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My 89 year old father just got out of a week’s stay in the hospital that left him weak and needing help to do almost everything in life. He lives in an assisted living home with my mother and until he went into the hospital he was totally independent. Suddenly now he can’t seem to find a reason to continue to live. It makes me so sad to see him this way. He has always been the most positive person I know in life. Now he says he has nothing to look forward to except death. Any ideas?

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Its been a week. Has Dad shown any improvement?
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Does he want to write his memoirs or take up art/painting? Did he have any other hobby interests he never had time for when he had to work? Is there volunteer work he can get involved in at his facility he would be able to do? Can you plan visits and talk these up so he can have things on his calendar to look forward to? Is he religious? Lots of time for prayer! Can he get signed up for visiting chaplains/clergy? There is purpose for everyone, just have to find it. As a caregiver, I have heard of people who find purpose in connecting socially with the other residents, but I myself have mainly had clients that actually needed to be kept separate from other residents due to personality quirks that would clash and be disruptive. These individuals mainly spent their day watching television and lived for the time family came to see them. If he's just moved, his mourning his former lifestyle may abate once he's transitioned enough into his new setting to discover the things about it he can enjoy, develop relationships with staff and caregivers.
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He is suffering from depression. You should probably make an appointment with his doctor. Many people suffer from depression when the weather gets colder.

Listen to his concerns. Ask him how he feels, rather than just responding with a sunny retort.

The doctor will likely immediately reach for the prescription pad.

Regsrdless, see whether you can get your father’s interests reignited. Maybe some excursions would help.

if he adds in some activities, increases personal interactions… think distraction and reconnection to that which he has always enjoyed. Music, films, physical activity, food…. My parents loved antiquing and that almost always started conversations about happy memories.

Doesn’t aging make us all feel this way? I can imagine it only gets more frustrating as we see more of our friends pass away and we lose our independence.

My dad did not want antidepressants, but they helped him feel happy again.
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Call his PCP immediately and see about getting dad on anti depressants STAT. My mother had this exact situation after a hospitalization. Came home wanting to die. Wouldn't eat, socialize, leave the apartment etc. Moped around all day like the walking dead, crying and inconsolable at times. Went from being the life of the party to lifeless and apathetic. Doc put her on Wellbutrin and within 2 weeks, she was back to her old self.

Sometimes only meds will fix this level of depression. No shame in that, we all need help at certain times in life.

Best of luck
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You need to get him mentally engaged in something he likes. Being physically challenged that can be hard to find something. My father in his old age started to Write his biography and some of his war stories. He could also put photo albums together. Or some type of craft.
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I think he should have gone straight to rehab to regain his strength. If that is not possible since he is already home, then you need to have home PT and OT set up immediately. They are very good at getting people to cooperate and back on their feet, if at all possible.
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I hope things get better for your father soon, but I'm not sure it's possible for anyone to help someone else find a purpose for living. It's something we decide for ourselves internally. Maybe meds would help but then again, maybe he doesn't want to go on. In some cases, that's understandable. Good luck with this.
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notgoodenough Oct 2022
You're so correct. It's one of the hardest things to reconcile with, when someone you love suffers from depression.

I've had to adopt this way of thinking with my daughter who suffers from anxiety/depression. I have to tell myself that this is why she has a psychiatrist, a therapist and is on medication. I don't have the skills or the training to make her "happy"; this is something she has to work on with her therapist. It's rough; but I tried for too long to try and make her "better". It was causing me problems with MY mental health.

Her doctor finally told me "You're not responsible for anyone else's happiness but your own". I try to repeat this mantra when I find myself being sucked into other people's (including but not limited to my daughter) unhappiness.
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In the AL can he have a pet? fish maybe? How about a plant to care for? Bonsai tree to trim and care for? Prayers for you
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Support him; listen to him; divert his attention with anything that brings momentary happiness, and give this a little time - to see which way things are going. Exercise - if he can and will do it - helps improve mood. But accept what he is feeling and help him with anything you can to assist with his needs. I bet you are already doing that. Best wishes.
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I don’t know if the AL has a music program but playing the “oldies” from his era is definitely a mood lifter. Otherwise, an antidepressant is also important.
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Jeannewc: This is concerning. He needs to visit a geriatric psychiatrist stat.
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He needs an emergency appointment with a Geriatric Psychiatrist if he wants to make a plan to create a life that is worth living for. I'm pretty sure depression is a major issue in assisted living. You and mom might want to make an appointment together, too.

