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PaulaNP
PaulaNP, Nurse Practitioner
Category: Health
Satisfied Customers: 431
Experience:  Nurse Practitioner; 36 years experience with adults, geriatrics,and children;Therapist
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My 90 year old mother had a stroke and heart attack. Her ...

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My 90 year old mother had a stroke and heart attack. Her throat is partially paralyzed and she cannot swallow hardly at all. She is not eating or drinking. How long can one live without the aid of a feeding tube or IV
Submitted: 6 years ago.
Category: Health
Expert:  PaulaNP replied 6 years ago.

Dear Mbran,

One can live about 2 weeks without water and food, depending on her stamina and heart strength. It is time to call in Hospice to make her final days comfortable, and to provide support for you and your family. Hospice can visit in the nursing home, and make suggestions for her care.

I am sorry that you have to do through this, I know how tough it is. I will be thinking of her at this time. Take care, Paula

Customer: replied 6 years ago.
My mother is in a rehabilitation hospital and is drinking ensure. It must be enough to sustain her..
No one has suggested hospice or anything else. I am concerned that they are not overyly concerned about her not taking in nurtrition. Can 1/2 cup of Enusre every day keep her alive??
Expert:  PaulaNP replied 6 years ago.

Hi,

Sorry, I misunderstood the situation.

No, 1/2 can of ensure a day will not keep someone alive for long. You can request that a speech therapist evaluate her swallowing ability. After this, a modified barium swallow xray may be done to see if she chokes or aspirates her food. She may need to have a special consistency of food to be able to swallow. Or, she may need a feeding tube for nutrition. Also, ask for a nutritionist to consult and make recommendations once it is determined what her swallowing difficulties are.

Here is some info for you:
http://www.chcr.brown.edu/dying/CONSUMERFEEDINGTUBE.HTM

Also, you must ask yourself what does your mother want at this time in her life? What will give her quality and comfort? Does she have a living will where she stated she did not want a feeding tube? Did she ever make her wishes known to you?

You might consult with her doctor and the facility's social worker about options and if a feeding tube would be of benefit or not. This is a hard decision, I know.,

Take care,

PAula

Paula

PaulaNP, Nurse Practitioner
Category: Health
Satisfied Customers: 431
Experience: Nurse Practitioner; 36 years experience with adults, geriatrics,and children;Therapist
PaulaNP and 4 other Health Specialists are ready to help you
Customer: replied 6 years ago.
Reply to PaulaNP's Post: She has had 3 barium swallowing tests and you are correct, not much has changed in the past 2 weeks.
She is very strong... she had gone to church and YOGA the day this all happened and then was on the floor of her home alone for 14 hours..She is working with a speech therapist daily..
I wish I could ask you questions personally again.
Thank you,
Marsha Braniff
HOuston, Texas
Expert:  PaulaNP replied 6 years ago.

Hi Marsha,

Thanks,

You can ask for me again. Just type my name in the subject line of write 'For Paula Sumner'.

Your mom sounds lke a remarkable person. Since she has had the swallow test the speech therapist should be able to recommend the types of food mom can swallow. Also, ask for the nutritionist to figure out what supplements which will be best. We are going off ensure to Resource 2.0-has more protein in it for our patients.

Do you know what the swallow test showed, and what recommendations were made?
Paula

Customer: replied 6 years ago.
Reply to PaulaNP's Post: The swallowing test showed paralysis on the left side of her throat and she can only have nectar like substances. She drools most of this out of her mouth.
When any water-like substance is introduced, she aspirates. She does have a living will and does not want any life support down. Her sense of humor is fabulous, one of the reasons this is so difficult.
Expert:  PaulaNP replied 6 years ago.

Yes, she needs nectar additive and a product called Thicket which thickens food. I had a patient who was told to hold his head at a certain angle to swallow-this came from the speech therapist who oversaw his studies. Have a sit down with everyone or a phone call if you are not in the area. Speak with the speech therapist, the doctor. the nursing administrator, the nutritionist about the how your mom might be fed or eat, and thoughts on a feeding tube. Then, talk to mom and see what she will accept if she is competent.

Frankly, I know nrsg homes. I would still ask for hospice-they frequently discharge patients in much better shape than when they got them. They will oversee her care in the rehab facility, and may have feeding suggestions and comfort measures or what is known as palliative care. Here is some more info for you:

http://nutritionandaging.fiu.edu/creative_solutions/hospice.asp

I hope this helps, Paula

Customer: replied 6 years ago.
Reply to PaulaNP's Post: Thanks again. I will be back in touch. She is working with a speech therapist. I am going back to Chicago tomorrow. My brother said that she has not even been drinking the ensure over the past 2 days. I am wondering if this is her way to let go.
Expert:  PaulaNP replied 6 years ago.

Dear Mbran.

It may be, the body just gets so weary, it gets hard to fight. In her physical state and age, there is not much hope for recovery. The kindest thing to do is give her permission to go-you can say it silently to her spirit-she will get the message.

Take care, Paula

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