My 93 year old Mom is in the ER after falling and excessive bleeding (doctor said she has diverticulitis), she wants to die. Advice?

Another update:  Mom is going to be released from the hospital today and is coming home.  A physical therapist will be coming to the house as my Mom is a little weak from the lost of blood and being on a liquid diet up to yesterday.

I'm so happy she is coming home!!  My Aunt is also thrilled as my Mom and Aunt both play cards every afternoon and they miss that (my Mom is a real card shark and always beats my Aunt, ha, ha!).  They also love to watch Wimbledon as my Mom knows most of the players.

Jenna

Jenna, I think that they are called practicing physicians because they are only applying what they have been taught and they see certain signs and symptoms and they jump to the text book, they are practicing what they think they know.

I also believe that hospitalists are there because they can't get a real job in medicine, when medical errors are the 3rd leading cause of death in the USA it says all I need to know.

Twice I was told that my dad would not pull through. Still going strong.

You pray.. Then decide how many decisions you want to make before her passing. If you continue with transfusions then there will be another decision to be made as to her failing process. You already know what she wants. You as her child can do that for her. She will not go because of a decision you make she will go with God when it is time... 4 signs of passing are. 1 blood pressure goes down and both numbers come together. 2 oxygen can not be maintained even on oxygen. 3 temputure goes up. 4 pulse goes up. All signs of body shutting down and not wanting to no matter what the mind says. Last thing you will see is breathing changes from oxygen going into body. To body doing motion but nothing going on. That is the last thing we do before passing that can go for minutes or some cases a few days. Be prepared for the less not more of this... Usually pass between 1am and 4 am. I have been with over 150 passing to the other side in my 20 years of doing Gods work. God loves you and is watching out for you. And already has you mother.. Blessings Always Cynthia

Jenna, the usual phrase is "hope for the best, prepare for the worst."

I'm sorry that you had this shock, glad that it didn't happen, but above all anxious that you don't leave yourself unguarded.

"How long have we got, doctor?" is the question they absolutely dread. They cannot win. If they don't warn family members of possible fears, they are blamed. If they do, and they're wrong, they're blamed.

I hope that your mother will recover well and there will be more time. But at the same time, just as a complete outsider, I can see that she's 93, has a number of serious health conditions, and has just been through a dangerous crisis. I say again that I am so happy for you that they have pulled her through, but take it one day at a time. It's all you and your mother's doctors can do. The facts are so complex, and change so fast, that there can't be any certainty.

Who's there for you to talk to? Is your aunt around? I'd like to think you have emotional support with you - as well as online :)

Hi all,

I don't know if this is the right place to ask this question.  Why do doctors tell me to prepare for the worse?  To protect themselves for legal reasons?  

As I have posted the doctors called me up 2 hours after my Mom was first admitted into the hospital and told me it was a matter of either minutes or an hour before she would pass away which scared me to no end.

Why do they tell me this when they were sooooooo wrong?   How can I believe them the next time this happens? 

I was a wreck, in shock, etc.   I personally don't think doctors should tell the family member that their parent is going to pass until they have all the facts.  Again, I think they say this to protect themselves for legal reasons. 

What do you think?
Thanks, Jenna

What has been your Mom's thoughts on this prior to the fall and even talking about it when she was younger?
How advanced is her Dementia? Can she make decisions at times? Does she understand? If the answer to the last 2 questions is NO then it is up to you to make the decisions that are in her best interest.
If she often uses the phrase "I want to die" when she is uncomfortable, in a frustrated state, not feeling well then I would not put much stock in that phrase alone.
If however she has never said that then it might be coming from a "clear moment" in her.
I would say if she needs further treatments I probably would not do anything. I would not subject her to a colonoscopy or other invasive testing, no surgery. Keeping her comfortable would be the first priority at this point.

Your Mom is 98 years old, she has said she wants to die. Do you think prolonging her life with medical treatments she is going to "get better" go back to work etc, etc.

My step Mom when she was 90 fell and broke her hip. Theyy said it would be a year of recovery. She said NO THANKS. She refused the surgery 4-5 days later the infection took her. She went peacefully in no pain. She led a good life. He children had power of attorney etc, etc. They could have over ruled her. Why?? She was in a nursing home by now and it would have been against her wishes.

