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Has changed sleeping habits, sleep day and awake all night. His body aches in legs and stays extremely cold. Anemic and has begun to experience difficulty getting in and out of shower/tub on his own. He has lost 12 pounds in the last 6 months. Continues to see primary care physician, however I think he needs to see a geriatric doctor to get a complete work-up. Recently diagnosed urinary tract infection and sinus infection.

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I agree with you. He needs to get a complete work up with blood tests. He could be anemic or have low thyroid, which could cause the coldness. Get him to someone who specializes in working with seniors. How is his cognitive skills? The sleeping all day and staying up all night could indicate some cognitive decline.
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You are caring for your father. Where, in his home? Do you have DPOA and health care proxy? I agree that he needs to be given a full physical med exam. Has the UTI been cured?
I recommend you consult with an elder affairs attorney for you own status as a caregiver. Are you getting help from your local http://www.aging.maryland.gov/ aging agency
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Sounds like my mother (92). Blood tests showed anemia, and iron pills helped a lot. The regular brands made her nauseous, but the doctor suggested ferrous glucomate, which has worked well (The pharmacy had to order this, so call them first or get a better price by buying online). She now gets blood tests every 6-8 weeks to be sure there's no internal blood leakage. I switched her from a regular doctor to the geriatric dept of the local hospital, and they have been super. Through them, we connected with a hematologist and ENT doc. The ENT found a blocked sinus, which a younger person might fix with surgery; in Mum's case, we've relieved it with saline spray and a humidifier. I suggest you not hesitate to ask for such specialty visits; these things can cause complications if left untreated.
Sleep patterns are an on-going challenge. If Mum feels any bit unwell, she stays in bed, and the body clock gets all messed up. When I can spend all day with her, I can limit nap time and help get night sleeping back. But that's not a constant. The doc said to limit naps to an hour and open the shades in the daytime. My success on the sleep issue is limited, but I just try to choose my battles.
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Having an 88 yr. old husband, have his doctor check his thyroid (TSH) levels. You are describing a hypothyroidism condition (which my husband has). If you find his current doctor not responding to your concerns, find another who will give him a complete workup. It also sounds like sundowners which comes with dementia. Check his B-12 too as it mimics dementia.
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Is his physician aware of everything that's happening? It wouldn't hurt to see a specialist. I would also suggest a complete workup which would also include a depression & dementia screening. Does your dad have other symptoms that he's not telling you about? Ask him. Everything you can gather to tell his doctor will help in the diagnosis. Is he having difficulty cooking? Would he be eligible for meals on wheels? What are his favorite foods? At his age, let him eat what he wants and there are ways to add nutrition to foods; you can get a consult from a dietitian. His symptoms could be from a number of things, write down every symptom and any questions you may have so when you go to the doctor you don't miss anything you wanted the doctor to know. UTI's and other infections can cause behavioral, sleep & appetite changes. Make sure he has adequate fluids, stock up on his favorite drinks, water, tea, juice etc. this is so important. You can also contact your local Area Agency on Aging or Bureau of Senior Services for information on in home assistance for your dad, they may also be able to provide a tub chair and hand held shower unit which would make bathing for him easier.
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I agree that he needs a geriatrician to give him a thorough examination. My father had cramping pains in his leg. It was peripheral vascular disease. Doctors may be able to help with the pain by treating the anemia and the PVD. I would let the doctor prescribe iron if it is needed. Having too much iron in the body is toxic to the liver and can make someone feel very sick indeed. Iron supplements need to be monitored.

My father stopped eating very much in his last few years on earth. What I would do was to buy ice cream treats, cookies, fruit and pudding cups, little cake treats, strawberries -- anything that he liked. I kept them in a place that he could go get what he wanted anytime he wanted. This junk food probably kept him alive for the last two years of his life. For dinner I found he preferred things like scrambled eggs or salads over heavier things. Light eating was easier on his stomach, which never felt very good.
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If you haven't had a conversation with you father about what his wishes are, this might be a good time. Some folks get to a point where they feel like they've lived the life they wanted, and don't really want to go on. This might or might not involve depression, as I had some very alert and non-depressed patients who just felt like they'd had enough of living. I would seek interventions if that is what he wants, but consider his wishes. If, with or without interventions, he continues to decline, you might consider a Hospice referral. We are all going to die, and at 87 most folks know it isn't that far off. They are usually not afraid of dying, but concerned about a prolonged period of suffering. Hospice helps make our family member's last days, weeks, months and even sometimes years more comfortable for them and their family.
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A complete work up with a geriatric doctor is the right way to go. Many older people have trouble with bathing and showering. They are afraid they will fall. Another thing to check are his eyes. My uncle also refused to go out and what I didn't realize until 2 years later was that he couldn't see.
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My Mum's geriatric doctor also said she should eat what she likes at 92. I'm grateful that she can still live on her own, but cooking seems to her like "too much work." I fix several days' worth of meals but also stock a supply of favorite soups and Lean Cuisine microwavable meals. She also likes chocolate Ensure (and CVS's equivalent), which is easy to grab when she doesn't even want to heat up stuff. Her tastes have gotten simpler, so yogurt and canned/jarred fruits are also good. And she never seems to tire of ice cream! And she deserves whatever she wants. Hope this helps!
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