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My dementia Mother been sleep since 8pm last night Friday and all day today; she kinda woke up but still 1/2 sleep around 2:30pm today, pee, I changed and clean her; feed her some Ensure, she went back to sleep; it's almost 8pm now, her brain want to wake up, but her body is not ready , like she cant seat up , her eyes closing, she said she's hungry, giving her some water; she doesn't want to eat anything, have no strength at all - well because she didn't have any food in almost 24 hrs. I don't know how to handle this? If we call the ambulance to take her to the hospital, not sure if they would do anything for her? Because last week she went to the ER, they checked her out and said all labs are normal, they let her go home after waited 8 hours there! So I don't want them to do nothing to help her and then send her home again, but at the same time, I don't know what to do at home. Is this the end of life signs?

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I'm so sorry for your great distress. (((Hugs))) to you al

Is your mom currently on Hospice?

Does she have a doc or nurse line you can call for advice?

Does she have an advance medical directive?

I think to be cautious, I woukd call 911 and have them evaluate.

Please keep in touch and tell us what you find out
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Elderlycare2020 Jul 2021
Thank You for your reply.
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Call her primary care doctor and describe the symptoms. Maybe ask if a hospice agency can send a nurse to do an assessment.
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What did she do yesterday?    Was it an exhausting day?  Did she begin to lose strength yesterday?   I see you're in Texas; what was the temperature high yesterday?   Do you live in an air conditioned apartment or home?   Was she out at all, exposed to the heat?
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The same exact thing happened to my 82 year old mther-in-law (no dementia). It was totally not like her so we called the ambulance. The 1st hospital sent her back home. Two days later we had to call them again. The second hospital kept her for UTI and low sodium. Can your mom go to a different hospital than where she went the 1st time?
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Elderlycare2020 Jul 2021
Thank You for your advices.
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Sounds like it's time to bring hospice on board. They will walk you through what to expect and make your mother comfortable. If her body is shutting down, she won't be hungry or thirsty, as that is part of the dying process, so don't try and force her to do either.
I believe some states require a doctors recommendation for hospice, but I know when I was first looking into getting my husband under hospice care in NC, I just called them myself, and they came out to do an evaluation.
I wish you the best.
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Is she in pain or just tired and sleepy. Since she has dementia, what would you want the hospital to do? Put her on an IV, treat her for an infection, prolong her life? ER's and hospital stays are very very disturbing for dementia elderly and they often get much worse, rather than better... and MAYBE get better once they come home, but their muscles atrophy and things are tougher for them and for you. Since she just went to the ER, I would assume you thought something was wrong and they didn't find it then. They likely won't find it again. I would call hospice in.
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Have you discussed her health situation with her PCP? If her ER trip is deemed not medically necessary by Medicare you could be seeing ambulance bills in the mail. Maybe she could be eligible for Hospice, but her doctor would need to certify it. The hospital doctors could, but they would have discussed the situation with you. Call her doctor now! Do you have POA for her health?
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