If he likes to do volunteer work, you might want to let the activities director know where he/she might find an extra pair of hands. If he likes dogs, he could volunteer to care for a pet when a resident is hospitalized or infirm.
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Accept what your Dad says. Don’t try to dismiss it. Listen and have empathy.

In addition, try to cheer him up. Again, don’t be dismissive, but you can still try tp help. Ask the Dr for an antidepressant. Exercise is very important, that’s a real game changer. Also, companionship from family and/or people his own age who are doing well. Music he likes, food he likes, books (audible/podcast too), TV shows, movies. If feasible, go to places he likes to visit. Pets are another thing, if he enjoys animals. Not suggesting he get a pet, that would be a little much, but visiting people who can bring there pet. A bird feeder outside a window to enjoy to the birds. Playing games (cards, board games etc) with others. Flowers, plants, a container garden for him to tend.

There are so very many, many things that can bring joy. Hospitals are the worst and can really bring a person down.

However, listen to him and understand, he is in a different stage now and although you should try things to cheer him up, he sees he is nearing the end, and that’s ok, even though it hard to accept. It’s hard to see a loved one grieving. Good luck, and please repost if you find anything that helped.
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Speak to his doctor about his hopefully temporary depression. Perhaps there are some short-term medications that can get him over the hump, until he feels better. Does he need physical therapy to get his strength back? If so, ask his doctor to prescribe PT. They may offer PT at his assisted living facility, perhaps the nurse there can prescribe it. Exercise also makes us feel better mentally. All the best to you both.
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Jeanne,

Did you get Dad to his PCP? Get "in home" physical therapy?
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AnnReid mentioned the healing effects of music. I second that and suggest you purchase a couple disc’s of world war 2 music. He was a teenager then and that’s all they played. The music was both sentimental (we’ll meet again don’t know where, don’t know when) and joyful, boogie woogie bugle boy). When you see him starting to perk up tell him how much you want him to stay around for awhile.
Thank you Ann Reid for the thought, I am going to play some tonight.
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All the reminders to acknowledge your father's feelings are so important. Listen to his sadness. Do not try to talk him out of his feelings. Expressing those feelings to you and anyone else who will listen without judgement will help him come to terms with his situation. He may begin to find some glimmers of joy with a little more time. Do not try to force a more positive attitude. Let him talk even if it is uncomfortable for you to hear. We too often want another person to be happy and positive to make ourselves feel better.
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I agree with having an honest but sensitive conversation with him about how no one gets out of here alive (per AlvaDeer's very wise thoughts).

I agree to consider meds for mood, which may help him be more willing to do rehab, if this is an option. Your mom benefits from his improvement, too.

It is still all very fresh, so give him (and yourself) a little time to come to grips with his new normal.
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Maybe you can split the difference. Acknowledge that his life is coming to an end, but tell him you want the remaining time to be as happy and comfortable as possible, even with his limitations. Are some things he would like to see before he passes? Any people out there he'd like to speak with? What daily things give him comfort? How can his last days be a little better?

I think trying to talk people out of their feelings as they face the end of life can be unwittingly insensitive. "But the grandkids! But you're still here! But I love you!" type of comments diminishes the validity of their feelings. We all die. Your dad is looking that in the face right now. Be there with him and let him accept the facts.