If you take this fall out of the picture is your Mother otherwise normally active, enjoying the day in some manner? My guess is no. Is carrying for your Mother a great joy to you? It does not interfere with your normal life?

The only winner in this game of prolonging life is the medical industry they get the money. Your Mother suffers. Probably you do to.

Why do you get to defy her wishes??
Allow nature to take its course.

Jenna, good news indeed!

Oh wow, a simple fix when everyone was imagining something dire. Well, at least you've had your practice run😜

Another Update:

Mom had the endoscopy procedure done and a partial colonoscopy which revealed 2 bleeding ulcers, one in her upper stomach and the other in her rectum. The doctor closed them both and mom is doing good. Cause of bleeding was found which is good news.

Palliative care, now, hon, because you know where your mom stands on the issue. Do not do further transfusions if she doesn't wish to have them. There are many worse ways to go if one has to go, and at a certain age we do have to. When Mom is strong enough work with her on details of what she would want if this happens again. At what point does she want you to refuse treatment for her? And so on. I am happy you don't have to face this now, but clearly you will. You know she doesn't now want a lot of care and intervention. Good luck and hugs to you both. I am glad she is better.

That's wonderful! From what I read diverticular bleeding is often self limiting, hopefully you will have smoother sailing for a while!

Wow! That is just amazing!!!! ((((Hugs))))).

I'm delighted to hear it!

Tell me - does your mother have any idea of how that section of the rollercoaster felt?! Oh boy. Deep breaths, and may she just trundle along for a while now :) Hugs.

Update: my mom is doing very well this morning and had a good night. She is no longer on hospice. The gastro doctor will first do a CT scan of her stomach and possibly an endoscopy later depending. I had a good nights sleep while my Aunt stayed with my mom last night. Hoping for the best! Jenna

I'm so sorry Jenna. How are you and how is your mother this morning?

Hi JennaRose. Your mother is eating? I would think she would not be allowed to.
Sounds like she has improved a lot. I say this as usually a nasogastric tube is inserted through the nose and hooked up to suction to remove stomach contents especially in the small intestine & the patient is not to take anything by mouth.

Sounds like she had a low red blood cell count & needed a transfusion- she could have a slow bleed internally. Anemia can cause one to pass out.

I am amazed she she was able to eat! That’s really good news. What did her team do to get her back to that point?

I hope you find peace during during this difficult time.

Oh Jenna, great big hugs and prayers.

Hospice will keep her from suffering, please use the services they offer for you as well. They can truly be a lifeline during this difficult time.

May God grant you strength and peace for this journey, may He give you grieving mercies and comfort. May your mom be granted peace and comfort as she leaves this worn out body.

Hugs!

JennaRose - When my severely disabled son turned 13 he was in the hospital. Rainman had a perforated intestine. Two perforations actually - one in the upper intestine and one in the lower.

After we had taken him home from the hospital he developed a complication from the surgery. You know, one of those things they warn you about when they lay out the procedure, but you don’t really listen to cause they tell you it’s rare...

But this time it happened. At first they couldn’t find the problem and after a few days of tests they were ready to release him from the hospital. The night prior to going home Rainman crashed - crash team in his room, 11 people working on him, a doctor sitting straddled on his chest... Rainman is completely non-verbal but that night - for the first
and only time - my baby said two words appropriately strung together - “No, Momma - No!”. He said it repeatedly. It was the worst night of my life.

At 3:00am a surgeon specializing in intestinal/stomach procedures was helicoptered in. Right before they wheeled Rainman into surgery they handed me a release to be signed - that I authorize them to put Rainman on a colostomy bag if necessary.

As horrible as this sounds - I actually hesitated for a minute. The thought of Rainman on a colostomy bag was unimaginable. He would have hated that. He would have always been fiddling with it. Hell, to this day I regularly Q-Tip small wads of paper from in his ears... Can you imagine what he might have managed with a stoma?

But, I did sign. Rainman, other than his severe autism and slight cerebral palsy - was a very happy and generally really healthy guy.

