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I'm the only child and my dad lives with my mom 15 minutes away. I've been handling his many medical issues including COPD diagnosis after one of his more recent strokes three years ago. He suffered a MAC infection along with the COPD and had just gotten over that after 18 months of fighting it. They told him he needed to quit smoking once and for all. He wants to quit but after smoking from age 12 up (he is now 70) it's been hard. They recommended the patch and lozenges, but soon after recommended he switch to Chantix. He stopped the patch abruptly without advising me and began to suffer stomach issues including nausea and minor vomiting. He had mood swings and absolutely no energy or appetite for four days. They recommended he get on Chantix right away and the appetite loss got even worse as the days went on. Now, he's sitting in a recliner - and sleeping there too as a result of the COPD - and has not eaten barely anything in three weeks. He eats the occasional slice of watermelon, slice of toast and sip of soup. He drank Gatorade during this time which is atypical of him, but stopped two days ago. He absolutely refuses to drink Ensure or Boost as he's tried it before and hates it. He did stop the Chantix two weeks ago at the advice of his pulmonologist. But the appetite hasn't come back at all. He has occasional cravings for food he sees on TV. My mom goes out and gets it for him, but when she brings it home he says he can't eat it and just to put it in the fridge. I asked him what would happen if he were to try and force himself to eat and he says, "I just can't. So I dont." When I talk to him and even cry sometimes I tell him he NEEDS to go to the doctor, and he brushes it off with sayings like, "Well... have a good evening." If we mention the hospital he says he'll refuse to go. Also, his lips are dry and cracked and bleeding the past couple days. My mom got him campho phenique but he won't use it as he says it smells too bad. He refuses to use vasoline as well. She just got him Blistex Ultra Rich Hydration SPF15. We're hoping this helps! He says how is he supposed to eat even if he wanted to with his lips so painful like this. This is killing me inside! I feel like we're not doing enough. Please, ANY suggestions are appreciated!

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Update, my father was transported to the ER last week in order to expediate the process of getting him into a care facility for rehab. This was at the advice of the homecare group that came in to assess him. Upon going to the hospital it was determined that he had a severe UTI (Bladder Infx - Staph). They put him on Cipro Oral Meds and waited until he didn't have a fever and moved him to a local nursing home for rehab. Now... mind you his personality is changing drastically and he's becoming extremely nasty and needy. Calling us at all hours begging us to bring him food and drink saying he's starving and thirsty. Mind you... he's using "someone else's phone" to call us. Reason being, upon his first night's stay at the nursing home, he had a serious hallucination in the middle of the night and dialed 911 saying that a family member was trying to kill him. They had police out looking for him and it was a mess. He doesn't even remember doing it. So... we had to take his cell phone away. Now he's being utterly nasty to my mother because she's the one holding it saying things to her like, "GET OUT!!" and "Don't you ever come back!! Do you hear me?!?!" I know my father can get a little bit rowdy at times... but this is not like him at all. He's also just getting on the patch (highest dosage possible) because he can't smoke in that facility and that's got him all in a tizzy. Mind you he begged for cigarettes at first almost to the point where he said he'd refuse their services and go home instead (making this even more of a nightmare for all of us). I don't know what to do. I'm beside myself. I'm watching my mother go through hell and back taking him fish-filet sandwiches from McDonalds... bringing him breakfast... bringing him cold cans of Coke. Having to trick him into believing I'm the one who sent the food because he "Refuses to accept food from HER!!" This is heartbreaking. And then he just called me at working saying that the nursing home isn't starving him... "HIS FAMILY IS STARVING HIM!!" Any suggestions or support would be great right about now. We thought this would be easier and that he'd focus on rehab and getting stronger. Instead, he is pouting and throwing fits and eventually he will plateau out of this nursing home as they'll soon document that the in-facility rehab isn't making him stronger. Therefore insurance won't cover it and we'll need to go through all of the paperwork to see if he even qualifies for medicaid.
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Mandolina, your Dad definitely needs to be seen at the ER for labs, to evaluate his gastric symptoms, and the possibility of bed sores. From there, you guys have a much greater chance of getting him the help he so desperately needs! Please call 911 to have him transfered, and cry if you must, or do whatever you can to convince him, and you should not try to transfer him yourself or risk injury to him and you! This can go from bad to Very bad in moments!

If your Dad cannot get out of the recliner, how is he using the toilet, or is he in Depends or something? Even then, it would be very difficult for him to be thoroughly clean down there., making any possible sore down there to become infected.

