Where do we go from here?

Sorry to read your update @Anjo2011. Your poor dad too, he is very old and vulnerable to be dealing with such a fast-moving situation.

@GnomeDePlume im so sorry to hear the update, the delirium is extremely upsetting to see and listen too. The nurses just say this is ‘normal’ for the environment. I have found them reluctant to discuss what is actually happening. Did she recognise you?
My DM has been in for four weeks, I had a meeting with the Dr yesterday, there has been no improvement in this time. She has an ongoing infection, a bigger and bigger catheter, now added in she has a severe kidney injury. The IV antibiotics have been changed yesterday, the next couple of days are crucial, she advised if no improvement they will withdraw treatment. She is not eating or drinking now. The difference in her over a couple of days is a shock.
I agree that there is no magic fit in terms of the ward, they are all firefighting nothing is pro active. If you can try and speak to the Dr about further steps and what is the plan moving forward. It’s like wading through treacle. My thoughts are with all of you, our stories are all so similar. Look after yourselves.

My mum age 78 until 3 months ago was working, driving, totally independent.
She then had a stroke and was in hospital for a couple of weeks, she then got out of hospital and her first night home fell down the stairs and broke her neck. She went back to hospital again for another couple of weeks. She's now home but is so different. Can't go upstairs, can't be left alone for long and is very confused. It seems to happen a lot after an older person has an illness and hospital stay.

I bought some little Christmas cake bites in Waitrose yesterday as I thought they might appeal to my DM who is in the same situation re appetite/hospital.

A nurse there told me sweet things usually work best with the very old who have gone off food.

I'm so sorry, @GnomeDePlume That must be really difficult! Who have you been able to talk to regarding her care? Is there a frailty team at the hospital? Has she been seen by a doctor recently on the ward? It does seem that the care and nursing staff chug along doing the obs, issuing medication and keeping them clean, watching for sores etc ( not dismissing the work involved in that, of course) but with no real plan in place.
It's really hard seeing this decline, and the not knowing is so stressful. It would be good for your stress levels to have an idea of what those in charge of her care are thinking about it, I think.
Hugs 💐

The maternity ward comment amused me @GnomeDePlume You really do need to look for the humour wherever you can in such a stressful situation, don't you?
My mum is actually eating reasonably well at the moment, but I resonate with an 85 year old having been told all her life to eat less. Born at the beginning of the war, rationing being part of life into their teens, gaining weight being a sign of absolute decadence.
These habits are so hard to break. My mum was very controlled ( and tbh quite contolling) about food. Even this year when there's been concern over her losing weight, she'd take one biscuit and then tell me to put the lid on the tin ( in case, God forbid, she'd go mad and indulge in a second one!)
As an aside, my DH, unlike the rest of the family, is quite 'curvy', and she'd get the biscuits out then ask me if he was allowed to have one.

Good luck with the continuing mother migration @GnomeDePlume The homes we've looked at have said they will come to meet mum in the ward to assess her. They will take her anyway, no doubt, but it's about which floor she'd be on ( they have general residence, and then dementia/nursing/care floors) Not sure if my mum's needs class as nursing care or not at the moment. She still thinks it's temporary and is adamant that she'll be better than before. The OT was trying to encourage her to be realistic but I spotted the glint in the eye and the set of mum's jaw which are oh so familiar!
Continuing to wish you and everyone here all the best!

It's worth trying anything Horace. My dad still loved a bacon butty in his last couple of years, after the dementia diagnosis, and occasionally people delivered generic advice about how he should eat healthily. I was relieved he would eat anything at all, and glad there was something left in life he enjoyed when most other pleasures were now out of reach. I would get some sweets or little cakes and offer them.

My Dad went onto hospital after a fall (because my parents hadn't adapted their house) was in hospital for weeks, got covid so couldn't do physio and was never the same again.

Dad, when he'd recovered from covid, ended up with a really sweet tooth and guzzled sweeties and cakes. Would it be worth trying them? Just thinking if she's eating very little then they've got a lot of calories.

So sorry OP, I recognise so much of what you're going through.

Thinking of you @GnomeDePlume 💐

I think residential care is probably the only viable option for her - it would present a huge burden on you to try and help her with living at home.
I would start working towards a financial plan that enables that
Do you have Power of Attorney? It sounds like she's losing or lost mental capacity so you need to take over to make the best decisions on her behalf
It's very tough - I've been through something similar recently.

@GnomeDePlume unfortunately as you’ve discovered a hip/leg fracture is a very significant injury at your mums age. You are right she will be losing muscle mass as length of immobility increases that makes it harder and harder to move well a real catch 22 situation. Delirium and post operative cognitive decline are both very common too in this age group and are made worse by the lose of normal routines etc.

Has your mum been seen by either the orthogeriatric team or a general geriatrician? It sounds like she might benefit from a comprehensive geriatric assessment. Looks at loads of different elements of functioning like balance etc, rationalises medication and considers ceilings of care and limits of escalation. Worth asking the ward staff if this has been done

Don't want to alarm you OP but I was watching a video where palliative care nurses mentioned that talking about journeys and suitcases and travelling and so on is sometimes a sign that an old or very ill person is reaching the end. I know that you probably feel very conflicted atm. A slow decline is torture to witness but so is the prospect of losing your mother. It's all horrible.

@GnomeDePlume its so difficult to watch. My DM says similar and talks about dead relatives a lot. I don’t even know if she knows I’m there, she knows it’s me but the majority of the visit is just confused conversation and going to sleep mid chat. Does your DM have many/any lucid moments? Sending you good thoughts and wishes, you can’t do any more than you are doing.

Just found this thread. Sending my love op. I seem to be in a similar cycle with dm at the moment. She's just out of a 2 week hospital stay due to bradycardia. The decline both physically and mentally was quite shocking. Incontinence and weakness/difficultly walking etc (and she wasn't amazing at that to begin with due to needing new knees and heart failure) and the short term memory has gone kaput. She is slowly regaining movement and strength and seems to be doing better incontinence wise, the memory though... and I am just here waiting for the next thing. It's awful hard.

Pneumonia, I've heard it described as the old man's friend.

It's very hard isn't it, keeping people alive because we can (and are obliged to) without consideration of quality of life. I think I would / will find this situation harder to cope with than grieving the natural loss of a loved parent.