Summary to last weekend: Mother very sick, found unresponsive or nearly so twice. Insurance wouldn't pay for rehab unless it was long-term, which would mean having to go to a skilled nursing facility paid by Medicaid. Which also meant she wouldn't have income, so any such move would be permanent. So I invited her to stay with me for a few months, with the goal of regaining independent living ability, or if she didn't recover enough physically, to have time to find a decent place.
So, Sunday, she was discharged from the hospital, though she really wasn't physically ready. I had one condition: that she be able to use the bedside commode on her own. The nurses had her do this, once, then she was sent home with me. And she wasn't able to move from the couch AT ALL after this. It really wasn't working out. No one could move her, not the nurses or the PT.
It was already becoming clear she wasn't going to recover, and I was going to have to find some other living situation for her, sooner rather than later.
On Wednesday, her health took a severe turn for the worse. She became less and less responsive, and basically slept all day. I could only get her to wake up for 30 seconds to a minute. We had a few fairly upsetting conversations, where I would say she obviously wasn't well and I needed her to go to the hospital, and she would say, "You just don't want me here." And I would say, "I just can't take care of you like this."
She started to look the way we'd found her the previous two times, but I knew she hadn't OD'd. I'd been monitoring her meds very closely, and she hadn't taken half of what she was prescribed that day.
I finally did call an ambulance, and once she was in the ER, her blood pressure plummeted, and the nurses were asking me what her wishes were. I said she didn't want CPR, but she had been okay with intubation on her previous visit.
I heard them say she was septic, and had been on the 18th, as well. No one ever told us this.
When the doctor asked her if he could put a tube in her, she refused. So she became DNR, and the doctor said (kindly) that she might not survive this, and another doctor told me she could easily go into cardiac arrest overnight.
She did survive, just on fluids and antibiotics, and was taken to the ICU. By Thursday afternoon, she was still in critical condition, and my aunt and I were having conversations with the case worker about hospice care. This was what I was certain she wanted. She doesn't want her life extended just because; she would rather be comfortable. Shortly after that, we switched her to comfort care: meaning, no antibiotics or mask, just oxygen and painkillers.
It really wasn't a difficult decision. I knew that was what she preferred to being in a nursing home on a support system for the rest of her life.
Yesterday, she came back to full consciousness, and we had a lot of big conversations. DNR, if she wanted to continue comfort care, how she felt about hospice care. She did choose to continue comfort care and formally sign a DNR. She was placed in a skilled nursing facility, where she will receive hospice care. The facility is really, really nice, but quite far away. About half an hour drive, so that's unfortunate, but it's not far from my aunt's home. And if it doesn't work out, we can move her in the future.
So yeah, things have continued to happen very quickly. Head-spinning, really. I am very glad I had her come stay with me, because she knows we tried, and I know we tried. It just isn't an option now. She needs much more care than I or any home care team can provide.