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My husband is 71, has end stage emphysema, COPD and A-fib. He can be difficult to reason with and is progressively failing health wise.

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Peggy, it sounds like your husband is appropriate for Hospice. Hospice is available to those who are in the last 6 months of life typically, however people can be on Hospice for much longer periods as long as they still qualify. It depends on the diagnosis of the individual (COPD is a valid hospice diagnosis), if there is a decline, then it could be time and Hospice is free when you have Medicaid, Medicare, or private insurance.

Hospice helps by providing care up to 5 days a week and weekends if there is an emergent reason. For instance: a care plan is tailored for your husband's needs - there could be a schedule where a RN would come in 2x a week, a CNA or LPN 1 - 2x per week and an Aide 1 - 2x per week. If it is a good hospice, the visits will last anywhere from 1 hour to 3 hours on average.

Hospice will assist with ADL's while there such as bathing or feeding. Hospices focus on comfort care and often offer other disciplines to help with comfort like Reflexology, Pet Therapy, Music Therapy, etc.

Hospices will also help the patient and family make all the end of life decisions that are necessary, and are used to working with stubborn patients and family members who are disagreeable. You would be offered a Social Worker and a Chaplain to help with those issues. You and your family would also be entitled to Bereavement services for 12 months after your husband passes. Everyone grieves differently and some need more help than others after a loved one is gone.

Contact your husband's physician and ask for a Hospice Evaluation, then either take his advice on which Hospice is good or do a little research to find out which Hospice will best fit your needs.
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My Dad also has severe COPD as well as osteoporosis and balance issues. He has minimal cognitive issues due to a fall-caused Traumatic Brain Injury in 2005, but other than some flattening of his personality and short term memory issues (what 83 year old doesn't have memory issues?) he's mentally intact. It is challenging for me to pick my battles, as he isn't too interested in eating healthy foods, doing anything but sitting in his chair and lately has a big desire to watch porn. This guy who couldn't even turn on the TV managed to find the Playboy channel and order a video which he turned on while I was making dinner in the same area. (not!!!) It's hard being a daughter and a caregiver, especially with my medical background and knowing what he should do to have better health and him not being interested. I have to pick my battles. Some type of organized day activity might be int he future, just to give us both a break from each other.
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She may need to be seen by geriatric psychiatrist for a change of meds.
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My Mom is 91 and has been living with my husband and me for 9 months now. Before she first moved in, she only used a walker to travel to the dining room at the independent living facility she lived in and didn't use it in her apartment. After several falls due to a permanent low blood pressure condition, we all decided she was too "with it" for assisted living but couldn't live alone. She says constantly that she just wants to die and finds nothing that interests her. She won't exercise and is becoming weaker by the day. She sleeps all afternoon and 12 hours at night. We have tried so many ways of keeping her busy and involved with others but she just wants to sit and watch news programs. She is on Effexor and does not seem very depressed. She has just given up. Why do I feel guilty for her decline? We had a psychiatric nurse in for weeks to evaluate and pep-talk her and as soon as she left the house after each session, she shut down again. I make all her favorite foods and accommodate her severe hearing loss as best we can (tv ears and hearing aids). She acts like an invalid most of the time and loves being waited on and handed Everything. Her act of not being able to do stuff is now coming true and I feel like an enabler but I can't force her to move! Guilt and frustration are my constant companions!
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Peggy, a big issue as we all age, but especially for those with serious medical conditions, is the diminishing ability to do the things we once could. Part of your husband's unreasonableness may be his frustration at the limitations his condition has forced upon him. If you can find ways to safely enable him he may become more cooperative. Ask for his advice and assistance when feasible. People need to feel needed and not a burden.

My father passed away 10 years ago at age 89, mentally as sharp as when he was young. However, the last 8 years his body deteriorated due to severe scoliosis and degenerative heart disease. It became too dangerous for Dad to take his boat out by himself, and ultimately he was too weak to manage it anyway. (They lived on a creek running to the Gulf of Mexico.) My brothers and I would take him out in the boat to fish or collect oysters. He couldn't climb in and out of the boat, but he knew where all the good oyster beds were. He needed our physical capability and we needed his knowledge.

