Context

Anne (my mother) has been at home with 24-hour nursing care since she had a serious hiatal hernia and surgery in June. The team is such a wonderful group of women; they have been so kind and caring to Anne, and we have become a support to each other over this time—I am grateful down to my bones for each and every one of them.

Anne also has late onset alzheimers/dementia, and I have been making decisions as her medical POA, with her cognitive decline increasing in pace recently.

It’s been a rough few weeks for her, with a kidney stone procedure and a hiatal hernia and cardiac issues—3 trips to the ER in as many weeks.

I had begun shifting the focus of Anne’s care to palliative just after the kidney stone. Shortly after this followed the choice to decline an operation for the hiatal hernia, and the choice not to consider installing a pacemaker.

It took rather longer than any of us would have liked to get proper pain control in place for the hiatal hernia when she was released from the hospital on the second trip, and Friday was a run to the ER after a fairly precipitous drop in her blood oxygen levels. She is home and comfortable, but significantly more confused. We are working to tune the pain meds to get the balance between lack of pain and a more clear head.

I am in Santa Fe, at least until Feb 11, but I booked a one-way ticket down. so....