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Thread: Comfort at the end of life: how to help with stress and pain

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  1. #1
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    Comfort at the end of life: how to help with stress and pain

    My eighty-eight year old mother has congestive heart failure for a variety of reasons. After a recent visit with her and the rest of my family, I am now convinced that if she lives to see her eighty-ninth birthday in October, it will be a miracle indeed.

    I am now trying to figure suggestions I can offer my sister (with whom my mother lives and whom my mother trusts as a health advisor) that can improve my mother's quality of life, help ease her stress and pain, and allow her to approach the end of her life less anxiously.

    I am mostly concerned about nutrition and exercise.

    For years, Momma has dutifully done what the doctor has told her about cholesterol, calories, fat: RUN AWAY FROM THEM!

    So, basically, she has avoided real food, though she eats desserts with gusto. Her rationale is that she has "been good" with the rest of her diet.

    This drives me a little nuts. My sister's view, is of course, why not let her have what makes her happy? And mostly, at this point, I agree. But she gets some kind of wild dessert every evening because my sister's partner is a chef. Momma is in many ways being killed with kindness.

    She needs to eat more of things she is paranoid about and much less of things she loves. Chocolate pudding with avocado is the only thing I can think of that might be of some benefit.

    Because of various meds she takes, she has problems with fatigue. She really doesn't do a lot at home at this point except go up and down a short flight of stairs or back and forth to the mailbox. She's now using a cane.

    I understand that--according to a study done a few years ago--lack of mobility is a sign of health on a major downhill slide.

    Inability To Complete Quarter-Mile Walk Is Significant Predictor - UPMC, Pittsburgh, PA, USA

    However, there have to be some simple things Momma could do standing or sitting that would, I don't know, keep her from feeling less congealed and inflexible.

    My sister said she probably would do some sort of movement if her doctor wrote her a prescription. So if there is anything she could do that a doctor might be willing to prescribe, I would certainly suggest it to my sister.

    Any suggestions would be much appreciated.

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    Besides diet and exercise interventions, consider hypnotherapy for her frame of mind.

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    First, I would evaluate what makes her happy or would make her happy. I would construct food or exercise constraints around that. There's no point in forcing her to do something that makes her unhappy, doctor's orders or no, especially when you feel you are working with a limited time span.
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    Quote Originally Posted by entwyf View Post
    So, basically, she has avoided real food, though she eats desserts with gusto. Her rationale is that she has "been good" with the rest of her diet.

    This drives me a little nuts. My sister's view, is of course, why not let her have what makes her happy? And mostly, at this point, I agree.
    Yeah it drives us paleo people nuts.

    One of my grandmas just turned 90, we visited her for mother's day this week. She asked me to run out and get her a Whopper with cheese!!! LOL, odd request given that she led a fairly clean healthy life. I think that's crazy, but she don't care. Probably at that point she is ready to go and just wants to have fun. Who are we to say no. And heck a Whopper probably isn't much worse than what they feed people at the nursing home.

    My other grandma just died today, 92!

  5. #5
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    Quote Originally Posted by entwyf View Post
    My eighty-eight year old mother has congestive heart failure for a variety of reasons. After a recent visit with her and the rest of my family, I am now convinced that if she lives to see her eighty-ninth birthday in October, it will be a miracle indeed.

    I am now trying to figure suggestions I can offer my sister (with whom my mother lives and whom my mother trusts as a health advisor) that can improve my mother's quality of life, help ease her stress and pain, and allow her to approach the end of her life less anxiously.

    I am mostly concerned about nutrition and exercise.
    Let her do whatever she wants. Really. At this point it is all about enjoying the time she has and you are probably right that it is rather limited. Nothing that you do to her diet or exercise is going to change that and imposing anything on her (dietary or exercise) is just not worth the stress it will cause.

    That said, if it is something she wants to do, great. You might get her to do some light walking just to keep the circulation flowing. You could have her caregiver focus on higher fat, lower sugar desserts such as flan or cheesecake and maybe sneak some extra "evil" fat in via things like melted butter or coconut oil in the mashed potatoes.

    Be with her as much as you possibly can. That will help the most.