Now, I absolutely am not saying - your mom is 93 - lived long enough and to go ahead and let her pass. I do not mean to imply that at all.

About a year before my mom died she was hospitalized for a fall. Because my mother had a very detailed, very strict Advanced Directive, her doctor had me sign a form saying I authorized an antibiotic to treat some cellulitis she had on her calf. Because - the antibiotic was technically a life saving measure - if left untreated the infection eventually turn into sepsis. But, seriously? I just couldn’t let my mom pass from something that was so easily treated.

Internal bleeding from a busted diverticula is not so easy to treat. ESPECIALLY in a 93 yr old woman who is already suffering from dementia. And, a colostomy bag and stoma? I can’t even imagine. Sheez - the difficulties and dangers don’t even start there. They start with the anesthesia and it just gets worst from there. And, I do mean for your mother firstly and then her family and caregivers second. Gut surgery, while fixes some things, makes a whole lot of other things more complicated and difficult. Whatever quality of life your mother still has at her age - with dementia and with the usual declines and limitations that go with living that long - that will pretty much disappear. In addition, with gut surgeries- one tends to eventually lead to another.

Rainman made it through the surgery with out a resectioning and
colostomy bag. THANK GOD!!! The surgeon said it was 50/50 so he took Rainmans autism into consideration. This meant removing a large section of his damaged intestines which in turn - has lead to a live of eating a certain way and
me keeping track of the specifics or Rainmans bowel movements as if I was documenting the details in curing cancer. The surgeon told me it won’t be a matter of something going wrong in his intestines again - it’s a matter of when.

Even with his restrictions, Rainman is now healthy and happy. I’m not sure your mother would have the same outcome. I so sorry. But take what time you’re able and think it through. Refer to your mothers Living Will. What would she choose - if she were able?

I'm so sorry, this has to be excruciatingly hard. I will keep both of you in my thoughts today. ((hugs))

Oh, Jenna!!!!!!!!

Know that we are all here with you, holding on tight. (((((Hugs)))))))

Edit:  My 93 year old Mom has dementia / alzheimer's

Jenna: I just saw your response to BarbBrooklyn above. Oh, honey, I am so sorry. I hope you find comfort in that your mother will be cared for and be in no pain. May peace find you both. Sending you a hug.

Lymie61: You wrote: "Where did you see on her profile that mom has dementia/Alzheimer's?"

I found this out by accident some time ago: click on the person's name. The profile pops up stating, "I am caring for my mother". "Mother" is in blue text and is underlined indicating it's a link. Place your cursor on the blue text, and a tiny dropdown window will open with more information.

If you look at Jenna's profile and click on who shes caring for (mother) it says that her mother has dementia.

Jenna, sit down and read your mother's Living Will.

Does it address the question of living with dementia? Does it talk about what sorts of life saving measures she wants taken?

Your mom has a life limiting disease and now she's apparently got internal bleeding. In her condition, I would not want to be scoped or have surgery. If they have to resect her bowel to stop the bleeding and she ends up with a colostomy bag for the rest of her life, will she be a happy camper?

Have you asked if hospice services might be appropriate? Is there the possibility of medicating her to keep her comfortable and not intervening?

I'm so sorry that you are having to make this very hard decision. ((((((Hugs)))))).

Jenna, suppose it is a diverticular hemorrhage that doesn't resolve on it's own, what would they do about it, emergency surgery? Would this involve a permanent or temporary stoma? And are you prepared to do that?
Remember, she already has a life limiting condition.

EDIT: I saw your response to cwillie just now, JennaRose. A hug to you.

My original post: Right now, you don't have much information to help you make a decision, such as is this terminal or something easily fixable.

A side note: does your mom have a living will or end-of-life instructions to guide you as you find out more?

I know you're struggling to do what's right for her. She's 93 and your profile states she has dementia/Alzheimer's. Sometimes what's right is giving her what she wishes. Please keep us updated on how she--and you--are doing.

It's hard to say because you don't know what you are really dealing with, and I don't know your mother so I can't determine whether she is sincere or she is having a pity party. I think I'd want a little more information before I made a decision, but then I'm a ducks in a row kind of person.