Advice needed - 91 year old dad is suddenly exhausted and has no appetite

[Anonymous]

Anonymous wrote:OP, I just wanted to say I am sorry. This sounds really hard on many different levels. My Mom died when she was 66 of mucosal melanoma. I had a couple of months to get used to her being gone - and then she was. I know she was scared but she put on a brave front. At age 91, your Dad can’t bounce back like someone younger and I would encourage you to take some time off work and be with him. It sounds like his body is preparing him for transition (I don’t remember the words hospice used but fevers and falling and vomiting - his body is for lack of a better word - failing).

I was pregnant when my Mom was sick and I did not take time to be with her as much as I should have. I had some pregnancy complications and I was saving leave for postpartum. It’s a huge regret of mine but it was so hard to see my Mom frail and incoherent. So I also avoided it.

I just wanted to encourage you to spend time with your Dad now if you can. Hope your work trip is short and you’re home soon. Sending strength.

I think the phrase you were looking for is failure to thrive. Amd yes, very common at end of life. Op, please take this advice to heart, even with excellent medical care and a diagnosis, your father may not have much time left at 91, and the decline may be more rapid than you expect.

DH is a surgeon and was with a close relative whose husband was in the ICU after getting a bad infection during chemo. My husband told her that she needed to say her goodbyes as it was obvious to him that her husband would be dead in the next few hours. No one on the hospital care team had thought to tell her this (and this was at one of this area’s leading hospitals). Don’t assume that you will necessarily be told bythe doctors/nurses when the end is very near.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP, I just wanted to say I am sorry. This sounds really hard on many different levels. My Mom died when she was 66 of mucosal melanoma. I had a couple of months to get used to her being gone - and then she was. I know she was scared but she put on a brave front. At age 91, your Dad can’t bounce back like someone younger and I would encourage you to take some time off work and be with him. It sounds like his body is preparing him for transition (I don’t remember the words hospice used but fevers and falling and vomiting - his body is for lack of a better word - failing).

I was pregnant when my Mom was sick and I did not take time to be with her as much as I should have. I had some pregnancy complications and I was saving leave for postpartum. It’s a huge regret of mine but it was so hard to see my Mom frail and incoherent. So I also avoided it.

I just wanted to encourage you to spend time with your Dad now if you can. Hope your work trip is short and you’re home soon. Sending strength.

I think the phrase you were looking for is failure to thrive. Amd yes, very common at end of life. Op, please take this advice to heart, even with excellent medical care and a diagnosis, your father may not have much time left at 91, and the decline may be more rapid than you expect.

DH is a surgeon and was with a close relative whose husband was in the ICU after getting a bad infection during chemo. My husband told her that she needed to say her goodbyes as it was obvious to him that her husband would be dead in the next few hours. No one on the hospital care team had thought to tell her this (and this was at one of this area’s leading hospitals). Don’t assume that you will necessarily be told bythe doctors/nurses when the end is very near.

Thank you so much for your advice. That is shocking to me that the hospital staff didn't alert her.

[Anonymous]

I would not wait to get medical attention. Any number of reasons come to mind and none of them good without medical intervention. why are you waiting... get him to good er asap

[Anonymous]

why are you asking about the obvious? A no brainer question

[Anonymous]

OP here. Here’s the latest update. He had a few tests yesterday and we finally got some preliminary answers. He does not have CHF after all. He does have a mass in his liver. We will find out today if it is a liquid cyst (which I obviously what I am hoping for) or if it is a tumor. This is all so hard. He just wants to go home. Hopefully when we have more answers today we can get a realistic plan to get him home, regardless of his prognosis...

[Anonymous]

Sorry op

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP, I just wanted to say I am sorry. This sounds really hard on many different levels. My Mom died when she was 66 of mucosal melanoma. I had a couple of months to get used to her being gone - and then she was. I know she was scared but she put on a brave front. At age 91, your Dad can’t bounce back like someone younger and I would encourage you to take some time off work and be with him. It sounds like his body is preparing him for transition (I don’t remember the words hospice used but fevers and falling and vomiting - his body is for lack of a better word - failing).

