Brain tumour. Is mum close to the end what happens with her care now?

[BeMintFatball]

Sorry for long title. I can’t see a clear pathway and so many unknowns.

Mum is 88 will be 89 in November. Last 2 years she has had major medical events all different all potentially life ending but she has battled through. It all started with a stroke that affected her right side.

Rapid decline over last 6 months and feels like the pace of decline is speeding up.

DH popped in on her 10 days ago and was lucky to witness the first seizures which he recorded. We had a FaceTime chat and decided to get her by car to our nearest hospital. This is an important point because had she called an ambulance she would have been taken to a hell hole of an A&E dept at hospital a few miles away in the opposite direction from us.

We are 99% certain the diagnosis is brain tumour. Mum has been put on anticonvulsant and a steroid to take the swelling down. We have told a oncologist and neurologist will be reviewing test results next week.

Her blood thinner has been replaced by aspirin. Does this mean surgery is a possibility?

She looks far more unwell than she did when first admitted.

If she is an unsafe discharge, where will she go? In recent weeks I been researching care homes near me but they have waiting lists. Are there emergency placements available? Or is this how bed blocking happens?

Hate not having a plan.

can anyone suggest what might happen next?

@BeMintFatball it's hard to see it now but with a brain tumour, a sharp decline is a blessing. Use this time to say all that you want to say. I'm so sorry you're dealing with this. I hope the hospice has a bed.

I have asked for my previous post to be deleted as I hadn’t seen your update.

The decline is likely to be swift and peaceful, once the syringe driver is in place it is an indication that you are looking at days rather than weeks.

Say the things you want to say to her as soon as you can, she may be unsettled but midazolam is usually prescribed during palliative care to calm.

Hopefully they will keep her comfortable and pain free. If she has stopped eating and drinking then it will be a matter of days. Take the time to sit with her and talk to her - hearing is the last sense to go. My mother died at home and in the last couple of days all the family and her closest friends visited and sat with her. Nurses usually know when the end is very close - the night nurse would say ‘not today’ but then on the last day she said ‘it will be sometime today’.
On The Pitt the main character had a lovely way to talk to the dying and what to say:
I love you
Thank you
I forgive you
Please forgive me

Lastly, When my son read my eulogy for my mother at her funeral, I realised I should have read it to her before she died.
I send my best wishes to you and your family.

Thank you all for your kind messages this morning.

The hospice have a connection with the nursing home. She won’t need to be moved they will come to her.

She had an injection to dry the secretions last night and then the excess was sucked out her mouth. She was more comfortable after that and slept peacefully

I woke up yesterday with a gut feeling I had to go to the home in the morning. I swapped my plans around and went to my Mum.

after 2 days of being almost entirely unconscious no fluid intake and no food, she looked pretty dreadful. Sleeping with her mouth wide open. But a fly landed on her and she woke up and brushed it away. A carer came in to tell me she had had a bowl of porridge and a thickened drink!

Spent the morning with her and left whilst carer spoon fed her puréed lunch.

Popped back late evening. She looked much better. Face no longer sucken. Breathing steady, mouth closed.

Hospice have turned her down. I am so , well I don’t know what the word is. I was ready for this to be the final goodbye. And now it seems she will carry on. New normal is bed bound with reduced swallowing ability.

Bless you xxx and your dear mum.

God bless you xx

I have very often seen people that have been unconscious for days wake up, eat, drink, talk, to only then quickly become unconscious again. This tends to happen shortly before someone dies. It is like the person has a last burst of energy. It could be what is happening with your mum.

It also may be that your mum does have longer that you initially thought. These last weeks/days can be like being on a roller coaster, up, down and no control over any of it. I would try and focus on the fact that your mum seems really well looked after by the carers and she is comfortable.
Sending hugs to you, this is such a tough time x

Hunger can rouse people when they are in fact dying. It’s counterintuitive and confusing to witness. My mum died peacefully not long after a similar scenario.

I think in America, largely, they call this 'the surge'. I don't know why it happens but I saw it often in my nursing career. A patient will suddenly become lucid and ask for their watch, or want to eat, or have proper conversation, etc. Sadly, it can create a hope that is short-lived.

There is a known phenomenon called terminal lucidity where people perk up significantly shortly before the end. I know it sounds awful to say but I hope for you and your mum's sake that's what it is. A family member has terminal glioblastoma and it's not pleasant.

Thinking of you and your mum, @BeMintFatball.