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He has difficulty swallowing liquids-he tends to mildly asperate, whereas he has no difficulty swalling solids. He insists on coffee every morning and hasn't any problem there as well. The problem is he has just recovered from a UTI (I think). His urine outflow is poor, dark or cloudy and has a horrible fishy odor. Our hospice team is great but they offer no answers. He has been terribly constipated/impacted, and I must manually un-impact him for every BM. Hospice has increased his Senecot and added everthing known to man that should normally blast the roof off the house. Still nothing. Does anyone have any advice or experienced this situation? I should also mention that within the past 3 weeks I have seen a noticable decline. Although he still loves food, he takes longer and longer to eat it. I am just worried hill will suffer more than he already does due to lack of fluids. UTI's and impaction are painful.

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Nikka - I would think that any palliative care might include intravenous saline to prevent dehydration. If he's on a morphine drip or other intravenous meds can they use the same port to get fluids into him? If not, this might require someone with more training than the basic aide - like a medical technician or a nurse but it should be possible. Don't wait for hospice to do anything - they should have thought of this already since dehydration is a huge risk for ill people and can cause great suffering. Call his doctors office and tell them about his urine and his inability to have a BM, stool softeners won't work if he's dehydrated and any pain meds tend to cause constipation - he's in a no win situation without fluids. You might also want to put him on some pureed foods to introduce some liquids.
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Ah duh - sorry - the foods I meant to list are things like jello, jello salad with fruits like mandarin oranges, pudding, strained yogurt with fruit - all those should help get water into his system. My dad was in a similar state and we made "quick gelato" at home; make a packet of instant vanilla pudding then add it to an ice cream maker with 2 cups of pureed cantelope and or other fruits. Often this was all he'd eat because it was cold and sweet. If you have no ice cream maker just mix it up and put it on the freezer in small containers, use a fork to "scrape" it out into a bowl like shaved ice.

Good luck!
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HI Nikka,

Is he at home with visiting Hospice?
Yesterday a Hospice nurse began a post. I can't recall her name. Started with C & a string of capital letter.
Look for the post! Sound like the person has a good grip & willing to share.

Fluids into fathers is a tough call. Lynn's suggestions are great. Fruit give my dad the runs. Many things do.

His doc recommened siluim (sp) to bulk his bowel. Fiber tablets. Now that he has a couple a day things are better. I understand it works both ways.

Good luck!!!
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Thank you all for your suggestions however It's hard to give advice without knowing the whole enchilada... He has a wretched cough due to the metastatic lung cancer so no dairy can be given he is on oral meds only at this time so an IV drip is not the answer for now. Hospice has not said outright that he is dehydrated mainly in part because they see him consume foods. They're only offer is to say that "unfortunately due to his pain meds and dissinterest in liquids, manual removal of impaction is the only thing left to do". Whatever, thanks anyway-
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oh ... ouch!
My sympathy is more than ever!
You are certainly right about the whole Enchillada!
(thanslate that Italy! You'll get a Gold Star!)
*sorry, Rossella has a get humor which we all need.


Is he home with you or in a Hospice facility?
Were you able to find the previous post of the Hospice nurse?

Good luck our friend ~
Please write often?

& hug that noble little Taco Dog for us!
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CIMAHOSPICECTX
is the Hospice nurse's tag to watch for. Posting often!

Be well?
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