Death doesn't have to be something to fear or dread. Help your dad make that transition by listening to him. Ask questions like, "What do you think happens after we die?" or "What are you most proud of in your life?" or "What was it like when you first met Mom?" Don't try to change his feelings because you're scared. And I get it. You ARE scared of life without your dad. That's completely valid, but he's probably not the person you should be telling that to. Look into some therapy for yourself and take good care.
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So sorry...
Listen to him.....
Be present with him...
Affirm his feelings....
As painful as it may be to listen to his " laments", it is important to give him permission to voice and vent as he needs to .....as long as he is safe.
Call his faith leader, pastor, rabbi, priest etc. and be sure that they are in regular visits with him. If he does not practice a faith, perhaps a local chaplain or a social worker .
If he is a veteran, perhaps enlist VA veterans support.
Illness brings grief and what is called " spiritual distress", "the loss of meaning, hope, purpose and direction". It will take time and energy and patience as his " new normal" evolves and accepts the present. It is not clear from your note what diagnosis or prognosis your father has. In addition to being sure that he is receiving the physical exercise other recovery needs met,( as he is able) it is vital that he have opportunity for conversation on his topic of choice, perhaps with you, other family, his faith leader, others, stay hydrated with water ( as his physician directed plan of care allows), read to him from books or papers of his choice, offer sound nutrition choices per physician directed diet, offer options for him to be helpful to others while he is aging/ or in recovery perhaps he can send cards or notes to veterans or some other outreach doable from home. Love him....aging brings so much change....and change wroughts grief .....grief from past is often relived, present grief and, grief about the future, the unknown
( anticipatory grief)
Get grief support for him and YOURSELF......your self care is equally important.....

Your father is grieving his decline.
You are grieving his decline.
All of the many physical, emotional, spiritual changes happening to him
( and you , although different) bring a fragility and uncertainty. Getting help and assessing both your needs with professionals will assist you both as you tread the waters of aging and illness.....
Peace.
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Does he like to read? This can be an endless treasure trove of time to pursue this interest and perhaps extend his current knowledge, if he likes to read. If he has any expertise in an area others could benefit from, he could also start a blog or a website and share his wisdom and knowledge with others. If and when he gets ambulatory, he could join a church group if he wants direction in life.
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RedVanAnnie Oct 2022
While he is this depressed, he is unlikely to give any attention or energy to reading.
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Why was he not sent to rehab to help get his strength back? If he didn't want rehab, why was "in home" not set up?

A week in a hospital can be depressing. Its a change in routine and there can be delirium involved. Elderly do not do well with change. Maybe a trip to his PCP would help. Don't wait for that "see ur primary in 2 weeks". When my Mom was in the hospital they screwed with their meds. Mom was on 80mg of B/P meds when she went in with pain from a back fracture. They upped it to 160 mg. I asked why at discharge, they said because of the pain, the fracture was repaired so no pain any more. Mom couldn't get off the couch. PT said her B/P was very low and called Moms PCP and he took it back to the 80mg and she was back to normal.

Ask the Nurse at the AL if Dads present meds were adjusted by the hospital or new ones added. My DH never had high B/P until he went in the hospital for AFib. They were able to get it under control. At discharge I asked why B/P meds. Was told because of the AFib, I said no AFib now. Waited that 2 wks they recommend, Dr. told my DH he should not be walking and took him off the meds.
The Hospital Drs do not consult with the patients primary.

If Dads meds have been adjusted or added to, this maybe his problem. If no "in home" therapy was set up, I'd get that done too. The Nurse maybe able to help u with this by calling Dads primary. She will need an order from the primary to change meds and set up in home which is paid by Medicare.
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If this is "suddenly" it could be depression due to last illness; speak to the doctor with him.
However, by the time my Dad was in his 90s he was over it. He had had a wonderful life. He was exhausted and wanted only to sleep. He was able to discuss this with me, and I had many patients as a nurse who were able to discuss with me that they were exhausted now by life and ready to go. They told me they couldn't talk honestly with families because "they don't want to and won't hear it".
So my advice is to talk honestly with Dad about his feelings. Tell him that he may be ready to go and you can understand that but that you are not ready to lose him; ask him if there is anything you can do to make him look forward to a bit more time with you. Be certain to honor his wishes about end of life, as that's what he is looking at.
I, as a nurse, am now a RETIRED nurse of 80. I know personally what many of my patients felt. I have had a good life. My children are approaching retirement age. I have seen much and done much and traveled. I am well and able still (happily) and I can still get around, but I am ready. There is no upside to the inevitable losses of aging. We lose out balance, our eyes, our ears, our ability to tolerate food, our stamina, our skin elasticity, our breathe, our hair, eventually our minds and all that makes us us. There is no going back from that long slow slide down. It is daunting. Many of us are ready, after a long life lived.
Talk with Dad, and with his doctor. Ask if a mild anti depressant might serve as a bridge over this last illness, and a willingness to go on a bit. Accept the truth of what your Dad feels, would be my advice. It would be such a gift to him. I will never forget my last honest conversations with my Dad. They were a great gift to us both.
My heart goes out to both of you.
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help2day Oct 2022
Alvadeer ~ Wow. There is so much truth to what you say. You have put this so eloquently. "Tell him that he may be ready to go and you can understand that but that you are not ready to lose him". My Mom started the "death talk" when she was in her mid 80's and it was so depressing because, while I tried to console her and be upbeat, it was like talking to the grim reaper. My Dad was even worse. While death did not seem imminent, at 80 yrs of age, he told my MIL that he "wouldn't be here by Christmas." This was in Sept. He had COPD. He was prescribed an inhaler that he would never use. After his death, I found prescriptions for the inhalers that he would fill still in the bags unused. Honestly, he was a negative person all his life and looking back, I think he willed himself to die. He was in the hospital ER with shortness of breath in November on his 80th birthday, no less. The last photo I have of him was him sitting in the ER bed with a birthday cake that his sister brought to him. It was so sad. He died the day before Thanksgiving of a heart attack in the hospital, only 7 days after he was admitted. It was awful as my Mom expected him to "get better" and come home. He didn't want to talk about death or his wishes. I'm positive he didn't talk to my Mom about it. He was afraid to die.