I'm so sorry this has become such a nightmare for you all. I hope he gets help ASAP! Take care!
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Mandolina, I hope your next update says they called 911 and that ER has had him admitted.
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Just an FYI that I didn't update on. My dad's bed sores we are not even sure are bed sores. He came back later and said that he's just sore from sitting so much. But still... I'm not sure because we can't get him turned over.
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They believe that going from the nicotine patch to the Chantix and all of that began his lack of appetite. So they gave him Megestrol to stimulate the appetite and upped his Mirtazipine to help aid in sleep, appetite and depression all at once. The depression pretty much went away and the appetite came back. Just to clarify, my mom said he's been eating like a horse the past few days... which according to her just means he's been eating and asking for more and more meals with substance. Also, to clarify, the cheese steak she made him was strictly the meat and cheese... no bun. That's how he likes it. My mom did always have a tendency to cook a little more on the greasy side unintentionally and she now feels awful about this whole thing. She said he's yelling out about every half hour in pain when he has a cramp, but then calms down although he's still uncomfortable. I actually forgot to ask how long it's been since he had a movement but my guess is too long. I am worried we might be dealing with impaction again and just not know it yet.
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Hmmmm, i think i would err on the side of 911. He could have a blockage, a twisted intestine, gall bladder, pancreatitis. A whole bunch of pretty painful conditions that should be worked up in the hospital. Plus, bedsores? They need to be evaluated and treated.
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It seems a bit much to go from not eating to cheese steak, that kind of meal can give anyone trouble.

Did the doctor probe for a reason behind his lack of appetite or just prescribe the appetite stimulant? I'd be concerned there is something else going on, I'm glad they are prepared to call 911 if he doesn't get any relief soon.

Has he had a bowel movement recently? Could he have an impaction? If there is any doubt DO NOT give laxatives.
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So I'll have to update on what the nurse at my dad's doctors office said to me today at some point. I did get to leave a message with his doctor who is scheduled to come back into the office tomorrow. For now things are the same except that he had a rough night sleeping because my mom thinks that the cheese steak she made for him last nite may have had too much oil in it. He has a sensitive stomach - like me - as well. He's been off and on Miralax as constipation has been a severe issue, but with not eating much for awhile they (My mom and dad) were worried about giving him Miralax. Anyway, he was sick to his stomach all day. Just very uncomfortable. Then my mom called this evening to say his cramps had intensified and that he is now moaning because of how uncomfortable it is. They had Tramadol At home from another appointment he had a couple months ago with some back pain. My friend who is an TH told me that we could try Tramadol as it's like Advil but stronger. If that doesn't bring him any relief do you all have any other suggestions?  She is concerned he'll emd up in the ER, but if they have to call 911 they will.

Also, should I be posting this in another section since it is unrelated to his lungs?
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If he's motivated you don't need to wait for PT, he can start on his own. There is a great website Elder Gym - google it - which has a lit of low impact exercises and includes videos on how to do them. You may think they are too simple to be of any benefit, but many of the ones my mom's PT had her doing are included there.
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Mandolina, your father can get home therapy based on a doctor's script. The doctor would most likely want to see him, but it sounds like that might be a problem if he's not able to get out of his chair. What does he do at night? Does he sleep in the chair?

EMS could be called, and he might be admitted to a hospital, but I'm not sure what other issues he has that would contribute to enough of a stay to get in rehab. And I suspect your father would resist that.

You might be able to get EMS to take your father to Urgent Care, but someone would have to take him home. So that's not necessarily a good option. (I'm just trying to think of what those options are and whether or not they're workable.)

One of your father's doctors might be able to script for a visiting physician to come out, DX, and write a script for PT, which is definitely what he needs. You might be able to find a DME supplier that has one of those bike pedalers; they're comparable to the pedal configuration of a bike, but are free standing, can be put on a table or floor and the arms and legs exercised.

I think those kinds of strengtheners are relatively safe b/c no standing is necessary. My father's used one for years to strengthen his legs.

In the meantime, you might want to look into chairs with lift mechanisms. I believe the chair can be elevated to the point that the individual can stand up, w/o thrusting or hurling himself.

No pain other than a few bed sores? He needs to be seen by someone who can Dx these, stage them, and give him proper cream. Sitting on a pillow might help, but medical cream/treatment is needed before they get worse. In fact, this might contribute to a DX that would allow him to be in a hospital for 3 days to get qualified for rehab. Does he realize how serious pressure ulcers can be?

Rereading this thread from the beginning, I don't say this to be cruel but I think your father is his own worse enemy. He's refusing to cooperate, to get treatment, and you and your mother are trying to compensate.

