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We have been living with and caring for him since my mom passed 5 years ago. Til now it’s mostly been that we do all the house and yard work, finances; basically everything but he cared for himself. He’s slow and not super steady but ok. This weekend he took a huge downturn. Sunday after church he could barely walk and seemed exhausted. I had to basically carry him in to his chair. He later fell off the toilet, I got him up but later he fell and I could not get him up... it’s like his legs won’t hold him at all... he said he felt like his body was super heavy. My nephew (dad’s grandson) was on his way over for a visit so we got him up. Sundays always seem to tire him but this was much worse. Monday morning I called his dr who told me to take him to ER for an evaluation. They did a bunch of tests and said the only thing they found was what they think is the beginning of pneumonia but not bad and they sent us home with antibiotics. But today he seems weaker and he fell three times today (mild falls, only damage was a scraped elbow) but now suddenly he is incontinent! This has never happened! I changed him 5 times since last night; tonight I bought Depends and he didn’t fight me on it at all so I know something is very wrong. He also seems - confused. I can’t believe this is all from a mild pneumonia. Of course I realize any illness is hard on someone his age but this seems like such a huge drop in his condition! I am calling his Dr first thing in the morning and will try to get more answers (we have an appointment next Monday but obviously we can’t wait til then) I just wonder if anyone has seen this in an elder in their care? Could the pneumonia cause this weakness and incontinence or should the dr be looking for something else??

i hope your father is ok!!
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Any news, ERAsD? Thinking of you and just thought I'd check in.
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How scary for you! Do you know if they checked his blood sugar in the ER? A quilting friend became very lethargic and weak very suddenly, fell several times, etc. The last time she fell, another friend was visiting and called EMS. The EMT checked her blood sugar and it was extremely low. Just a thought. Sending you a great big hug, because you sound like you could use one!
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Lilfarmer67 Mar 16, 2021
Nvm, just realized I already responded
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ERAsDaughter, I read your post earlier today and couldn't think of any response, but reading it again this evening provoked something I recall about my father's  many episodes of pneumonia.  

As you probably know, it's an infection of the lungs.   I recall that my father had breathing difficulties with his multiple pneumonia episodes, and that may have happened to your father.  If he wasn't able to breath normally, he may not have had the strength to stand, and that might have precipitated his falls.

Did anyone mention CHF (congestive heart failure)?   That frequently accompanied my father's pneumonia episodes.   That's kind of a "double whammy" for an older person.

Perhaps it's b/c of the pandemic, but I was surprised to learn that early stage pneumonia was D'X'ed but he was sent home.     I think I'd follow up on this, tomorrow, to see if you can get an emergency appointment with a pulmonologist.   He or she will check his lungs to determine capacity, and probably would take another x-ray (which I assume was done at the ER).

Is the Monday doctor appointment with a pulmonologist or cardiologist?  If not, I would seriously think about adding either or both to your list of doctors.  

And please keep us informed as to your father's progress.

I don't pretend to know if anything else is going on, but lungs and breathing capacity were always involved when my father's pace slowed down.

I hope you find an answer soon.  And BTW, have you been to this ER before, and was treatment satisfactory?    I'm thinking you might try a different ER.
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Was your father checked for a UTI? My mother symptoms when she has a UTI are fatigued, confusion difficulty walking, leg weakness, urinary incontinence. Your dad is fortunate he did not fracture his hip. He needs help when he is up and about otherwise he could get seriously hurt. Should not be alone. I would bring him back to the ER for admission. I am surprised they discharged him home from the ER in his condition. Way too many falls. They should have admitted him for observation. Good luck.
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ERAsDaughter,
It seems like it only happened yesterday, but I recall needing to get a consult on here when my elderly loved one was in trouble New Year's Eve, many years ago.

