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I am caring for my 90 year old father at home. He is getting very frail, but can still just about manage to wash and dress himself although doing this leaves him exhausted.


He spends most of the day dozing and watching TV and only really wakes briefly to eat or drink anything I bring him. Often I have to remind him several times to eat or drink the things I serve him. He doesn't have dementia or anything and isn't actually on any meds. He says he is exhausted. Sometimes he is very short of breath and gets anxious about this.


Up until a month ago he went out but now he doesn't want to leave his chair so the only exercise he gets is walking to the toilet and to his chair/bed.


I am really struggling with the situation and the atmosphere of constantly being around someone who thinks he's dying and wonder how others deal with this.


Thanks


Julie

I read that you are fearing a wheelchair maybe in his future. My advise is not to fear it, but think positively about it. When Mom was still in IL in her late 80s she was on a walker but just couldn’t walk very far or over uneven ground. It made trips to the doctor or fun outings very difficult for her, so she didn’t want to go. We got a foldable transport wheelchair (but one with big rear wheels that was good on gravel and grass) for $100 and we could fold it up and put it in the car trunk for outings. It was a wonderful help to get her outside of her apartment. Maybe he would feel more inclined to do something if it wasn’t such as struggle.
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Zdarov Apr 4, 2019
Thank you for that viewpoint, very nice
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When was your father last examined by a doctor?

The shortness of breath, markedly increased fatigue, excessive sleeping and inability to initiate eating and drinking sound a *heck* of a lot like a heart or brain problem to me. You say he isn't currently taking any meds; in that case this might be an acute issue that really good, useful things can be done about.

If you haven't already had him checked out, get on the phone to his GP and get an emergency appointment for today. (Don't ask your father's permission, because if he's feeling as knackered as he sounds he'll say no. Just do it.)
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JulieKac Apr 3, 2019
Thanks for this. Will do.
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Hi Julie
At 90 your dad could be exhausted just by being 90. On the surface his symptoms sound like heart failure. When did he last see his doctor?
My mom had CHF and she found it helpful to use a oximeter. This showed her O2 levels as well as her pulse. Her O2 was always good so this reassured her to a degree. Many things could cause exhaustion.
Is he losing weight? If he declines food he will become more exhausted. It’s not good to force food or drink. But he will get weaker and weaker. At what point do you intend to seek medical help? Or does he not want help?
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HI, Julie.

Do you have access to geriatric psych services? Or any psychiatrist?

My mom was like this. Long story short, she'd had a small stroke, which we didnt know about. She became panicked about everything. Wouldn't go out because of fecal incontinence but wouldn't talk about it with us or her doctor.

Her GPA just kept giving her antianxiety meds which she took only when feeling panicked. It's a bad idea. You need a higher dose and you end up with rebound.

Gerpsych put her on a steady, very low dose to get ahead of the anxiety. Eventually an antidepressant was added which was even better relief.

I want to emphasize that no amount of reassurance, cheering up, us being there or having 24/7 aides in the house helped.

Getting her the proper medication did.
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JulieKac Apr 2, 2019
In England there aren't really any geriatric psych services. Currently Dad has the Lorazepam but only takes on IF he feels anxious. Perhaps taking a dose constantly would help.
I take your point about no amount of reassurance, cheering up really helping in this situation. I have tried talking to Dad about what he'd like to do - ie anything special he hasn't done but would like to do - anything special he'd like to eat etc. He doesn't seem to get joy from anything. I think his dog is the only thing that gives him any pleasure/ comfort.
Dad is not incontinent but has the odd small accident. Although he is a bit embarrassed by this, he does let me know. ie he tells me that he had a small accident in his pjs.
Perhaps I should talk to the doctor about the meds?
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So, Julie, I just read you're profile. Your husband and home are Turkey but you're currently in the UK caring for your dad. His doc says he's fine, although dad is getting frailer and is short of breath.

You're asking about the "waiting game". Are you asking about waiting for him to die?

If you are looking at this caregiving in the UK as a temporary plan until your dad passes on, if there is no discernable (at least by his gp) illness, I'd say you might be looking at another 10 years. You want to plan accordingly.

What is the shortness of breath about? I'd definitely look into an O2 meter; is it possibly anxiety? Has he been seen by a psychiatrist for evaluation and possibly medication for his anxiety and depression? Has his GP evaluated his breathlessness?

