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My dad who is 89 and alert and able to walk on his own has been hospitalized in a month. The first time, he want to the ER. He had a nail bed infection in one finger which the retirement home doctor had started treating with an oral antibiotic. However the IV antibiotic jumpstarted the attack on the infection plus the doctor lanced the finger since it was so swollen. He was diagnosed earlier at the retirement home w/anemia. The retirement doctor had suggested an iron supplement and wanted to check into the cause. When my dad was released the first time, he came home and complained of fatigue and then became dehydrated. The retire. home doctor once again diagnosed that and wanted to send him to the ER for IV rehydration which my dad refused. The next day, he was sent to the hospital because he was still dehydrated. That was addressed at the hospital but then they started looking into his anemia. They decided w/o consulting us (my dad is competent) administered blood transfusion to jumpstart his red blood cell production and some hours later an antibiotic for his finger (which seemed almost healed to us). Not quite 24 hours later, he had a low-grade fever and some diarrhea. Now he is on an antibiotic. My brother and I who are close by told the staff that any intervention needs to be cleared by us. Has anyone had an elderly relative get a blood transfusion? What have been your experiences?

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My mom was admitted to the hospital twice in January and February for blood transfusions due to severe anemia which had been present for several years. A relocation and change in doctors prompted the new doctors to actually 'do' something, rather than just say 'eat more iron, eat more iron' as old doctors had done. She had a colonoscopy and EGD which revealed a few problems on the first hospitalization, but additional testing revealed that the real source of the anemia was multiple myeloma. After each transfusion she felt a little better, and had no problems other than a bruised arm from the stent. Keep asking questions to look for the cause of the anemia and treat the cause; the blood transfusions will help but only for the short term.
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My 89 year old mother has had several blood transfusions. I don't have the issues you do as she lives with me and I have POA. She is being treated with procrit shots weekly to try to keep her blood count up. I don't see that this helps. I can't remember what they call her condition (not reproducing). They let her drop too low before they transfuse causing weekness, confusion, etc. Also, she is always on anti-biotics for urinary infections & I was told the anti-b also cause the blood to drop.
My mom has a senior advantage supplimental ins that goes along with medicare. Before any procedures are done, they run it by their in-hospital dr who works for the combination medical/ins company. They don't want any unnecessary procedures because it costs them money.
I know if I had not been in charge of my mom's care for the last 10 years she wouldn't still be here. Raising 4 boys was a breeze compared to being responsible for my mom's care.
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Be assertive whenever your elderly relative is hospitalized. You (or they, if they're competent) have the right to call all the shots. They are vulnerable to every department in the hospital being called in to 'consult' (and then prescribe drugs and procedures) for every little symptom. Hospitals, by and large, are not geared to care for the whole patient. They see each person as collection of conditions and symptoms. That can be fine for a younger person, but for the elderly, it can mean the beginning of a long, torturous decline.
You have to be vigilant. We had a situation where my father-in-law's POA and medical POA both clearly refused an invasive procedure only to have the doctor visit his room after we'd left and have him sign for it (he was very clearly experiencing hospital dementia and not capable of making even small decisions). They performed the procedure the next morning.
It really makes you question their motives. Medicare is a very tempting 'cash cow'.
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J - I think you have 2 issues here plus the is transfusion good ?: 1 is that your dad can still "sign off' either verbally or by signature to have things done for him. & I would imagine that he really is not totally competent or cognitive to truly be doing this and can be easily persuaded by staff to allow for procedures to be done. Until that changes (like you have MPOA and DPOA and tell the staff that any & all procedures have to be cleared by you or your bro.) you will be stuck in being a bystander. 2: his suitability for being in a "retirement" facility. If he is on a pattern of being dehydrated, then he is just not suitable for independent living and I'd look to find another facility for him that is at a higher level - either AL or NH. At 89 this is not going to get better. If you are the poa's, you need to be firm about all this and have the paperwork that clearly states no transfusion. My mom has this written in her DNR at the NH she is at now, but she has had a DNR with no transfusions since she was in IL. Her DNR was done over a decade ago and thank goodness as when they get older they won't do it quite as readily. It was in her residence paperwork at the IL as well as on the wall next to her bed and inside the door to her apt, so NOBODY could say they thought it was OK to do. But all this is moot if dad tells them yes go ahead.

Years ago when my mom was going through her dementia testing @ the medical school, her gerotologist told me that dehydration is for them the # 1 reason elderly men get admitted to the ER and hip break # 1 for women & they all eventually have anemia and cataracts if they live long enough. But for the men it gets to be a continuous pattern that the dear old guy is a widow and goes working in the yard or goes out on an errand and doesn't rehydrate and then collapses with 911 called, goes to ER then hospital for 3 days with all sorts of transfusions (blood, electrolites, etc) and then is tippy-top refreshed then back home. Only to do this again. Transfusions works great and is of minimal intervention but doesn't solve the bigger problem. Think about if this is what the situation is for your dad. Good luck!
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