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Mother in law - currently receiving hospice care pt 1
2 weeks ago we were told that my mother in law's heart was functioning at 10-15%. We discussed options (which there really weren't any) and she entered at home hospice care. She has been on dialysis for about a year (3x a week). I am not sure where her kidney's are at as far as functioning but I am guessing very minimal because up until the last week she hadn't urinated in 6 months. So she has kidney failure, CHF and liver failure. She has been hospitalized 4+ times in the past several months, a few months ago she fell and got bruised up pretty badly. Then she fell again and her mobility got very limited. 2 weeks ago she was able to sit up on the side of her hospital bed and eat, she could roll over by herself.  Now she cannot sit up on her own, she cannot control her bowels and she has to be on constant oxygen. I have several questions that I hope can be answered generally. (see below for a list of her current symptoms)

1. She has a defibrillator, I know there can be some ethical issues with switching it off during a terminal illness but what exactly happens when a person is trying to die, but the device is on. I have read stories about extreme pain.

2. She has never ever missed dialysis, but she has now missed it twice in 1 week (2 out of 4 visits) each time we take her there she has to be lifted like a baby into her wheelchair. Movement while dressing her (which is really just putting her socks on and putting a nightgown over her head) causes her to be seriously out of breath, as does the movement to the wheelchair. Is there probably going to be a point where she will decide not to go anymore? We are trying to figure out how this should be handled, since we have been told that she will die without it.

3. She is constantly coughing up stuff, which I am guessing is from her lungs. This isn't likely to imrove is it?

cont.
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