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Gleason 6
Veteran Member
Joined : Mar 2011
Posts : 879
Posted 11/20/2012 11:26 AM (GMT -8)
My 93 year old dad lives with me. My wife and daughter are at her mothers house for a much needed visit with her family. My son has basketball games, so he's home with us. My dad who usually does pretty well for 93, has become very weak. This started suddenly Sunday when he got up. He's in bed right now. He fell twice and did not get hurt, so I took today to be with him. I thought maybe he was dehydrated, so I have need pumping him up,with Gatorade as best I can. So far no change.

It's a struggle just to get him up to use his urinal or to get fluids in him. I checked his pulse and it is strong and regular. No fluids building in his legs, so I don't think he is retaining water.

I just not sure what to do. Call the EMT and get him in a hospital? He is DNR, and says he just want to be with my Mom. She died 4 years ago after 62 years of marriage and he misses her so. One side of me say as long as he is comfortable, let him rest here at home. The other side says I can't care for him and get him to a hospital where he could get an IV with some fluids and a cath.

Thanks.
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JAVGuzzi
Regular Member
Joined : Nov 2012
Posts : 270
Posted 11/20/2012 11:35 AM (GMT -8)
I would call his Dr. for advice or get him to the ER. What is his BP ?
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James C.
Veteran Member
Joined : Aug 2007
Posts : 4464
Posted 11/20/2012 11:41 AM (GMT -8)
What does your father wish, if he is capable of understanding his situation and expressing his thoughts?
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Raddad
Veteran Member
Joined : Jul 2011
Posts : 1857
Posted 11/20/2012 11:46 AM (GMT -8)
Good Question James.

I do not envy you Gleason 6, will be a hard conversation.

Hugs!

Bud
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Steve n Dallas
Veteran Member
Joined : Mar 2008
Posts : 5246
Posted 11/20/2012 11:48 AM (GMT -8)
Ditto to what James asked... Maybe he's tossing in the towel.

Does he eat food OK?
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MauiViv
Regular Member
Joined : Oct 2012
Posts : 112
Posted 11/20/2012 11:59 AM (GMT -8)
call your local hospice. they will give you suggestions and probably send out a nurse to discuss things with you and him if he can participate. hospice is fabulous.
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worriedabouthubby
Regular Member
Joined : Aug 2012
Posts : 358
Posted 11/20/2012 1:08 PM (GMT -8)
I have cared for my mother-in-law for more than 5 years now.  She too is a DNR and she has had strokes, heart problems and last year the day after Thanksgiving, she broke her hip.  I fully understand your delimia.  She, too is a DNR.  We've now had multiple converstaions about what she wants and doesn't want regarding 'critical' care. 

If your Dad  is  a DNR, does he also have a POST or MOST(physicians's/medical orders for scope of treatment) or a living will/advance directives?  If so, do they indicate what he wants done/not done? Such documents allow a person to specify if the WANT  IVs, artificial nutrition, etc. as well as dealing with DNR issues.

   

If your/his insurance has a 24 hour nurse line, that would be an excellent place to start. 

Contacting his Primary Care Physician is an excellent idea, as is contacting hospice.  There are many things that can cause sudden, dibilitating weakness, espeically in a fragile elder.  You were right to suspect dehydration and congestive heart failure, but if he is not showing other symptoms of those, there are many other things a physician could check.  Does he have a history of strokes or heart or kidney problems?  What has his appitite been? Is he keeping food down? 

If you have a wrist blood pressure cuff, I'd check his bp and pulse with that.  And check his temperature.  The more info you can give his doc the better.  Also- hold his hands in yours and ask him to squeeze both at the same time- see if they are about equal in strength. 

With his symptoms, you'll be sitting in an ER waiting.  He's not bleeding, having trouble breathing, or showing obvious  signs of heart problems or a stroke, so other cases would probably be seen first. 

Prayers going up for you both now. 

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Gleason 6
Veteran Member
Joined : Mar 2011
Posts : 879
Posted 11/20/2012 2:04 PM (GMT -8)
Well, he had a PT person coming to the house today, so I let her come even though I knew he would not be doing any PT. she talked with the nurse and thought it best to take him to the ER for tests. Got the EMT's to take him to the ER. So, here I am in a room in the ER. BP, pulse, EKG, all normal...for a 92 year old. Took a chest X-ray to check for pneumonia. Well see what they turn up. Nothing really stands out tough right now. He does not have heart disease, height BP, breathing problems, etc. no dementia. I sometimes think he's healthier than me :)
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gunfighter
Veteran Member
Joined : Sep 2012
Posts : 1249
Posted 11/20/2012 2:39 PM (GMT -8)
Gleason 6,
I am so sorry. When I heard your story I thought about "stroke" since that's what happened to my elderly mother before she died at the age of 95...I wish you both the best.
Bill
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Purgatory
Elite Member
Joined : Oct 2008
Posts : 25448
Posted 11/20/2012 2:55 PM (GMT -8)
sounds like you are between a rock and a hard place. going to the er is erring on the safe side, and i fully agree, that way, if there is more going on than meets the eye, he will be in the right place.

