My mother is 93 and is on her 4th hospital trip in the last 2 years. 3 times for a UTI and another for a skin infection that turned into sepsis. She is a strong person, but has dementia. Her advanced directive says no life support if it only temporarily prolongs the dying process. Each time she returned to long term care from the hospital she was worse mentally. I dont think she would want to keep going back to the hospital. She still knows me (son) and knows who my daughter is. I can chat with her about the weather, my job, my daughters college plans although she is very forgetful and requires constant reminders and explanations on things. Quality of life is not great. She is alone a lot, is unable mentally to read and turn on the TV. She lights up with a big smile when I visit her.
There is a DNR in place which currently allows hospital trips. There is an option to avoid hospital trips if possible and instead provide comfort for them in long term care instead of sending them to the hospital. Its to avoid, not prevent. I assume if she breaks her leg for example she will go to the hospital.
Wondering what people do in this situation. Has anyone had or has a parent that still knows who you are where you have chosen to avoid sending them back to the hospital? If she was completely gone mentally it would be an easier decision to make. Watching things in the hospital the last few days makes me think it's undignified for her with the dementia, confusion and all the tests.
That's the point at which I decided we were done with hospitals and put her on hospice care. I said we would treat her in place as best as possible, and she had phenomenal care. She was treated for treatable issues that cropped up such as wound care, a bout with Covid, and gout, and she lasted another seven months with infinitely less distress and far better care than she'd had in a hospital overrun with Covid cases.
I would say it's time to consider similar measures for your mom.
Palliative Care or Hospice can treat her without having to go to the hospital.
My uncle nearly died. His children told him once again that he must enter a facility. He wanted to hire full time ‘in home’ help.
His children said, “No, dad. It will end up costing more than a facility and you cannot afford to hire in home help. We aren’t going to quit our jobs to help. So, the only choice left is for you to go to a facility.”
He agreed and he was well cared for. He died at age 96.
More trips to the ER for something easily treated at home would just make her angrier and worse. BUT...dying from a massive infection caused by a UTI sounds just awful.
Do encourage her to drink and keep 'flushed out'. It's a balancing act, once someone loses the desire to drink and stay hydrated and if you don't drink, you're also not peeing and then the urine can get toxic pretty quick.
With my mom, she was in and out of hospice care for 2.5 years. In the interim periods, when she was not allowed to be on hospice, she'd go to the hospital when something serious happened. She didn't like it, and she had a DNR at her request. She hated needles. She had an in-home caregiver who stayed with her in the hospital, but not around the clock. Mom would go home to resume life with the caregiver when she recovered enough to be discharged.
It was not the best way to handle it, as far as I was concerned, but there was family pressure. I believe Mom would have been better off in a long-term care home and avoiding hospitals at that time. She had dementia and didn't know much of anything. She was bed-bound and couldn't really talk.
So that's my experience for what it's worth.