Granddaughter: Barbara Bush is ‘a fighter,’ in good spirits

Former first lady Barbara Bush, who was reported to be in failing health over the weekend, is in “great spirits,” and the family is grateful for “everybody’s prayers and thoughts,” her granddaughter said Monday.

Bush family spokesman Jim McGrath said in a news release Sunday that “Mrs. Bush, now age 92, has decided not to seek additional medical treatment and will instead focus on comfort care” at home in Houston after consultations with her doctors and family.

McGrath did not elaborate on the nature of Bush’s health problems but on Monday said she’s suffered in recent years from congestive heart failure and chronic obstructive pulmonary disease. She also has been treated for decades for Graves’ disease, which is a thyroid condition, had heart surgery in 2009 for a severe narrowing of her main heart valve and was hospitalized a year before that for surgery on a perforated ulcer.

Jenna Bush Hager, an anchor on NBC’s “Today” show, said Monday morning that Bush is resting comfort- ably with family.

“She’s a fighter. She’s an enforcer,” Hager said, using the family’s nickname for her grandmother. “We’re grateful for her, for everybody’s prayers and thoughts, and just know the world is better because she is in it.”

Hager said former President George H.W. Bush “still says, ‘I love you, Barbie’ every night,” and described her grandparents’ close relationship as “remarkable.”

President Donald Trump’s press secretary, Sarah Huckabee Sanders, said in a statement Sunday evening that “the president’s and first lady’s prayers are with all of the Bush family during this time.”

People who opt for comfort care receive treatment only for their symptoms, such as shortness of breath or pain, rather than trying to prolong life or cure the underlying health problem, said Tim Simpson, a certified hospice and palliative nurse for almost 28 years.

For example, patients having trouble breathing might receive oxygen or steroids, or if they have fluid in their legs because of a bad heart, they might receive diuretics.

“With comfort measures, there are no unnecessary tests except those needed to relieve a patient’s symptoms,” said Simpson, chief nursing officer at Seasons Hospice in Illinois.

Hospice care has some technical differences. It’s for patients who are not expected to live more than six months, Simpson said. They sign a waiver officially saying they want only treatment for their symptoms that does not prolong life, he said.

Comfort care is more of a verbal understanding between a doctor and a patient, Simpson said.

Heart failure is one of the top reasons older people are hospitalized and is a leading cause of death. It develops when the heart muscle weakens over time and can no longer pump effectively, sometimes because of damage from a heart attack. Fluid can back up into the lungs and leave people gasping for breath.

Many people have both heart and lung problems, said Dr. Kyle Hogarth, a pulmonologist and associate professor in pulmonary and critical care at the University of Chicago Medicine.