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Covid and Dementia and what's left?
I had a call from the nursing home. Mom is testing positive for Covid again. She has had it twice and now they think it's a 3rd time. She is vaccinated. At first we though it was just that she's still testing positive from when she had Covid in December but she's now not eating or drinking well and she sleeps most of the time.
Mom's dementia is really bad. She can't communicate much at all. She knows me I think.
She's miserable when she can think. For 2 years she has said that she wished she had died when my dad died. She has Parkinson's so she is 100% dependent on others physically. She can't even sit up in bed without help. I know that she'd rather that it was over with.
Covid is in the nursing home. I know that there are other cases so I really don't want to visit. If I did I'd have to then isolate at mom's unoccupied house for a week for fear of getting it and giving it to my family. If she was in her right mind she'd tell me to stay away.
If mom isn't drinking better tomorrow they are thinking of putting her on an IV at the nursing home but if it doesn't improve they would send her to the hospital. Mom's is DNR. I'm her HCP and DPOA.
What would you do if you were in this situation? She is miserable and only her total lack of understanding keeps her from becoming more miserable. Does it make sense to prolong something knowing she'd prefer to just go? She's 86.
I agree with everyone else about hospice and comfort care.
Maybe the staff can set up a FaceTime or zoom visit for you, that way she could hear your voice and you could see her and remain covid free?
I completely agree with all the other members. No IV! I know that’s what I would want. Why would they want to put your mom in more pain.
I agree with everyone’s thoughts/ but I wonder if the facility’s hands are tied? DNR means do not resuscitate. There is a document ( and it might be that one) where the wishes towards a ventilator or feeding tube are stated. I don’t know that an IV or hospital stay would fall under either document except in terms of religion. ( sone religions refuse transfusions). The facility may be required by law to treat. Hospice being involved would allow comfort care rather than treatment.
My step dad tested positive for covid last month. I asked the director if he would need a negative test to get out of isolation. He said no, because step dad could test positive for months. They use the rapid tests now.
If you have her health care POA, here at least, you can refuse the IV. In my experience some docs do not know enough is enough. I have refused futile treatment twice, once for my mom and once for DH#1.
It is extremely hard, in my experience to say no, even if the treatment proposed is futile, but it is why Mom gave you the POA. Use it to do what Mom would want you to do. Your mom trusts you to fulfill her wishes.
Thanks everyone for your thoughts.
The document that makes me HCP talks about her wishes. I'd guess a lot of this is boilerplate.
Most relevant is:
"If at such time the situation should arise in which there is no reasonable expectation of my recovery from extreme physical or mental disability or disease, I direct that I be allowed to die with dignity, and not be kept alive by extreme or heroic measures involving either medications or artificial life support systems. I also desire that, under such circumstances, appropriate "do not resuscitate" or similar orders be entered.
I do not fear death itself as much as the indignities of deterioration, dependence and hopeless pain. I therefore ask that medication be mercifully administered to me to alleviate pain and suffering, even if such measures may shorten my remaining life"
"It is my intention that my agent make such decisions as my agent would perceive to be in accordance with my wishes however expressed but if my agent cannot determine my wishes, my agent is fully empowered to make such decision as my agent shall deem in my best interests."
"To give or withhold consent to any medical procedure, test or treatment, even though such might be against conventional medical advice, and to arrange for medical treatment of any kind even though such may lead to permanent physical damage or addiction or hasten my death."
I know that she does not want to live this way. Before her mental capacity took the steep nosedive that it did beginning July 2021, she told me multiple times that she did not want to live any more.
As for Covid, I don't know if she has it or not. She has taken 2 rapid tests that came back positive and a PCR test that was inconclusive. They are doing another PCR test. I don't know if her lack of eating and drinking and her sleeping all the time is because of Covid or independent of Covid.
I just know that she is miserable and would not want to continue to live this way.
I’m so sorry to hear about your mom. Please take comfort in knowing that you did your best for her last days and that she is at rest now. Thank you for sharing your experience, I’m sure it will help many of us as we travel through this journey.
I'm sorry to hear about your pain in making this decision , but that is *just* why she selected you to watch out for you when she no longer can, just like she watched out for you when you were too little and she kept you safe.
Saying "yes" to medical treatments is easy, if you then had to disconnect basics like food and fluids you could end up battling the hospitals lawyers for a court order just for the purpose of them wanting a tidy legal bottom line regardless of the human pain to you or your Mom.
It takes wisdom and love to know we all have to say good-bye one day, and to make it for the other person as easy as possible, regardless of the tears of the survivors.
Few get the end they may want, but this is just a tiny part of your Mom's life. Remember the good parts and let this fade in time.
I’m sorry for your loss. You were able to honor your mom’s wishes. I’m sorry this pandemic made it more difficult for you.
I’m so sorry for your pain and loss.
I was thinking that she might have just turned to actively dying despite Covid. Her test could’ve been positive due to the other instance instead of a new one and just a coincidence that she decided she was ready to go.
She was blessed to have you in her corner. I hope you can find some comfort and peace soon.
Thanks! I have my doubts that she died of Covid. She had just had an asymptonatic case in December and moved to nursing home the day that she'd be considered non-infectious. People can be over Covid but test positive for up to 90 days. I'm inclined to think that she didn't really have Covid for a 3rd time but I don't know. The nursing home never told me if she had been previously tested before this and if she was negative. But my suspicion is that it was just her natural time.
I'm curious what the death certificate says. Not that it will be correct. Since Parkinson's does not actually kill people directly, I'd say that she simply died of old age.