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My mom 87 has a very general weakness and feels that she is dying - almost everyday now...for months. She has home health care aides for years. Her blood work is perfect although she does get UTIs. With all the medical intervention, we CANNOT figure out what is causing this awful weakness! They think the spinal stenosis but this is frustrating. Trying to get her palliative care but none exist in her county.



Health issues:


-severe spinal stenosis (impaired mobility)


-depression


-metabolic encephalopathy

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Likely it's the depression which manifests often as exhaustion. ON the other hand some seniors ARE honestly exhausted with life and ready to go. My dad was and he was extremely articulate about it when asked. He wished only to sleep and longed for the "long, long nap".

Speak with your mom about whether she is depressed, or overly tired. Check her blood pressure daily and be certain she is hydrated. Speak with her doc (whomever is POA) and then perhaps you may just need to accept that for her things are winding down a bit now.
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You do not mention dementia, which my mother has, but here’s our experience. My mother is also medicated for depression.

In her early stages of dementia, instead of acknowledging that she was forgetting things, my mother blamed everything for being broken, us forgetting to tell her anything, etc. Although she was mobile, quite strong and good physical health, she vehemently denied cognitive decline, instead focusing on her virtually nonexistent physical decline. We kept her active, walking every day, weather permitting. But she would get in this strange mindset that she was frail and dying. It might last for hours or days, then she’d be fine. But she did return to the issue repeatedly for almost a year. One day we watched (and photographed) as she used a mop as a crutch and dramatically struggled 55’ over to us, explaining that wanted us to see how she was dying and too weak to make it a few feet to reach her walking stick that stood by her front door. (that she had walked past, to get outside to us) Just then, a neighbour pulled up our driveway. She dropped the mop and scampered over to the car for a visit.

We supposed that her mind looped on a fear and, until she was distracted, she acted out that fear.

This is strictly anecdotal - no medical explanation.
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Who isn’t depressed when at the end of life and there’s nothing left to hope for? She needs an antidepressant if she isn’t on one as yet. .

I would look into hospice for her. It’s not just for people whose deaths are imminent. They handle physical and mental care. My mother just enrolled and so far we are very pleased with the team we have.
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How is the depression being managed? Keeping in mind that the brain is an organ often left out of medical intervention, has behavioral therapy been discussed/offered?
I did a quick search of clinical articles(1) on depression in the elderly. Besides acknowledging that it is a huge concern since it speeds physical decline, common ways to address/prevent it were:

~ medication can alter chemical signals, reducing symptoms

~ spirituality/religious belief that provide hope can empower a person to better cope with their situation, relieving them of the hopelessness that's so disabling^.

~ cognitive therapy can help a person adjust their thinking, avoid looking back at 'I used to' and focus on 'what I can do today'... [One benefit of the pandemic is that Medicare is still covering virtual therapy...]

~ physical/mental exercise can stimulate mood, improve circulation... A couple of articles said robotic pet therapy was shown to reduce depression, pain, stress hormone levels, boredom, and loneliness while increasing happiness and quality of life! (On a personal note, I was amazed to learn how just a life-like stuffed puppy boosted a terminal friend's mood! It gave her something to fuss over, talk to, talk about - it gave her joy.)

We KNOW aging is HARD. But quality of life can always be tweaked.

Best wishes for your family.


(1) Something I used to do when I had a paying career LOL {PubMed, National Library of Medicine, NIH}

(2) A favorite video of mine in that regard is Imagine the Time, where 3 individuals saddled with challenges are able to have a positive view of the future because of trusting the Bible's promises of a much better days ahead - https://bit.ly/3NshPH4
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As this has been thoroughly discussed with her MDs, I cannot think of any answer whatsoever. I am sorry that the end of her life is so miserable. There is very little upside to this kind of aging misery. While you say palliative care is not available, I would discuss Hospice and certainly forgo any life sustaining or life saving heroic measures in future. After all the good medical intervention you have done anything we might say would be pure guesswork. You are not alone. Many of our aging are miserable. It is a time of one loss following another for so many.
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CaringDaughter7 Jun 2023
Thank you for the supportive reply!
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