Mom has cut way back on eating, what comes next?

FreakingOut

Hello Everyone~

My Mom got sent to the hospital a couple of weeks ago because she got really weak and was having a hard time sitting up and even speaking.  Her dementia got super bad too.  While in the hospital she got diagnosed with a bladder infection and covid.  One day on the antibiotics and mentally she seemed back to her baseline.  BUT, the next night in the hospital she sounded weaker and the third day even weaker.  The fourth day they sent her back to the nursing home where they kept her quarantined in her room because of the covid.

At the nursing home she was super lethargic and wouldn't eat or drink hardly anything.  She slept more than usual and got super weak again.  I had kept calling the home to check on her and finally asked them to send her back to the ER.  She's in the hospital again, but she won't hardly eat or drink.  Her mental state has declined some and it's now harder for her to find words.  Just a month ago, she went out to eat with us for Christmas and my sister took her to a movie!  She was not terribly strong, but at least she could get around with a walker and have a conversation of sorts.

My questions are a.) does this seem like a normal progression in state?  It seems kind of fast to me, BUT she was getting a lot pickier about eating before being hospitalized, it has just gotten way worse; b.) what I'm wondering about most is what happens next?  I envision them sending her back to the nursing home, they can't get her to eat, she gets weak, goes back to the ER, etc.  Are we talking hospice at this point? 

This just seems to have happened so fast, but maybe the signs were there and this hospital stay just exacerbated an already existing progression?

RanchersWife

I’m sorry your mom has been ill. I’m recovering from covid and have no appetite. I’m also extremely fatigued. I would spend some more time there trying to get her to eat something yummy. 

My husband’s aunt survived covid but never regained her desire to eat or drink. I think this is something to be watched for. 

harshedbuzz

Freaking Out-

Any one of those things could cause a decline in a PWD's condition. Combined I would expect a devastating loss of skills.

Hospitalizations and UTIs are notorious for really changing how a person presents but are generally reversible to some degree once the infection clears, they've returned home and the PWD returns to their usual routine. With COVID, that bounce back doesn't necessarily happen as quickly. The loss of taste and smell can interfere with getting food and hydration in which further complicates recovery.

The couple of people I know with elderly LOs who got COVID and "did well" report a hastening of progression whether in dementia, MS or cardiac issues. 

What does her doctor say? A friend's mom recently died from COVID- likely the Delta variant. The hospitalist and NP caring for her in the hospital called daily with updates and there was discussion about treatment options. Once it became clear mom wasn't coming back from the virus, she was moved to the SNF associated with her CCRD and hospice was brought in. She lived another month in the SNF with a "Do Not Transport" order. Her appetite really tanked with COVID and never rebounded which really frustrated my friend who on a visceral level felt mom could regain strength if she'd eat even though she knew intellectually that wasn't going to be the case. 

I would bring in hospice if you can arrange it. Worst case scenario you and your mom get support for whatever is ahead. Best case, she's graduated in a couple of months because she's improved.


HB

FreakingOut

Mom appeared to be essentially asymptomatic with the covid, and they didn't say much about it @harshedbuzz.  The doctor's aren't really telling me much of anything, which is kind of weird. 

terei

Is hospice on board? At this point I would be discontinuing ER visits that are simply prolonging  your mom’s progression.    With the small info you provided I would be sure she is being kept comfortable + be on hand if possible.  End of life decisions are hard, I know.

mommyandme (m&m)

I would definitely call on hospice.  I too would not transport her to the hospital anymore.  If this is the end, hospice will help her be comfortable and peaceful.  No more pricks and physical violations.   If it’s not, no harm no foul.  

I’m so sorry for this difficult journey we are all on.