I was pregnant when my Mom was sick and I did not take time to be with her as much as I should have. I had some pregnancy complications and I was saving leave for postpartum. It’s a huge regret of mine but it was so hard to see my Mom frail and incoherent. So I also avoided it.

I just wanted to encourage you to spend time with your Dad now if you can. Hope your work trip is short and you’re home soon. Sending strength.

I think the phrase you were looking for is failure to thrive. Amd yes, very common at end of life. Op, please take this advice to heart, even with excellent medical care and a diagnosis, your father may not have much time left at 91, and the decline may be more rapid than you expect.

DH is a surgeon and was with a close relative whose husband was in the ICU after getting a bad infection during chemo. My husband told her that she needed to say her goodbyes as it was obvious to him that her husband would be dead in the next few hours. No one on the hospital care team had thought to tell her this (and this was at one of this area’s leading hospitals). Don’t assume that you will necessarily be told bythe doctors/nurses when the end is very near.

Thank you so much for your advice. That is shocking to me that the hospital staff didn't alert her.

This happened with our dad. He was 76 and got sepsis while he had cancer, miracousky beat it—but was never the same. We kept chalking up weakness to sepsis recovery—not cancer advancing. Oncologist’s Office kept saying my dasd’s bloodwork was good as he grew weaker and weaker and was disappearing before our eyes. They kept telling us he had great chances. When he was finally admitted to a different hospital near the end—it was the ER doctor that broke the news to us. It was shocking and we kept wondering why nobody had been straight. The end was fairly quick after that.

But, it started with barely eating/drinking and lower energy. The non-eating, drinking is very common at end of life and my dad LOVED food.

I’m sorry, OP.

[Anonymous]

Oh my goodness, OP - I’m so sorry. Hope they can get to the bottom of this quickly so your dad can get home. Once you know what you’re dealing with, you can sit down as a family and really discuss not only what he’ll need in the concrete sense, but also what his wishes are going forward regarding the care he will or won’t receive. Home hospice is a wonderful resource as a provider of palliative care to keep him comfortable in the event that he doesn’t wish for intensive treatment.

Keep us posted. Sending good thoughts your way!

[Anonymous]

See what the docs say, and be sure to put what your dad wants front and center. Remind the docs this is about quality of life, not quantity at this point.

I'm sorry, OP.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP, I just wanted to say I am sorry. This sounds really hard on many different levels. My Mom died when she was 66 of mucosal melanoma. I had a couple of months to get used to her being gone - and then she was. I know she was scared but she put on a brave front. At age 91, your Dad can’t bounce back like someone younger and I would encourage you to take some time off work and be with him. It sounds like his body is preparing him for transition (I don’t remember the words hospice used but fevers and falling and vomiting - his body is for lack of a better word - failing).

I was pregnant when my Mom was sick and I did not take time to be with her as much as I should have. I had some pregnancy complications and I was saving leave for postpartum. It’s a huge regret of mine but it was so hard to see my Mom frail and incoherent. So I also avoided it.

I just wanted to encourage you to spend time with your Dad now if you can. Hope your work trip is short and you’re home soon. Sending strength.

I think the phrase you were looking for is failure to thrive. Amd yes, very common at end of life. Op, please take this advice to heart, even with excellent medical care and a diagnosis, your father may not have much time left at 91, and the decline may be more rapid than you expect.

DH is a surgeon and was with a close relative whose husband was in the ICU after getting a bad infection during chemo. My husband told her that she needed to say her goodbyes as it was obvious to him that her husband would be dead in the next few hours. No one on the hospital care team had thought to tell her this (and this was at one of this area’s leading hospitals). Don’t assume that you will necessarily be told bythe doctors/nurses when the end is very near.