The stressor was, in no way was it going to work going to the ER on New Year's, he wasn't going, and his wife-in-charge was already in the hospital as a patient.
He wouldn't even allow me to get an accurate b/p, but it was low enough that
most recommended he be seen. The stress was awful, and I knew how to take a b/p, make an assessment, and a decision. Just not that night, without help from supporters here on AC! 💞💞❤️️💞

He survived for four years, and that night we ate ice cream and had coffee.
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ERA's daughter,
Another word for hospice is palliative care. The patient may improve with less medical interventions and less medications. It is comfort care. This is best discussed with the doctor who knows your father's history.

To explain, Morphine in small doses can help a person breathe easier with pneumonia, but too large a dose and adding ativan can sometimes hasten death.

Pneumonia can turn worse quickly, and of course you are right that you should not wait until next Monday.

My point was with Covid, did the doctors look for that, because you did not mention it. At 90, are the doctors not going to talk about Covid and your Dad?

Feel free to take your dear father to the ER again, another ER, or get him in with his regular PCP earlier.

How is it going? I see you might have deleted your comments.
So sorry if I upset you. There is no shame in navigating the pandemic the best you know how, because we all understand that the information out there is changeable and variable. Well, maybe not all of us understand.

I will always present the side of caution, but I try to understand other's views.
I was not judging you, just trying to get enough information to get some help for you.

Just today, as I was backing up when an unmasked neighbor approached me to get a flyer, another neighbor said to me: "It's okay, you are wearing a mask".
It hit me as if she had decided the guidelines are either a mask OR social distancing. And, decided for me! It's both, but she gets to decide for herself, her rules. However, she has had Covid. Rarely going outside or to church has also affected me. But I cannot deal with the judgment of others who make up their own rules and decide I am wrong for strictly following guidelines.

So, if there is a Covid possibility, let's deal with that too because your father has a whole lot of symptoms that are concerning. imo.

Again, I apologize if I have upset you. I will let the others help you instead.
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ERAsDaughter Mar 4, 2021
I am sure I simply mistook what you were saying and took it poorly because, as could be expected, I am quite stressed at the moment. Thanks, tho.
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be careful. sometimes there’s an infection and this leads to SEPSIS (infection spreads to whole body and blood) (it’s life-threatening and must be cared for at hospital; emergency). i’m not saying it’s necessarily sepsis, but ask the doctors about it. if it’s sepsis, the earlier it’s treated the better. every hour counts. normally treated at hospital with IV antibiotics and fluids.

confusion, etc, also symptom of sepsis. but it can be something else too. get it checked. hug!!!
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ERAsDaughter Mar 4, 2021
Thank you
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What is his Covid status?
Was he tested?
Did he have a vaccine yet?

In your area, do people observe 6 ft. distancing,
wearing masks,
gatherings under a specific number of people?

He is 90 and going to church. You say Sundays always seem to tire him.
As a vulnerable elderly, do you think he could be staying home?

Pneumonia is serious in this age, 90. Please start believing. What are you doing to treat the pneumonia? Sometimes, the wrong antibiotic can cause some of the symptoms you have described. Cipro / Ciprofloxacin is one suspect.

Ask the doctor if it is time to bring in hospice, because the right treatment can help him be comfortable. And the result is he could get better and be discharged from hospice. Hospice care can be free, or low cost. Tell hospice that he does not want the cocktail ativan and morphine.

Hoping he is better today.
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ERAsDaughter Mar 4, 2021
I am not at all sure what you mean by “start believing”?? I took him to ER. Got him on meds. Doing all I can. 
“Staying home doing nothing” this past year because of covid has done him more harm than good - not being able to go do the 3-4 things per week he normally did made him go downhill physically and mentally. 
I would not allow a prescription of anything in the Cipro family - nearly killed me. He has pneumonia - why in the world would he be given morphine?
I apologize if I am misunderstanding what you’ve said.
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Well, normally, the ER is pretty good about running a lot of tests to see what's going on with the elders when they're brought in. At least they are here in Colo when my mother has been brought in with all sorts of issues at 84-93 years old. She's had pneumonia a few times, too...........last time, she was 92 and it hit her really hard; it was in both lungs but not too advanced. Landed her in the hospital for nearly a whole week and rehab for 21 days afterward. She was having hospital delirium and seeing mice running along the floor and trying to pack up her belongings in the little paper folder the utensils come in on the dinner tray. So..........can your dad be weak and confused from mild pneumonia? I'd say YES. Lung issues can knock the socks off of a 90 year old person and make them weaker than you can possibly imagine. He may actually need to be hospitalized if he doesn't improve VERY quickly here!!

