting some fluid through things such as ice chips or mouth care. My mom died about 4-5 days after she refused even mouth care. But, she had a strong heart.
My mother failed a swallow test. She was in IV Ringer’s for 5 weeks- nothing else. The she passed the swallow test. We think the nasogastric tube may have caused swelling and impeded swallowing even after it was taken out.
My daughter had a brain injury and failed hers miserably. They were going to put a port in her tummy for nutrition, but she was determined and managed to work on her swallowing, step by step, with the swallow expert and was finally able to ingest something- thickened liquids at first.
I wonder if someone could work with your Dad. Is there any possible temporary cause for the swallow issue, like swollen throat/airway?
Of course some older people (and families) want to let go, which is different from an injured person who is young.
We think my mother is about to die bout 4 times a year. But at some point they really are close.