[RKDinOKC]

Well for quite some time she has be having dementia problems. She has be slowly declining since her post cancer drug side effect stroke in 2005.
The recent problems started when I took that vacation last November, she stopped eating solid foods, and fell. The fall got 90 days of in home care that helped her shower, did physical therapy, and a nurse checking her weight. Dropped from 145 to 115 lbs, now back up to 124. Also has arthritis spurs in her knee that keeps her from walking much when it hurts. And any stress it's the first thing to start bothering her.

She was recovering pretty good from the fall, except for the eating solid foods part until our Golden Retriever Camber died. Camber slept in Mom's bedroom, and followed mom around, and always tried to get Mom to let her outside before she came to me. Mom's dog. The day after Camber passed Mom started sitting slumped with her head down, her knee started hurting more, and she started becoming incontinent. That is one of the reasons I ran out and got another puppy. She has started drinking and eating soft foods more. The last week has also started a parkinsons like shake in her hands and the incontinence is getting more frequent. Any changes in her environment typically cause a decline or loss of some ability.

The help I've been getting is because of the fall and can only go for 90 days. The decline because of Camber's death will extend that help, for another 90 days. But the home care people can't really do anything about the pain except what the doctor had already prescribed besides recommending over the counter stuff that doesn't really help much.

Was told to call home care if we needed anything instead of her doctor or calling an ambulance. I have been calling them and asking for more to help with the pain in her knee and her mobility after camber passing. If her knee doesn't hurt she gets around and goes to the bathroom even likes to go to the grocery store and push the cart for me. If it hurts she just sits there. Besides the nurse to re-evaluate her assistance and physical therapy, they also sent out the social worker to re-review her case. He came out when they started the home care after her fall and found she was making too much and had too much money to be put on the advantage program, which is typically about 18 hours of help however I need to use it.

Because of the recent decline, knee pain, incontinence, and shaking the home care nurse AND the social worker are asking her doctor to recommend Hospice. The social worker says it's not like in the past where you have to be 6 months from death, it's a matter of the illness continuing until death, what the patient can do for themselves and what they need to be comfortable. Says they can do more for her pain management, and having people come help with medicare hospice where her insurance won't. The example he gave was the doctor can only give cortizone shots for her knee every few months under her insurance (which changed only this past year thank you insurance company), but hospice can provide a shot every day if needed.

My brother and I are hoping they can do some sort of lapriscopy on her knee with only a local anesthetic. Her doc says it would require general anesthetic, and with dementia if she gets put under, she doesn't wake up. Social worker knee surgery under local very possible because the hospice will bring in another doctor that will take over her case with the idea of making her as comfortable as possible instead of only doing what insurance allows. Says the first thing they do is review and change medications which may help her knee.

And for the record, neither Me or Mom like me changing her diapers or giving her a bath, or even helping her dress. She prefers a woman do it to maintain her dignity.