    I say all of this as someone whose father passed away of CHD last year at the age of 87.

    Hugs.

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    Quote Originally Posted by Paleobird View Post
    Let her do whatever she wants. Really. At this point it is all about enjoying the time she has and you are probably right that it is rather limited.
    i agree. she could go on an all-dessert diet spend time with people and activities that make her ridiculously happy, and, you know, you might consider something nice for her like a weekly massage. Indian head massage is particularly awesome -- your'e dressed, someone just rubs your head for 30 minutes. It's nice.

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    Quote Originally Posted by zoebird View Post
    i agree. she could go on an all-dessert diet spend time with people and activities that make her ridiculously happy, and, you know, you might consider something nice for her like a weekly massage. Indian head massage is particularly awesome -- your'e dressed, someone just rubs your head for 30 minutes. It's nice.
    ^This. If I ever get diagnosed with something terminal or the like you will find me living out my last few remaining days in a cheesecake and beer/scotch induced coma.

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    Quote Originally Posted by Paleobird View Post
    Let her do whatever she wants. Really. At this point it is all about enjoying the time she has and you are probably right that it is rather limited. Nothing that you do to her diet or exercise is going to change that and imposing anything on her (dietary or exercise) is just not worth the stress it will cause.

    That said, if it is something she wants to do, great. You might get her to do some light walking just to keep the circulation flowing. You could have her caregiver focus on higher fat, lower sugar desserts such as flan or cheesecake and maybe sneak some extra "evil" fat in via things like melted butter or coconut oil in the mashed potatoes.

    Be with her as much as you possibly can. That will help the most.

    I say all of this as someone whose father passed away of CHD last year at the age of 87.

    Hugs.
    this. end of discussion.

    would you really consider taking her "wild desserts" away from her in an attempt to squeeze a few extra days/weeks/months of life out of her for your own selfish reasons? take a step back and think about it. you'd be doing her a disservice. you're truly not going to make any difference, except maybe upsetting her. if she wants whiskey and ice cream for breakfast tomorrow, then you better run to the store and get it for her. that's how you can help

    as for exercise. do whatever she can do. walk with her. maybe get her in to tai chi or chair/senior yoga. how about water exercise?.

  9. #9
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    I would not like to take anything from my mother that makes her happy. What I want to do, but cannot do because I live five hundred miles away, is (at the very least) convince someone that changes **of some sort** in her diet could (at the very least) make her more comfortable.

    It would not be a bad thing for her to have less inflammation, less confusion, better sleep, better breathing.

    I just heard from my sister that, after a week in the hospital (because the doctor wanted to get rid of fluid that made her legs swell and made it hard for her to breathe), Momma is back home but confused. No wonder. She was given a large dose of diuretic; her potassium level went down as the swelling in her ankles went down; her heartbeat spiked at one point at 136 . . .

    She basically, for the sake of less swollen ankles, got a punch to both body and brain. No wonder she's out of whack . . .

    Why does getting old and having one's body come to a halt have to be one hard blow after another? Why can't there be some freaking way for the medical profession to support bodily functions in a thoughtful, integrated way instead of throwing things at symptoms, one after the other?

  10. #10
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    Quote Originally Posted by entwyf View Post
    I would not like to take anything from my mother that makes her happy. What I want to do, but cannot do because I live five hundred miles away, is (at the very least) convince someone that changes **of some sort** in her diet could (at the very least) make her more comfortable.

    It would not be a bad thing for her to have less inflammation, less confusion, better sleep, better breathing.
    Back in December we took wheat out of my father's diet (having read Wheat Belly) and noticed an immediate improvement in his cognitive abilities. He's 93, has a pacemaker and was diagnosed with Alzheimer's 3 years ago. Until then he was steadily declining and all the information we had was that this was a one way journey. At that time all I cared about was that each moment of his day was as enjoyable for him as I could make it. I was giving him anything he fancied and would eat, because after all, if you can't enjoy yourself at 93 when you have Alzheimer's, then when can you? So, chocolate, biscuits, cake etc and all the low fat stuff my mother had bought was thrown out.

