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He's 88 with CHF. Heart pumping at 10%. I am only caretaker and this is all very new. I have teen who is in denial Papa is going to leave us. I don't know what to expect. Very hard for me to prepare my teen. Papa is still talking, being tough, so it's hard to understand. Not that we know, but what signs are there?

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Thank you Coolieslady. I will do that.
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The best advice I can give is to read any information hospice might have given you on "Crossing Over". If they did not, contact them about getting some information for you. Not sure about your hospice associates but ours have been extremely supportive. We have been able to express any concerns, guilt, insecurities and any thing else that comes up. They have been through this before and while they might not advise you what to do, they will have suggestions. Talk to them.
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Thank you. Doing my best.
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Mydaughter I was where you are now. I cared for my dad the last 24 hours sometimes it seems like a dream but it just all happened so fast. The last 24 hours I started dad on his morphine and ativan. Not sure of the spelling but both medicine relaxed him and as time went by he fell into a very deep slumber. At this time I would position dads extremities and continue his meds. Hospice came in because I was scared but this was the sleep before he passed. I remember being sad but I always spoke to dad when I left and entered his room plus when I gave him his medicine. I climbed up in his small bed and slept 4 hours holding his hand. I know he knew I was there. The next morning all the siblings and friends came but dad never woke. The DNR was signed because he was just to frail and we new they would do worse damage so my dad had it his way and we knew that he would not be in anymore pain. What you are doing now is the best we as children can do. I know your sad and feel alot of emotions but you are strong and your children will see this. Just kiss, hug and express how much he you appreciate and love him. He knows he's leaving the ones he loves but let him know you will be okay because he will be sad too plus scared. I will pray for you and yours. Please get us posted.
God Bless...Linda
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I may sound like a broken record, but the book FINAL GIFTS is extremely helpful in understanding how a person facing his/her mortality thinks. They are not on the same page as the people around them.
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Thank you Lindham. Dad has endstage CHF. No edema or fluid in lungs right now, but shortness of breath. Just began having to take low dose morphine to help. He says it helps. We are taking things one da at a time. Only myself and teen, so I need to know as much as possible. I do understand the unpredictably, and God's will is the ultimate, but I'd like to be as prepared as possible.I have to rremain strong as I am the only one for my teen.
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Mydaughter, I can only tell you that when my father was passing I asked hospice after every visit to talk with me about my dads vitals and how things looked from thier point. The last day, dad was more quite and things just stop such as urinating etc... I called all my daughters in and they spent time just holding his hand expressing their love. A deep sleep overcame him but I was told he was in a place that he could still hear us so the family always talked to dad still. They say the lower extremities get cold but my dad always stayed warm. He was in a peaceful sleep but his lungs slowly started filling with fluid. The next morning he passed away knowing everyone who loved him was with him. Talk with Hospice about a small booklet that helps to explain and prepare you. It was very helpful to me.
God bless
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I don't care how prepared you may think you are or what you believe to tell you son-death is part of life. We have never learned how to celebrate going home to GOD. Having lost 2 daughter's with in the past 5 years & have a son who is still here but who will not even talk to me??All my children are so with me in SPIRIT-no differences with the 2 in Spirit & the one who walks this earth. They all live with in me.
I am an R.N.-still active in the profession & have a husband who suffers from Solvent Dementia, who I care for-when I am home or not busy. He requires meds, which I will not over see anymore. He is not requiring 24/7 care-just redirection & is not violent. Not now...but has been.
Life hands us teachers, we don't always want-I fine that if I can look inside & see the LIGHT-it's a great day. I pray a lot & I play the guitar a lot.

