My 85-year-old dad went into the hospital right after Christmas with an inflamed and infected gallbladder and gallstones. Long story short, after being in and out of hospital and 2 rehabs over 2 months, they decided against ever doing surgery to remove gallbladder and placed a tube and drain in. The docs say surgery is too risky because of all his other health issues (Parkinson's, stage 3 kidney disease, congestive heart failure, T2 diabetes, previous stroke). Not sure how much more risky it can be as the tube caused sepsis and my dad nearly died in early Jan. but recovered and did another stint in rehab and is now back home. I have 2 part-time caregivers that help just part of the day and he's doing pretty well considering everything he's been through. He never had dementia but did experience some bad delirium from being in the hospital and rehabs for so long but it is now gone. I do notice some short-term memory issues.
As of this week, on our most recent follow up to have the gallbladder tube xrayed and checked, they determined it was starting to get inflamed again and put the drain bag back on and basically said, he'll have to have this indefinitely since they won't ever do surgery.
I am just wondering if anyone else had an elderly parent or other deal with this? What is the longterm prognosis with living with a gallbladder tube and drain? I am worried about sepsis again. My dad's quality of life has declined significantly now, he can no longer drive and is much weaker walking and needs a wheelchair more often. He can still independently dress, toilet, etc. but does need help with meals and other things. I am an only child, my mom died 1.5 years ago so I do have 2 wonderful caregivers but just part-time, as that is all we can afford. I have tried to talk dad into AL but he won't do it, wants to stay home but that's all he does, can't do much now and seems depressed.
I just wonder how long physically an elderly person with my dad's many other health issues can realistically live with such a tube/drain without further complications?
Wow, that's some laundry list of ailments--your poor dad!! Sad that they won't risk taking out the gallbladder, esp since it is now done laproscopically and it has almost no downtime--( as compared to the old days when you were cut stem to stern)....
Having a drain bag in 24/7 is just an invite to repeated infections--as you're learning. If those things are not handled almost 100% sterile--you get infections in a second. Mother has a permanent urinary catheter and has constant UTI's as she simply cannot manage to be sterile in cleaning the bags, etc.
I don't think you can ever be able to say "this person will live x-length of time with any specific health conditions. I've been amazed many times by the sheer willpower that seems to keep some elderly folks going.
I'd start with a frank talk with dad's dr. If dad wants to be "home" and you can provide the care he needs, and are OK with that--just keep on keeping on. It stinks, I know.
At this point, moving him to full time care makes sense--but if the dr says he has, say 6 months at the outside--I would just ride it out and do my best.
I would think that eventually his poor old body is just going to be pushed too far by one more infection, on top of all his other needs.
I think someone else will have more pertinent info--I just wanted to show you some support. You've got a lot on your plate.
But she is 15 yrs younger and doesn’t have the other health issues as your dad.
We often hear people talk about how easy gall bladder is to treat now but there are many who find that option is not open to them.
Your dad is having to manage a lot. I encourage you to read ‘Being Mortal Medicine and What Matters in the End” by Atul Gawande. It might help you and your dad be on the same page for his care needs going forward. We have to remember to focus on what’s important to our loved ones not just dr appts and safety.
You might also want to speak to his doctor about how you would know when he is a candidate for palliative or hospice care.
If he is on Original Medicare he should be a candidate for home health now. (Medicare Advantage plans may also have this option, I’m just not familiar with them.) This would provide him and you with a bit of extra care, a second pair of eyes to notice infections or changes in his vitals. In home physical therapy can help him with his energy and boost his spirits.
At 85 he is vulnerable to falls and being able to keep his strength and balance is important for quality of life. This would help him stay home longer in better shape.
Come back and let us know how he is doing and how you are doing.
How much QOL does dad have NOW? Not much, I'd bet.
If I don't agree with a dr, I find another one. A dismissive doc who gives you 5 minutes and isn't helpful is an ex-doc. Remember this: the doctor works FOR YOU. You can "fire them".
Even with more care, dad can still do damage to the drain or to himself. Nobody can 'eagle-eye' a patient 24/7.
I do understand that gallbladder surgery is no big deal, but it is for the elderly with other co-morbidities. They are most concerned about the anesthesia and his heart and kidneys.
Right now my dad's QOL has def declined some, he can no longer drive and that makes him really mad and depressed but I am more concerned that surgery could cause cognitive decline, which thankfully, my dad does not have right now. I just don't want him to end up in a nursing home after surgery when right now he is at least still able to be home where he wants to be. Also, the biggest issue, is my dad is scared to do the surgery and I think we have to take his desires and concerns seriously because that is really what matters most. At this age and with all his other problems, it is about quality of life and not quantity. We will see what the surgeon decides on Friday and go from there.
I currently have 2 private-pay caregivers very part-time. What is the home health thing thru Medicare? My dad does already get PT and OT at home. Is there another benefit of a nurse or something we can get? How do I find out? I am guessing dr?
Thank you.
Home Health is paid for by Original Medicare and is available for patients who aren’t needing a nursing home but do need help from a nurse. (Medicare Advantage May also provide but I’m not familiar with them).
Your dad having so many health issues might qualify. Generally it’s a nurse once a week to check vitals, set up meds, monitor drain, check his PT/INR if he is on blood thinner, help watch his weight and fluid for his CHF. Keep an eye on bowel function, etc.
An aid could come a couple of times a week to bath him, help keep an eye on the drain, notice any swelling or other issues. They keep the dr advised and can cut back on trips to the dr or to do blood work as they can do the blood work, check for UTIs etc from home.
Pick up the book “Being Mortal” by Atul Gawande if you haven’t already. Help your dad figure out what is important to him at this time of his life.
Your dad has quiet a bit going on with his health. It’s a fine balance.
It's a worthwhile concern, but a good anesthesiologist and surgeon could work together to insure a quick procedure (which they do anyway!)
I hope he is a candidate for laparoscopic removal. As Midkid said above, the procedure is done swiftly thus not much anesthesia is necessary. Either way has risks, unfortunately, as does any surgical procedure.
Good luck!