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A very recent stress test confirms he is functioning at 30% of his heart's ability. His pacemaker's battery was replaced a week ago, it only lasted three years, so that tells you it was working overtime. They usually last five to seven years. He finally revealed last night that he is upset that "no one told him" he was that bad off, he thinks I knew about it (I did not not until the cardiologist read the results.) Dad is wanting a miracle from the doctor, it is difficult to discuss the issue with him as he gets agitated pretty quickly. Dementia is also getting worse. Any suggestions on how to cope with this phase? I have a sense that I will find him passed away in his chair one of these days from a major heart attack, he also has a sense of doom now. I know it's coming, but I don't think you are ever really ready. Thanks for listening. . .

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Many hospices also embrace palliative care as a pre hospice program.
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Not sure it's available to you, but if it is, consider palliative care consultation. Doesn't equal hospice (not that hospice is bad, but the thought is alarming to some), and palliative care providers have special training in helping people talk about "the big picture" of how their health is doing, and how it's likely to change in the upcoming months. They will also have ideas about minimizing shortness of breath and discomfort.
Other options: advanced illness management programs (they are like pre-hospice) exist in some areas. Palliative care consults can be hard to get in outpatient setting but often are available during a hospital stay.
I always tell people getting palliative care help doesn't mean giving up; it's just getting special help with symptoms and with talking about what's going on.
Good luck! Leslie
ps: agree with the others: 30% is not a horrible ejection fraction and it's better to go by symptoms, how much he can exert himself, whether he keeps needing hospitalization, etc.
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Veronica, great questions! No oxygen, has slept in a recliner since his five way bypass in 1996, lymphodema in lower extremities (compression stockings REALLY help,) coughs up a lot of phlegm, really fatigued. But know what guys? He has been having weird dreams and is anxiety ridden. This afternoon, he told me his dream last night: trying to reach the top of a hill where there a super bright light. Every time he thought he was making it, he fell backwards. I asked what he thought it was about, he replied death and that it is not his time. And, with all the great responses I received from everyone (on top of the dream,) I believe he staying put for a while. You all are the BEST!!! Thanks for easing my heart and mind, and my dad's as well!
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Can your dad still get around , eat and breath at the same time? Does he need oxygen? Can he sleep in a regular bed or does he need to sleep upright in his chair. Does fluid build up in his body, specially feet and legs? Do his hands and feet turn blue, also around his mouth?
Have you considered having hospice come in and evaluate him. I doubt he will agree to it but maybe you can be in the vicinity of their office one day and get him in for a chat. Death from CHF is rarely fast and dramatic rather a slowing down of the body till he just fades away. Hospice can do a lot to improve his comfort, provide equipment and help with his care. Above all they will tell you and him the truth
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People can perk along with 30% for quite a while, especially with the right meds. And if that's actually shortening fraction not ejection fraction it's not as bad either.
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Carol, you are right on the money, "will to live!" Your dad sounds like a lot like mine, and loves the little dog I have who he calls "his dog." My Corgi/Jack Russell has indeed been good medicine! I know we talk a lot about dementia and "Uncle Al" on the forum, so I'm really glad to receive this information and Eyerishlass, thank you!
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Yes, my Dad has Congestive Heart Failure, too. I think that's the percentage the Dr told him that he was functioning at --- several years ago --- he's 77 years old now. Although he is quite sedentary and has coughing spells, he shows no signs of keeling over in the near future.

My Dad is quite cantankerous (sp?) with some dementia and depression, too. What helps Dad is socializing with friends who visit him in the nursing home. He, also, has a counselor that comes to see him on a weekly basis. I bring my dog when I visit Dad and that puppy seems to be therapy for everyone.

As Eyerishlass says, what a Dr says is certainly not a death sentence. There's a lot to be said for an individual's will to live.
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This is great information! My dad got the second pacemaker with a two coil defibrulator three years ago, they told him would have died a year before that without the new one. I'm going to ask his cardiologist at next week's visit about collaterals. The stress test also revealed two blocked arteries as well, the images of his heart were blue and green with very little red, heart is enlarged as well. Maybe after I query the doc, I'll be able to better help him deal with this. He's a "don't ask don't tell guy," for him to finally say "I'm scared" instead of "everything's just great, I feel fine," was a huge moment last night. Thanks for your reply, Annie
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No one's heart functions 100% so that 30% is not 30% out of 100%. My dad, also with congestive heart failure, was told that his heart was functioning between 9%-12% and that the only reason his heart was functioning at all was because it had created it's own arteries (called collaterals) for blood supply. I thought this was a death sentence yet he lived on for many months. I too expected him to die any second of a massive heart attack but it was liver failure that got him in the end, not the heart. You just never know.
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