Please let us know how this is going! We care!
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JulieKac Apr 2, 2019
Hi
Thanks for caring.
The GP send Dad for a chest Xray but it didn't show anything. Sometimes Dad's shortness of breath is due to anxiety and he has been prescribed Lorazepam. He takes half a tab if he feels panicky.
Apart from this, I have called the doc a couple of times and he just told me to call an ambulance if his breathing problems were severe. (Not very helpful>) A trip to the hospital could be more stressful for him and would probably mean a long wait in A&E.
I asked about the 'waiting game' because seems to have convinced himself he is dying. He has definitely deteriorated a lot in the last month and I feel he is fading.
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Julie
I heard once that an egg a day could keep elders from being frail. It seems to work for my aunt (92). If he is in no pain, I suppose he is doing as well as he can manage.
Perhaps spring weather will inspire him?
I am sorry you are still separated from your husband. It is difficult to live with someone who is lethargic and in decline without it affecting you. Try to get out each day and take a walk.
I wish I had a better answer for you.
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JulieKac Apr 2, 2019
Hi
Someone else has suggested eggs but Dad never liked eggs so I can only get him to eat one every couple of weeks!
My husband was here for 10 days and we worked on the garden as we thought this would perk him up a bit. We pruned the trees and planted bright annuals. It took a lot of encouragement to get him outside (once) just to take a look. This is mainly due to his fear of falling as he is getting very wobbly on his legs.
We also tried to get him out in the car for a drive, but he was adamant about not wanting to go out.
Yes, walking is good therapy for me. While my hubby was here we went for long walks on the seafront every afternoon. I am going to try and keep that up. It is very easy for me to slip into lethargic mode which doesn't help anyone.
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What would be happening if you weren't sacrificing your life to be there with him? I know that every country has different healthcare systems but I doubt that the UK is allowing little old men and women like your father to fend for themselves when they haven't got a built in caregiver, somehow you've got to tap into that system and get them to understand that although you love your father your life is in a different country and you are not available to give up years of to care for him. Perhaps it is time to consider some type of long term care facility.
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JulieKac Apr 2, 2019
If I weren't around I guess the social services would reassess Dad's condition and suggest more care at home. I don't think at this point they would consider that he needed long term care, they would probably suggest more regular care visits. I think he'd have to be a lot worse before they'd suggest a care home.
On the one hand, if I discussed this with him, he might manage better like this (for a while). As I have said before, if he has to fend for himself, in some ways it motivates him to do more (he has no choice). Because of his panic attacks I don't really want to broach the subject. It's tricky.
My husband is Turkish and in their culture they would never allow parents to go into care - but they do have extended families. He thinks I should be here with Dad for the short term.
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I'm inclined to be a little ticked off at your doctor - it a younger man was presenting with those symptoms I have no doubt they would be digging a little deeper to find out what is wrong. Yes, 90 is old but it is becoming much more common for people to live well into their 90's and beyond, a person without any previous health difficulties should not be feeling as he does simply because of age. Have you asked your father what he wants to do at this point, whether he is willing to push harder for answers?
Your father sounds a lot like my mother at 90 - she was also functioning reasonably well but she had a long history of cardiovascular disease and TIAs, as well as advanced AMD. First came the falls because of the frailty, then her mind started slipping, then she became incontinent, then wheelchair bound. The decisions I made early on were based on the opinion of multiple health care workers that she was imminently dying - one ass in the ER told me "sometimes they just get tired" as her diagnosis. It took the better part of a decade for my mother to finally pass away at age 99, by then she was as dependent as a newborn infant and needed to be cared for in a nursing home. My biggest regret is that I never pushed for answers earlier on and I'll never know what the heck happened to her or whether any of it was in any way preventable.
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JulieKac Apr 2, 2019
Yes, I agree that the doctor would be looking into this more if Dad were a younger man. It is difficult to accept that his age is the only factor. The doctor's attitude seems to be he is just old and tired. I have spoken to Dad about it and he really doesn't want to get into hospital visits and stays (who does?). He just wants to sit in the safety of his armchair.
I fear for what comes next as with his dwindling mobility, falls are on the horizon, so are wheelchairs etc.
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Julie
i remembered responding to you earlier so I went back and found your posts.
So it sounds like he could get more care if he weren’t so healthy!
The doctor isn’t impressed enough with his decline to take action.
You were wondering if you have actually caused his decline by being there as you do the things he did before including taking care of his dog.
He has been treated for anxiety in the past. So it sounds like that is the same issue now. All things the same except he has lost weight and is weaker.
He needs an intervention of sorts. Can you see yourself taking him out to a different doctor? It’s clear to see you don’t want to go against your fathers wishes but the set up you have now has you being forced to witness his slow decline because he doesn’t feel like doing anything different. I’m sorry Julie but he appears to be mental and you are going along with it.
He doesn’t want you to go home and he’s making sure you don’t by becoming weak and helpless. You’ve been there about five months now and he’s not better. I hope you will insist that he seeks a second opinion in hopes of helping you both.
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JulieKac Apr 2, 2019
Hi Again

Dad is a lot worse than he was last year when I started looking after him but I don't think that is because I am here. He is a lot worse. I could get social services to come and do another assessment and they would probably recommend more care. At the moment a carer comes in 3 times a week for 30 mins. (Not much help really.)

I think you are right about needing an intervention, but in the UK there's not really much choice. The doctor offered Dad an abdominal ultrasound but he refused to go and I had to cancel the appointment.
Yes, the set up I have now is as you say 'forcing me to witness his slow decline' because he has given up. He thinks he's dying. I just wondered if that might be an intuitive feeling.

I am not sure that it's fair to say he can't be bothered and is making sure I can't go home by becoming weak and helpless; he really has no energy and cannot physically do things he did a couple of months ago. He sits slumped in his chair most of the day and struggles to get himself washed and dressed. I really don't think he'd be able to get himself in/ out of the car and go into a supermarket (which he could do a couple of months ago.)My husband was here last week and he would usually perk up and act as if he was ok as he's very proud. He just wasn't able to do that this time.
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Have you considered calling Hospice? It seems as though he is in need of supportive comfort care and is not interested in intervention.
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JulieKac Apr 2, 2019
I could talk to someone at a hospice but again here in England hospice is really end of life care and I don't think they would consider him bad enough to need it. Some kind of supportive comfort care would be good, but it is not really available here.
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