Another issue my be decreased appetite and inability to absorb nutrients. Your husband needs all the nutrition his body can absorb, but---correct me if I'm wrong---in his condition he probably doesn't have much of an appetite.

My mother (who is now 93 with advancing dementia) was my father's devoted caregiver, but sometimes she couldn't see the forest for the trees. She would serve Dad regular portions at mealtime. He would stare at a mountain of food that he couldn't possibly finish and she would act as if he was being picky. Whenever I was there I would set a little cup of raisins and sunflower seeds or some other small healthy snack by his favorite chair so he could nibble during the day. Yo Baby yogurt is a great snack for small appetites, especially for anyone needing the extra calories of full-fat dairy. It's half the size of a regular yogurt cup and so yummy!

Your query sparked a flashback about my dad. Hope I gave you some helpful ideas. Blessings on you and your significant other!
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My wife has lewy body dementia and is mentally capable of making decisions, but her body is always In pain and she says that her body feels heavy and she also has a problem with balance.
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Sure. My mother-in-law was physically in poor shape, but was mentally sharp. That's what made it difficult when she made comments such as, "Everything is for your convenience." It didn't happen often, but her attitude of entitlement could be hard to swallow.
Barbara M., author
What to Do about Mama?
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Is your husband a candidate for Hospice?

What about the oxygen? Perhaps his brain is somewhat compromised because of oxygen deprivation? My mother's landlord was on oxygen and he was the nicest person until the disease progressed. He was unreasonable, etc. Not the man I knew.

I'm thinking because of meds, oxygen? etc., not to mention he knows he's at the end of his life, is causing all this. It's sad, but it's what happens, I guess.

Have you spoken to his doctor about this? Sometimes doctors are so busy, they can't answer all your questions, but perhaps someone like a psychologist (not psychiatrist) but someone you can talk to re how this affects you?

I'm sure there will be more posts re this once the day gets going. So, stay tuned :) And believe me, we're all thinking of you. This isn't easy, caring for someone close to us and watching them 'die'. It's the hardest thing I've ever done and I believe it's the hardest thing we will ever do.

You may not be able to reason with him. Kind of take the issue, ask yourself if it's that important, and go with it.
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My Dad is 93 with Parkinson's, mentally sharp. My father would rather be automonous than safe. Sometimes it drives me to distraction. My Dad explained it is his life, let him live it the way he wants. Since I have learned to do it his way, life is much easier, and we enjoy each other rather than bicker. i have learned to trust in his intelligemce not to do anything dumb. Hope it helps
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Brandywine, I don't think Peggy was looking for a caregiver, but rather asking if there is anyone on this site who is in the same boat.
My mother comes and goes. UTIs are the worst. Her mind totally goes if she gets one. During those times I can understand memory care facilities. But mostly mo Mother is pretty much O.K. at 103. Her health is failing and she is frail, but she still bathes herself, feeds herself and takes a hand full of vitamins.
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My Mum is 91. We never joked much, and I thought she didn't have much sense of humor. But now I have found new territory with this! We kid about "gremlins" who moved her rollator when I find it across the room from where she's sitting because she decided not to use it. We've extended this to other areas, too, like where did all the cookies go? Gremlins! Who made this mess? Gremlins! You can get the idea here. Also, she cooperates best when she participates in decisions. She saw no need for homecare to come, but I explained that it's a big worry off my mind that someone is coming by, and if she's fallen, she's not lying on the floor for hours. What she won't do for herself, she often will do so that her kids aren't worrying or otherwise burdened. It's important to respect her mental capacity and not treat her like a child, but reminding her that my purpose is to help her stay safe, healthy, and have as much quality of life as I can contribute. Also, it helps to acknowledge her frustration at the limitations she lives with and not just harp on her to count her blessings. Good luck and God bless!
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Patience, patience, patience. My mother is in the same situation and there are days I want to pull my hair out but then i'm reminded that she is still there mentally. There is a blessing in there just take the time and remind yourself of that. It's hard but you'll get through it.
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I care for my Dad who will be 98 in the spring. He is still mentally intact in spite of physical pain and periodic lack of sleep. It is a challenge to work with someone set in his ways, especially where safety and other important matters are concerned.
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This site is a nation-wide/international site. Your best bet is to run an ad in your local paper.
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