COPD

[Kisa]

My mom has had emphysema for about 15 years. She was on O2 24/7 at over 4 liters for years and in 2002 was hospitalized with Co2 at 99....Dr. said she had less than 2 months to live. Here we are 7 years later. Now she is on .5 liters of o2 24/7, and is a co2 retainer big time. Her goal sat rate is like 88. Anytime she is hospitalized the nurses jack up the O2 when they see her sat rate, and then the co2 climbs sky high.....the hospital is not a good place for her to be.She has been on a bipap since 2002 to pull out the co2 at night when she sleeps, and since Jan. 09 has had to take mid day naps with it to try to pull out the co2.
2 years ago she went through a low o2, and had a heart attack There was brain damage from the low sat rate. Things were rough, but she still had quality of life.
Now, in 2009, she has full blown dementia because part of her brain has died due to low o2. She has total urinary incontinance, CHF, and has been in and out of the hospital w. pneumonia urinary tract infections, and she is now taking apart her o2, and bipap machines, forgetting what she is doing, and sleeps 99% of the time. It's hard to have any conversation because she falls asleep mid sentence. She now has to nap with the bipap to keep from going acidodic...and it's not looking good.
Her ankles and feet look like egg plants they are so swollen. She lives w/ my sister who is 1,200 miles away from me. I feel so awful being so far away, but economic times make it hard for me to fly home.
They have a nurse that visits, and a telemed machine where they weigh her and take her vitals everyday. Today her weight is up 5 pounds from yesterday....after calling the nurse, ten hours later she called and said it is all part of the dying process....Do you let someone just drown in their own fluid?
My sister and I do not know what to expect. Have the Doctors decided that because she is terminal they don;t have to treat her? the Dr. said she could live another year or more, but with out medical care, may not last the week. What comes next? My sis and I do not know what the normal dying process os with COPD She has lost bladder control will she lose control of her bowels too?
Mom is a wonderful woman, and she deserves to die with dignity and respect...She is suffering, and so is my sister especially who is her caretaker. I am hurting too, but part of my hurt is not being with them at this difficult period.
Anything that anyone could offer us in order to understand what to expect would be so appreciated. Also, is it normal for a Dr. to write off a terminal patient and stop treating them??? That seems to be what we are faced with, and it's agonizing.

[Davy9]

I am sorry to read about the situation with your Mother. From what you share it seems fairly certain that her demise is eminent. Some day we will all face this same moment in life. There is a medical discipline dedicated to this part of living, the final moments. It is called hospice care. It uses a wide range of medications and therapies to keep the patient from great suffering and anxiety. This includes the prospect of retained fluid and the 'drowning' you describe. Hospice also helps the family with the dying process and grieving. Your Mom already has homecare and hospice can as well be done in the home setting. Discuss this with your sister and she can contact the homecare agency for a hospice referral. She can also contact a hospice agency directly. They will need a physicians order for hospice care.

You probably should also determine if you want to make arrangements to visit with your Mom. You care about her a great deal and her time is soon.

Your Mom has had a wonderful life and has dealt courageously with a lengthy illness. It is time that she is allowed to rest and to end her discomforts. You need to allow her this and give her your permission to pass. It will not be easy. It never is easy. You will cry and will accept that this is a normal part of life. The pain will pass and you will have the wonderful memories of your wonderful mother for as long as you live.

[Kisa]

Thank you for you kind words, and encouragment. I have talked with my sister about hospice. She hasn't made those calls so I will do it.
I am trying to get a plane ticket home. Money is so tight for me right now that I lack the funds, and it is very hard on me not to be able to have already flown home. I am trying everything I can to get home.
Again, thank you for your kind and thoughtful reply.

[QuilterInVA]

You should discuss with your doctor if it is time for your mother to be placed in pallitive care and hospice to be asked to help. It does not sound like your mother has any quality of life anymore. That's what I had to do for my husband. Hospice is wonderful and they kept him comfortable and pain free and helped me deal with my emotions and the situation.