I can give information to you about the disease process however this is not going to be of any help for your in the mist of it all.
We all are born alone & we all die alone. We don't in this culture know how to celebrate death-
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First, let me offer my heartfelt sympathy.It is my opinion that dealing with the dying or death of a loved one is a personal journey that each person must take alone. But you can do it and you will it! I highly recommend reading a book called Final Gifts by Maggie Callahan and Patricia Kelley. It was recommended to me by a friend whose mother died of cancer. I will be forever grateful.
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Mydaughter: Some info which might help you
The Progression of Heart Failure

Causes of Heart Failure
Heart failure often develops after your heart has been damaged or weakened by other conditions, including coronary artery disease, heart attack, high blood pressure and cardiomyopathy.
Your heart consists of two ventricles. What pumps through the left ventricle must pump through the right ventricle or complications occur. The left ventricle is usually the first to fail because it works harder to pump blood to the entire body. Left ventricle failure can also hide right ventricle failure.
Heart failure occurs when your heart can no longer pump enough blood to sustain your body. Vital organs like the kidneys, liver and brain are starved of the oxygen and nutrients they need to function properly.
Symptoms of Heart Failure
Confusion, impaired thinking - Changing levels of certain substances
in the blood, such as sodium, cause confusion.
Shortness of breath (dyspnea) - When the blood is flowing from the
lungs back to the heart, the blood “backs up” into the pulmonary
veins because the heart can’t keep up.
Persistent coughing or wheezing - The heart’s decreased pumping
ability causes fluid to build up in the lungs.
Increased heart rate/palpitations - To “make up” for the loss in
pumping capacity, the heart beats faster.
Swelling (edema) - The excess fluid caused by the heart’s decreased
pumping ability also builds up in the body tissues. The kidneys are less
able to dispose of sodium and water.
Lack of appetite, nausea - The digestive system receives less blood.
Tiredness, fatigue - The heart can’t pump enough blood for the entire
body, so it diverts blood away from the less vital organs, like the muscles
in the limbs, and sends it to the heart and brain.
Stages of Heart Failure
The progression of heart failure is divided into four classes based on your symptoms and quality of life:

The Progression of Heart Failure

If you have heart failure, you’re not alone. Millions of people around the world are suffering from this chronic and progressive disease.
Causes of Heart Failure
Heart failure often develops after your heart has been damaged or weakened by other conditions, including coronary artery disease, heart attack, high blood pressure and cardiomyopathy.
Your heart consists of two ventricles. What pumps through the left ventricle must pump through the right ventricle or complications occur. The left ventricle is usually the first to fail because it works harder to pump blood to the entire body. Left ventricle failure can also hide right ventricle failure.
Heart failure occurs when your heart can no longer pump enough blood to sustain your body. Vital organs like the kidneys, liver and brain are starved of the oxygen and nutrients they need to function properly.
Symptoms of Heart Failure
Confusion, impaired thinking - Changing levels of certain substances
in the blood, such as sodium, cause confusion.
Shortness of breath (dyspnea) - When the blood is flowing from the
lungs back to the heart, the blood “backs up” into the pulmonary
veins because the heart can’t keep up.
Persistent coughing or wheezing - The heart’s decreased pumping
ability causes fluid to build up in the lungs.
Increased heart rate/palpitations - To “make up” for the loss in
pumping capacity, the heart beats faster.
Swelling (edema) - The excess fluid caused by the heart’s decreased
pumping ability also builds up in the body tissues. The kidneys are less
able to dispose of sodium and water.
Lack of appetite, nausea - The digestive system receives less blood.
Tiredness, fatigue - The heart can’t pump enough blood for the entire
body, so it diverts blood away from the less vital organs, like the muscles
in the limbs, and sends it to the heart and brain.
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The dying process is unique for everyone. Hiring hospice isn't like pulling a trigger, death is a process that can take hours, days, or a couple of weeks. Maybe more. There are many signs and symptoms but they don't necessarily mean that death is occurring at the moment you notice the sign or symptom. I'm sure hospice gave you much information on what to look for, what to expect. Some people find it difficult to read but I found it extremely helpful. I have worked many hospice cases myself and I always encourage the family to read over the materials we give them.

As for your teen, this may be the first death s(he) has ever experienced and it may be the not knowing that is difficult and confusing and at that tender age it may just be easier to not deal with it at all. The night my mom died I was with my brother and my daughter who was 13 at the time. We were in a hospital room. My daughter had fallen asleep on the little fold out couch in the room and when my mom began to actually die I woke her up and asked her if she'd like to say goodbye to grandma. She did and she was holding her grandma's hand as my mom died. My daughter is 20 now and has told me numerous times how grateful she was to have been there. Kids are tough. And as cliché as it sounds, death is a part of life.
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