    We took him off wheat because he had already done that for himself many years ago when his hip was deteriorating, before it was replaced. He's now about 80% primal and we've replaced the chocolate and biscuits etc with cheese and apple slices (he can only chew with his front teeth) and breakfast is bacon and egg, not toast, but he still has baked beans and potatoes.

    But ... despite being 93, he's actually very healthy. He's never carried much fat and his pacemaker is literally to set the pace for his heart, the muscle itself is fine. And the alzheimer's medication is his only prescription medication, he has no blood pressure or other meds. 5 years ago he was towing a caravan across Europe for half the year, doing the cooking, the shopping and the gardening. Apart from the Alzheimer's there's no reason he shouldn't go on for another 10 years. If he had been physically failing as well, then I'm not sure I would have been so keen to try. Also, if he had been upset by my removing the sandwiches, toast, biscuits, hot cross buns, cake, sausages, beer, fish and chips (!!) etc and more recently, chocolate, then it wouldn't have been worth the upset to him. With the Alzheimer's he's not actually aware of what he's missing - just what I'm giving him, and he's happy with bacon and egg, and cheese and apple, and (hard) cider and smoked sausage and beans, roast chicken etc.

    Quote Originally Posted by entwyf View Post
    I just heard from my sister that, after a week in the hospital (because the doctor wanted to get rid of fluid that made her legs swell and made it hard for her to breathe), Momma is back home but confused. No wonder. She was given a large dose of diuretic; her potassium level went down as the swelling in her ankles went down; her heartbeat spiked at one point at 136 . . .

    She basically, for the sake of less swollen ankles, got a punch to both body and brain. No wonder she's out of whack . . .

    Why does getting old and having one's body come to a halt have to be one hard blow after another? Why can't there be some freaking way for the medical profession to support bodily functions in a thoughtful, integrated way instead of throwing things at symptoms, one after the other?
    We had investigations started into why my father appeared to be bleeding into his underwear. When it reached the point at which they were talking a colonoscopy - at 92 with Alzheimer's? We declined and explained to his GP that we would not agree to anything that threatened his mental quality of life, such as the sedatives they suggested using for the colonoscopy, which would have worked directly against his Alzheimer's meds. Let alone the 2 days of clearing his gut out!! (It has turned out to be haemarrhoids in the end.) In his condition, any hospitalisation is likely to precipitate a major downturn in his mental state.

    It does appear that doctors can only cope with one symptom as a time. Why they can't consider the overall impact of treatment I don't know, but it appears to be up to families to watch out for our loved ones best interests as best we can.

    I'm so sorry that your mother is suffering. I'm not sure that at this point you'd see much impact from any changes you could make. Apart from being 80% primal, I also have my father on high dose vit D3, vit K, vit B12, phosphatidylserine supplements and cooking with coconut oil. I have complete control of his diet. In 6 months we've seen small but significant (to us) improvements in his mental abilities.

    But physically, he doesn't appear to have recovered any ground. At the moment, exercise is far too much of an effort and it's all he can do to walk to and get in and out of the car or move around the house. If he continues to improve mentally then I think he'll be happy to go for longer walks and maybe his physical form will improve, but I suspect we're months or another year away from physical improvement - assuming he doesn't keel over with a stroke before then!

    Whether, given her physical condition, introducing primal foods or removing processed foods would improve any of her conditions is debatable. Cutting them slightly probaby wouldn't make much difference. People who are in better health can go through withdrawal and cravings for weeks by removing grains and sugar which is additional stress on the body. I'd say that though her favourite/comfort foods may well be the things that made her sick, at this point they may well also be what is giving her any enjoyment in her life. And of course, unless she is deemed to have lost mental capacity, well, much as it hurts us to watch others making themselves sick, it is their choice.

    I'm so sorry you're in this position, entwyf. It's very very hard to see someone failing and not to be able to do anything. I think all you can do is to keep her as happy as she can be from moment to moment and if this means unhealthy eating, there's probably nothing you can do about it, but I'm not sure it would make much difference either.
    Me, My Father and The Alzheimer's - http://www.marksdailyapple.com/forum/thread84213.html

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