Maybe it WOULD be good for EMS to come, take him to a hospital, and give him some frank advice that if he doesn't respect his body and care for it, his issues are going to get a LOT worse.

There's only so much you can do to compensate for an uncooperative patient; many of us have "been there, done that." Don't blame yourself; you and your mother are dealing with someone who isn't working with you.

I'm sure others have had to have a "come to reality" talk with their parents to get them to cooperate and take care of themselves. Again, I'm not trying to be cruel, but there's only so much you can do when a parent won't work with you.

Maybe your Amish neighbor can offer some down to earth religious advice to spur your father to action.

I wish you luck; I know this is a difficult situation and that you're probably worrying 24/7 about your father's health.

Your mother might try to get a job at places that either cater to seniors or have reputations of being supportive of seniors. She might ask the local Senior Center if there are any openings there, or if they know of any. Actually, getting out of the house would probably be good for her.
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So my dad is eating again and his depression level is going down. He says he's feeling better in that retrospect. The only thing I really need advice for now is this...

He's lost so much muscle mass that he can't get out of his chair. A stronger bigger Amish neighbor stopped by - a buddy of his - and he tried to pull my dad out of his recliner. He couldn't. So yeah... that says something. Now, my dad WANTS to get out of his chair, but I'm thinking maybe he needs some type of in-home physical therapy? My dad is 70, my mom is 68. Her unemployment is just about to end and sadly with all of their bills, she needs to go back to work and is unable to retire. She's trying to get a job but at her age it's extremely difficult. When she starts being gone during the day, who will care for my father? He will definitely refuse going to a home, and I don't want to send him to one. He just wants to put on muscle and regain strength to regain his mobility. Does anyone have suggestions? I'm not sure if insurance would cover hospice coming in or if he would even qualify for in-home physical therapy or if he needs more than that? He said he's in no real pain other than a few bed sores, which he is now sitting on a pillow to try and help with. He really wants out of his recliner. Friends... now's the time. If you have any advice, I'm open to it.
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It is liquid so administer using a teaspoon or whatever the prescribed dose is. We gave it in the morning. It was only prescribed for a month or two but it was effective for my mother. So happy to have helped you!
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@GardenArtist:  No, he is not. He was at the beginning on oxygen at night only. His oxygen levels are typically around 94-96. He actually did not want oxygen, but went along with it. Then the medical supplier came in on a routine check a few months later and gave him something to check his O2 levels at night, and when they read the results it was determined that he didn't need it/didn't qualify for it. So they took him off of it. And... his pulmonologist was very happy with the levels and said he didn't want him on O2.
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Mandolina, is your father on oxygen b/c of his COPD?
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I just wanted to start off by saying thank you to everyone for all of the positive feedback. I am also thankful for a nurse at my dad's pulmonology office who has stuck by me through all that's happened and has never EVER made me feel like I'm a bother!! She recommended we try the Megestrol for appetite stimulant first before approaching our local hospice support program for COPD patients. Basically not an "End of Life" program, but rather a program that is used many times to prevent the patient from getting to that stage. So I got the Megestrol called in by his PCP today and while we just discovered that the pharmacy is currently out of it, it will be in for him tomorrow. I'll keep you all updated on his progress. In the meantime if any of you have experience with the Megestrol and have any advice about how to take it, when to take it, for how long he should take it, etc... please let me know your thoughts. Thanks again friends!
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There are a lot of discussions on this site about elders who won't eat, the key to resolving this is understanding the cause. Is it depression? Inability to swallow properly? Pain or discomfort after eating? Lack of appetite? Dental problems? Something else? Getting him to the doctor may have to involve some trickery - for instance I've read of people telling their loved ones that their insurance is requesting everyone get an annual physical or they will drop coverage - or bribery - I'll take you to the casino after the appointment. Or you can just firmly insist he needs help and call the paramedics as Barb suggested in the first post. Good luck with this, and let us know what you decide to do.
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There is a medication given to promote appetite in the elderly named Megesterol (Megace). Ask her PCP if it's appropriate for him. It is only given for a month or two. I got it prescribed for my mom when she just would not eat and it did work - she gained an appetite and a few pounds too! 
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I've had "the talk" with my mom on several occasions, basically asking her if she is tired of her life and is ready to go. So far she has always said no, so I have told her that not eating or drinking will increase her frailty and shorten her life so she MUST eat. I was prepared to honour her wishes if she had given a different answer though.
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My FIL started telling us "I can't eat" . To make a very long story shirt, he'd had a stroke and could no longer swallow.

Call 911. Have the EMTs evaluate and take them aside, beg them to convince your dad to get checked out at the ER.
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