That's not to say you shouldn't call 911 if he falls again or brush off the doctor's appointment he has. Just to say that I've seen my mother on this very journey your dad is on and it's ugly. He can be incontinent right now simply b/c he's feeling too weak to use the toilet & it's easier to just use a Depends, you know?

In any event, seek help if/when you need it, naturally, and keep an eye on him all the time. The antibiotics SHOULD kick in w/i a day or two & you SHOULD see some improvement. Also keep in mind that things can go south VERY quickly for a 90 year old.........so if you see him worsen, don't hesitate to call 911. Better safe than sorry, right?

Wishing you the best of luck; hang in there!
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ERAsDaughter Mar 4, 2021
Thank you for the thoughts
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Was he checked for a stroke or a heart-related event? My 98-yr old aunt in FL is quite chatty and my cousin (her caregiver) said all of a sudden she could hardly speak and not really walk. She has advanced dementia. We chose to wait and see how she was the next day and she seemed improved. Now she has returned to her "old" self but we have no idea what happened to her. I grew up with this aunt in my home and am her PoA. It was not a nice feeling to decide to "wait" but I had to weigh whether bringing her to the hospital knowing they'd stick her full of IVs and tubes etc. was in her best interest. My point is, at your dad's advanced age you, too, will need to weigh how much intervention you seek on his behalf. Does he have a Living Will? If so, I'd go read it and give it to his doctor. If not, and your dad recovers to the point where he has enough cognition and energy to think clearly, you may want to consider asking him what he wishes for any further medical intervention. And then you must honor those wishes. May not be easy. I wish you much wisdom and peace in your heart as you go on this journey with him.
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ERAsDaughter Mar 3, 2021
Thank you. He was checked for stroke and those sorts of “emergency” types of issues and they didn’t find anything.
We have medical POA, he does have Living Will and has requested DNR. Only nutritional help if needed. We will of course respect his wishes.
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Next time he falls call 911 or whatever rescue service you have.
IF there is no injury generally there is no charge for what is called a "Lift Assist"
(I used this 9 times while I was caring for my Husband the rescue service could not have been more kind and caring. They are trained to do this without getting hurt themselves OR injuring the person they are lifting up)
I would call the doctor and ask if the appointment could be moved to a sooner time.
There is a lot that can be going on.
Mini strokes
UTI
Dehydration
just to name a few.
There are now Over the Counter UTI test strips that might help if you wanted to possibly rule out a UTI but it may or may not be as accurate as a lab test.
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ERAsDaughter Mar 3, 2021
Thank you for that info. I will check with my local services to see if that is how it works in our area... I would’ve thought I’d be charged if I called 911, so I’ll look into that.
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What you described is what was happening to my FIL when we moved him here. He was always pretty strong physically but he was so frail that we put in a stair lift! He was peeing everywhere, up all hours of the night, confused, disoriented and slept all day.

Anyway, his neurologist didn’t have much advice but his family doctor decided to give him antibiotics just in case there was an infection somewhere they were missing. That did the trick. His mind is still gone but his physical strength returned to where it was to before and he is back to taking walks and taking care of his own bathing and such.

He was also sleeping all day because he was up all night - confused and groggy. We asked that he be taken off Gabapentin and on melatonin. That did the trick, he falls asleep and sleeps all night for now.
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ERAsDaughter Mar 3, 2021
Thank you
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Yes, call his doctor first thing.

If you become more concerned during the night - I don't know how emergency services work in your location, but call whoever you'd get in touch with for advice about a medical emergency.

I don't think we amateurs should be guessing about this. Thinking of you, hope the night goes quickly for you, hugs.
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ERAsDaughter Mar 3, 2021
Thank you
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