no easy answers for your situation, wish both you and your dad the very best

david
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nhwife
Veteran Member
Joined : Mar 2012
Posts : 723
Posted 11/20/2012 3:15 PM (GMT -8)
It is difficult. My mom is 92 and just had a spell on Sunday. We are lucky that my mom's live-in housemate is a former nurse so was able to keep on top of vitals. But it brings us up short, for sure.
I am my mom's health proxy and I know her wishes are DNR. She doesn't want what happened to my dad to happen to her.
Hoping all is resolving for you as I write this but I know that things can change remarkably quickly at this age.
I wait for it.
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Gleason 6
Veteran Member
Joined : Mar 2011
Posts : 879
Posted 11/20/2012 3:32 PM (GMT -8)
Still waiting for test results, but they are thinking pneumonia.
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John T
Veteran Member
Joined : Nov 2008
Posts : 4315
Posted 11/20/2012 4:07 PM (GMT -8)
G6,
I'm in the exact situation with my mom. She refuses to go to the hospital, got rid of her emergency call button and has "Do Not Call 911" posted all over her house. I though about this a long time and concluded I just have to go along with her wishes. You can call Hospice, it's what they do and they do it very well and it's fully covered by Medicare. They will come 3 or 4 times a week and make him comfortable and do testing to adjust his meds.
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JAVGuzzi
Regular Member
Joined : Nov 2012
Posts : 270
Posted 11/20/2012 4:44 PM (GMT -8)
G6 :
Good to hear he is at the ER. He is getting the help he needs. Good luck.
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Swimom
Veteran Member
Joined : Apr 2006
Posts : 1732
Posted 11/20/2012 7:10 PM (GMT -8)
Hi 6,

I hope your Dad gets to feeling better soon. Seniors are like kids; no manuals to give us the clues until they're

sick, sick. Poor guy. I would have guessed a UTI or pneumonia. Both of those tend to sneak up with no real symptoms other than weakness and general malaise. Glad he's getting medical attention so quickly. Wishing him well.

Swim

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Gleason 6
Veteran Member
Joined : Mar 2011
Posts : 879
Posted 11/20/2012 7:17 PM (GMT -8)
Thanks. Just got home from the hospital. He was admitted for the night and I asked the doctor to call when he sees him at 7:00am (yikes!). I'll know then if they will keep him tomorrow or release him. I'd like to see them keep him another day and see if he gets his strength back. Wondering how I'm going to get him up the 3 steps into house.

Pneumonia never crossed my mind. Learn something every day I guess. I'm glad to now what it is.
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worriedabouthubby
Regular Member
Joined : Aug 2012
Posts : 358
Posted 11/20/2012 7:31 PM (GMT -8)
Pnumonia is sometimes called 'the old man's disease'.  Unfortunately it is much more common in the elderly.  If your dad does have it, after he is over it, talk to the doc about getting a pnumonia vaccine. You should get one too (if you are over 50).  UTI are also common in the elderly- related to dehydration, too. 

Rest and take care of yourself.  Prayers continue. 

(Private message me if you want info on the POST/MOST forms I mentioned earlier - or ask your doc. )

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Swimom
Veteran Member
Joined : Apr 2006
Posts : 1732
Posted 11/20/2012 7:35 PM (GMT -8)
Rest easy. He's in good hands for the night. As for his pepp; it may take a little time to gain his strength back. Given his generally good health for his youth :) he'll get there. Acute change is about the only signal we get sometimes and you were right on top of it.

While I don't miss working in all kinds of weather and 72 hours a week at my age, I do miss working the road as a Medic. Never hesitate to call for transport when your gut tells you something just doesn't seem right. Glad you made the call :)

Swim
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overthepond
Veteran Member
Joined : Apr 2011
Posts : 648
Posted 11/21/2012 2:40 AM (GMT -8)
Just sending you and your father a hug Gleason, hoping for better news soon.
It is no fun this aging business!
Susan
x
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JAVGuzzi
Regular Member
Joined : Nov 2012
Posts : 270
Posted 11/21/2012 6:05 PM (GMT -8)
Pneumonia in the elderly isn't anything to fool around with. Older people usually have immune systems that are compromised compared to their younger years.

A 76 y/o friend of mine died recently as a result of pneumonia. He needed to go to the Dr. sooner than his caregiver decided, IMHO. He was in the hospital for about two weeks before he succumbed.
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Gleason 6
Veteran Member
Joined : Mar 2011
Posts : 879
Posted 11/21/2012 6:45 PM (GMT -8)
Swim, that's exactly what they were thinking when we got to the ER...pneumonia or UTI. I thought of dehydration and neither one of those cross my mind.

He was weak again this morning but tonight he seems to have more pep. Maybe the antibiotics are taking hold.

I make jumbo lump crab cakes for thanksgiving dinner when it's just my son and me. I'll take my dad one when I go to visit him tomorrow and hopefully being thankful that he's doing better.

Plans are to keep him in the hospital till Sundays and then for a couple of weeks in rehab. But I think it's time to look into a care facility. I want him to be safe. When we started crying for him he was driving and independent. He's gotten a lot weaker over the past 4 years. I'm glad we have a plan and he'll get the care he needs. Ian really glad I called the EMT's.
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Purgatory
Elite Member
Joined : Oct 2008
Posts : 25448
Posted 11/21/2012 8:00 PM (GMT -8)
gleason, put your mind to rest, you absolutely did the right thing for your dad, and keeping him a few days in the hospital extra should give you some peace of mind. hope he pulls and stabalizes back fine.

there are many of here with elderly parent(s) that have a mind and will of their own. my 85 year old mother is no different. she still keeps her own house on 2 1/2 acres of lawn, lives alone. her memory is failing, her driving is scary at best, and she goes to doctors constantly - yet constantly refuses to be compliant with any of them - she fills the scripts they order, then tosses the meds. we have been trying to get her to sell her house (was paid off 20 years ago) and move into an assisted care community. one of the best in our area is 1/2 mile from where we live. she refuses, nothing to do with money, because she doesnt want to be around other "old" people, her words. sometimes, there's not much you can do in these situations, but hope for the best. if it were up to me, her driver's license should be revoked for good, she is a danger to others and herself anytime she drives. only good thing, she doesnt drive much. she has a 2003 honda civic that she bought new after my father died, and it only has 22,000 miles on it, but still she's always getting tickets and fender benders - always her fault.

good luck with your dad

david
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