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

[Anonymous]

I am so sorry, OP. Fighting infection in a 91-year old, even a healthy one, is not the same as middle age even. It is much tougher for the body to amount immune response. I wish him the best and hope the poor guy gets some relief.

[Anonymous]

Thanks so much again to the PPs who have weighed in with kind words and advice. He did have the access drained yesterday. He's in pain, but they are giving him pain meds and it is helping. They're talking about discharge as early as the weekend. We are talking today with hospice and plan on having that for him so he can be at home (I appreciated the advice about finding a good rehab facility, but we met with the geriatrician yesterday and they agreed that home care would be better for him than rehab). Apparently they will help us through the set up process so it's not too stressful for my mom. Still getting mixed messages about his prognosis. Still don't actually know if he has CHF or not. I appreciate all the help we have gotten at Inova Fairfax but if I have one complaint it is that it doesn't seem like the various medical departments communicate well with each other. We have heard different things from internal medicine, surgery, cardiology, GI and geriatrics. It would be really helpful if there was one main point of contact and the message was more uniform.

Any advice pre-hospice? Getting it set up between now and the weekend seems like short notice, but I'm guessing they must have a process that is pretty efficient?

[Anonymous]

Hospice can move quickly - the most important thing you need is an evaluation to determine whether he meets the criteria (presumably yes, but it's not automatic by age or condition.) Once my dad was approved, the hospice visits began pretty much immediately. Bear in mind that you may still need visiting nurses or other supports. But in my experience hospice agencies are just phenomenal about sorting out the process. Truly angels on earth.

[Anonymous]

Agree about hospice. And they will be be a great support to you as you navigate caring for your dad at home.

[Anonymous]

Just chiming in to say that I am following this thread and though I don't have any advice, I am thinking of you OP and your dear Dad and sweet mother. You seem like really wonderful people. I hope you dad improves quickly.

[Anonymous]

*your

[Anonymous]

Good luck op. I am also following and sending prayers your way.

[Anonymous]

Anonymous wrote:Good luck op. I am also following and sending prayers your way.

Same here. Thinking good thoughts for you and your family.

[Anonymous]

Be careful in choosing hospice care company. Many are for profit and offer very little care. Find out if they have an RN and MD on call, even on weekends. Prayers and good wishes for you.

[Anonymous]

How is your dad doing? Thinking of you both.

[Anonymous]

Hi all. OP here. Thanks for everyone who has checked in. You're all really sweet and generous to think of him.

He went home on hospice (Capital hospice). So far so good. They made it really seamless. We also hired 24 hour home aide help (my mom is strong but would have been completely overwhelmed). Yesterday morning before he went home, we were told his time is short. That being said, we have never gotten a consistent message or even diagnosis from the hospital. We don't actually know if he has CHF but we were told his main issue is the infection of his liver and not to worry about anything else. He was so incredibly anxious to get home that they sent him home on oral antibiotics rather than continue aggressive treatment with IV antibiotics.

Once he got home he really perked up. He's eaten a few eggs, had some coke and is much more lucid. One of my brothers came down from NYC to say his goodbyes (maybe not?) and it really cheered my dad up - he has been chatty and energetic all morning. He even walked upstairs by himself (despite the aide trying to get him to stop) because he wanted to get in his own bed. He stayed in his own bed for a while then decided he'd rather be downstairs lol. At least now he feels like staying downstairs was HIS choice.

The hospice nurse told us sometimes patients "rally" when they get home and it gives the family false hopes that they're going to recover. She said he could recover but that we should also accept that his prognosis is dire (they don't think he will ever recover from the massive abscess in his liver). I'm trying to stay positive and happy around him, celebrate him, let him have his wishes and hope for the best and not second guess having gone home on hospice.

It is really interesting to see his change in energy and affect once he found out he was going home. The day before he went home he seemed like he was dying. He was confused, could barely speak and seemed to be hallucinating. Now he's about 90% lucid and is speaking clearly.

The home care aides have been really nice so far too, and are a great help - but we will probably scale that back if he continues to do so well - maybe we will wait a week or so to see. The company we are using is really good about us being able to cancel or scale back at any time.

[Anonymous]

Op, I am so happy to hear your dad is back home, amd enjoying his family..

[Anonymous]

Anonymous wrote:Op, I am so happy to hear your dad is back home, amd enjoying his family..

Thank you, that means a lot. One of my younger brothers came home for the weekend to say goodbye, and it really perked my Dad up. Now that he's gone my Dad is starting to fade again. I'm lucky at 46 I've never really has to deal with someone dying and I'm learning a lot of lessons. It doesn't have to be as traumatic as it initially felt. We are way more laid back now about his care, paying attention only to his wants and needs. It's revelatory to give up on the stress of trying to keep him alive. Other PPs mentioned this very early in this thread and they were right.

[Anonymous]

Thank you for the update, op. My mom died at home from cancer, and her being at home was really such a blessing. I think our culture doesn't handle end-of-life issues very well, generally speaking. I'm so glad you were able to honor his wishes and have him back home. We'll be thinking of you.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Op, I am so happy to hear your dad is back home, amd enjoying his family..

Thank you, that means a lot. One of my younger brothers came home for the weekend to say goodbye, and it really perked my Dad up. Now that he's gone my Dad is starting to fade again. I'm lucky at 46 I've never really has to deal with someone dying and I'm learning a lot of lessons. It doesn't have to be as traumatic as it initially felt. We are way more laid back now about his care, paying attention only to his wants and needs. It's revelatory to give up on the stress of trying to keep him alive. Other PPs mentioned this very early in this thread and they were right.

Hugs to you and your family OP. Aren't hospice workers the greatest people on earth? I hope your dad has many happy and peaceful days at home.