My in-laws were just the opposite. It was so refreshing to have these "death conversations" with them because, while no one WANTS to die, they were very positive, yet pragmatic, about the end of their lives. I've chosen to be positive, like them, when talking to my own children about death. Death is a part of life. Everyone will face it.

You're so right. We get to an age (with our various ailments) when we're just done with living. Our bodies hurt and there's really nothing to do about that. Some elders stay totally engaged in their waning years but others (like my parents) just want to go. They were so depressed about it. It's hard as a child to accept those feelings from your parents, but as I age, I'm getting it.
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Jeannewc, if the family hasn't done a Family Tree, now would be a good time. People love to answer questions about their past. For example, my Dad had ridden horse back to school 1-12 grades. The school had a barn where the student's horses stayed. That was so interesting.

After my parents had past, I got interested in doing a Family Tree as I wanted to know more about my parent's own cousins, aunts/uncles. Oh how I wished my folks were still around to answer questions, and to help identify old photos.

I bet your Dad would love to hear "Dad, I need your help on some research". Worth a try.
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help2day Oct 2022
That is such a great idea. I so wish I would have done this with my Mom. However, my Aunt (Dad's sister), did come over one time to sit at the kitchen table with my Mom to identify some relatives in black and white photos on Dad's side of the family (he had already passed by that time). My Mom was already forgetful by that time and my Aunt was invaluable. Wish I would have done this sooner than later.
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My dad dealt with this at around the same age. A small daily dose of Zoloft was a big help in having him be more positive and content. He had no real side effects, just a better attitude
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i know it's hard to see a parent depressed but these things take time. if he just got out of the hospital and the loss of abilities is new, he has to process the grief of having lost so much of his normal functioning. the only thing you can do is love him and let him know you are there for him and you care. he may come out of it gradually and naturally, but if it goes on for weeks he may need some antidepressants prescribed by a geriatric psychiatrist. just know that you can't give someone else a reason to live, you can only love and support them until they find it themselves.
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Hopefully you will be able to do at least part of this with the help of the staff at the AL.

If there is a social worker available in the Al where your dad resides, ask for their recommendation for the psychiatrist who sees residents there.

I was surprised to learn that several of the residents in my LO’s facility received psychiatric services, and she was seen by a very competent, gentle person who after learning a little about her from me, her POA, interviewed her with me present, and prescribed small amounts of geriatric approved medications and saw LO every couple months.

The change was gradual, but heartwarming.

There was a planned schedule of activities at her AL, including music, arts and crafts, religious activities for all major denominations, and LO’s favorite, cooking!

If your dad had any enthusiasms or hobbies previously, bring small reminders with you to his residence, maybe a magazine about whatever he liked before. See if you can think of adaptive ways of restoring his interest.

Music is very healing, and one of the easier ways to provide some sensory input when depression is a problem.

Bless you for being sensitive to his situation, and big hope that you’ll be able to come up with some solutions!
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