This is very good and valuable advice.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP, I just wanted to say I am sorry. This sounds really hard on many different levels. My Mom died when she was 66 of mucosal melanoma. I had a couple of months to get used to her being gone - and then she was. I know she was scared but she put on a brave front. At age 91, your Dad can’t bounce back like someone younger and I would encourage you to take some time off work and be with him. It sounds like his body is preparing him for transition (I don’t remember the words hospice used but fevers and falling and vomiting - his body is for lack of a better word - failing).

I was pregnant when my Mom was sick and I did not take time to be with her as much as I should have. I had some pregnancy complications and I was saving leave for postpartum. It’s a huge regret of mine but it was so hard to see my Mom frail and incoherent. So I also avoided it.

I just wanted to encourage you to spend time with your Dad now if you can. Hope your work trip is short and you’re home soon. Sending strength.

I think the phrase you were looking for is failure to thrive. Amd yes, very common at end of life. Op, please take this advice to heart, even with excellent medical care and a diagnosis, your father may not have much time left at 91, and the decline may be more rapid than you expect.

DH is a surgeon and was with a close relative whose husband was in the ICU after getting a bad infection during chemo. My husband told her that she needed to say her goodbyes as it was obvious to him that her husband would be dead in the next few hours. No one on the hospital care team had thought to tell her this (and this was at one of this area’s leading hospitals). Don’t assume that you will necessarily be told bythe doctors/nurses when the end is very near.

Thank you so much for your advice. That is shocking to me that the hospital staff didn't alert her.

This happened with our dad. He was 76 and got sepsis while he had cancer, miracousky beat it—but was never the same. We kept chalking up weakness to sepsis recovery—not cancer advancing. Oncologist’s Office kept saying my dasd’s bloodwork was good as he grew weaker and weaker and was disappearing before our eyes. They kept telling us he had great chances. When he was finally admitted to a different hospital near the end—it was the ER doctor that broke the news to us. It was shocking and we kept wondering why nobody had been straight. The end was fairly quick after that.

But, it started with barely eating/drinking and lower energy. The non-eating, drinking is very common at end of life and my dad LOVED food.

I’m sorry, OP.

I think this can be tricky for doctors to navigate. Some patients don't want to know what time the doctor thinks is left. My mom did NOT want to hear anything like that from the doctor. She finally asked, but it was, I think, when she had started to come to terms on her own about it.

[Anonymous]

At 91, or younger, many elders would prefer to go "against medical advice" and let nature take it's course. If they die, they die. They are ready (mentally, emotionally). They may or may not wish to express this to you. They may not know how to, what words to use, or they may be very private. Death is a very private matter. I don't think they owe you or anyone an explanation even though it is heartbreaking. This is just one possible scenario of course.

[Anonymous]

Failure to thrive doesn’t cause a fever.

Op’s Dad need a diagnosis of the liver problem before he decides if he wants to withdraw medical care, if he needs specific medical care.

[Anonymous]

Anonymous wrote:Failure to thrive doesn’t cause a fever.

Op’s Dad need a diagnosis of the liver problem before he decides if he wants to withdraw medical care, if he needs specific medical care.

Failure to thrive in elderly persons is defined by The Institute of Medicine as weight loss of more than 5%, decreased appetite, poor nutrition, and physical inactivity, often associated with dehydration, depression, immune dysfunction, and low cholesterol.

The mass in the liver and fever indicate a medical problem independent of failure to thrive, unless it’s an infection related to his immune system as it could be.

[Anonymous]

OP here with another update. He had an abscess in his liver. They are starting him on IV antibiotics. I'm not sure yet what his prognosis is or what the care plan is beyond antibiotics. He feels really sick today and desperately wants to get home. I know we can't get him home until we have a bed on the first floor and also have a little more info about his diagnosis and prognosis, but we are definitely tryouts by to prioritize his wishes of getting home. I'm so incredibly relieved it isn't a malignancy but still not sure what the implications of a liver abscess are in someone his age with his medical history...