I think we made some progress today! I went with her to her doctor appointment and came away with the results I wanted. Dr. Moraleda confirmed what I suspected - Mom was in congestive heart failure. He said she had two choices: (1) be admitted to the hospital; or (2) manage it from the Nursing Home. She immediately stated she was NOT going back into the hospital. When he started talking about upping the dose of her "water pill", I spoke with him about putting in a foley catheter so she wouldn't have to worry about getting to the bathroom in time. He immediately agreed and wrote the order. He also ordered IM Lasix (shots) and potassium. I decided I like Dr. Moraleda. He listens, he pays close attention to what she has to say, treats her with dignity, and recognizes what makes sense for her at this stage in her life. After we got her settled back into her room, it was a joy to see the change in her. It was like a big burden was taken off her shoulders. She was in a good mood and even went down to play bingo - after we showed her how we could cover the catheter so no one would see it.
You would not believe how swollen her legs and feet are! It is very frustrating that she had to get to this point before anything was done. She has had a wound on her ankle for months - unable to heal because her ankles kept getting bigger and bigger. I am really hoping it heals up now, as her swelling goes down.
I asked about the pacemaker and how we will know when it has quit working. The doctor said he thinks it is still going because her pulse is still regular. When it goes out, the pulse will become irregular and she make have times of feeling faint or even passing out. And at one point, her heart will just stop. I expect that after the fluid is removed she is going to have a spurt of feeling really good again....until the pacemaker stops. She is at peace with her demise - talks about it very matter-of-factly and wants to be sure everything is taken care of.
I'm optimistic that she will have a good quality of life for a few more weeks or months. And right now she is ahead in Rummy. She won two games and I won only one.
By the way, she LOVES her email. She has kept every one of them in a manila envelope and really looks forward each day to getting "my email". So keep them coming! Even if it is just a short "I've been thinking of you" type of email, it is worth your time to cheer her day. I also showed her a lot of pictures from Facebook and she really enjoyed that.
I leave tomorrow (Tuesday). It's going to be hard this time, as I'm not sure I'll ever see her again......