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My grandfather is 78 and in the past year he has gone from very active to sleeping all the time. He is no longer wanting to eat. He has lost a great amount of weight and now needs adult diapers because he no longer feels when he has to urinate. He is losing his balance and falling and is now walking with a walker or cane. All of this in 1 year. He is refusing to go to the doctor because he says there is nothing wrong with him, even though he has been urinating blood off and on for the last year. What can I do to help him and what does all this mean? Is he giving up on life?

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Correction on my error--prostate cancer.
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Shann, If that is how gdad feels, he needs a diagnosis so he can go onto hospice services and have a good passing. If his doc does not think he is within 6 mos of dying, he can prescribe anti depressants as well as pain relief. He can even decline treatment of anything and have palliative care only from his doc. If he is within 6 mos, he can have palliative care from hospice - comfort care only. That will help him tremendously.
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I just read your post. This is so sad for you and your Grandfather. Even though he has a history of Cancer in the family, he should still get it checked out. He may be suffering for no reason. It could be just a simple infection and clear up with antibiotics. Even if it is cancer, as he suspects, there are comfort measures that will help him. Not sure how to clear up his other issue. That sounds like you may need to call a family meeting and advocate for him. I'm sending you prayers for a positive outcome.
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Thank you everyone for your answers. Not long after posting the question, my grandfather finally told me what was going on with him. He says that he knows he is sick and that he has known for awhile. His father and brother both had cancer and went through chemo and very tough times and then passed. My grandfather decided he doesn't want to accept any help for it. He wants to just let it be. He says he has lost his will to live because he feels trapped. He has a 43 year old son and a 22 year old grandson who has lived with him for 8 years now. They do not work and they have taken over everything in his home. Including telling my grandfather whom can and cannot stay the night in his home. My grandfather pays for everything, including the many video games they want. He feels he cannot kick them out because they have no where else to go so he decides to come stay with me to get away from his own home which is sad. He feels there is nothing left in him to fight anymore and he wants to go be with his wife who passed 14 years ago.
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Shanin, I see from your profile that your grandfather is living with you in your home. Did he come to live with you one year ago, then? What were the reasons he gave for agreeing to do this?

If he were living independently and made the free decision, not affecting anybody else, that whatever was wrong he preferred to ignore it, that would be one thing. But he chose instead to accept your support and move in with you. Now he's stopping you taking proper care of him by consulting a doctor and at least getting clarity on what is happening with him - not to mention that dealing with incontinence is no fun for the household either, to be blunt about it, even if obviously it isn't his fault and nobody blames him.

But he can't at one and the same time rely on your care AND pretend that his health is none of your business. Not fair and not logical.

I hope you'll come back in response to people's comments and support and let us know what you think.
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I agree with CarlaCB. 911 would consider this an emergency and as you cannot lift your grandfather into a vehicle, they would help you. I had to call them last year for my elderly mother and they told me that people don't realize all the things that they help with.
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I agree with the other commenter about the UTI, it really can cause confusion and withdrawal...I was just at the hospital with my mom...she didn't know who I was and was totally unresponsive until the antibiotics started working...
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Shanin I wouldn't jump to thinking he is giving up on life. The symptoms you describe can all be related to several possibilities, some simple and most treatable if not fixable. It sounds like these all happened at or around the same time and all fairly quick too which supports the possibility of something like an infection (UTI), as does blood in the urine or medication issue but most of us I think can relate to difficulties getting someone to the doctor that doesn't want to go. I think more often than not particularly when they start really digging their heels in, the real reason is fear. They know something is wrong and are afraid that it's something major so as long as they don't go to the doctor they can maintain the facade, to themselves as well as the rest of the world, that they are healthy. It may be a drawback to not having any health issues that need to be tracked regularly as they age actually. At least when they are on a medication or have something that is managed but needs to be checked to maintain that there is a non-threatening need to see and get to know a doctor on a regular basis.

Anyway as others have suggested there are several medical reasons that could be causing your grandfathers energy and spirit changes and of course low energy that has him sleeping so much of the time and not getting out contributes to mood and depression, things that if he were younger people would more quickly say must have a medical reason. Another problem I have found, the tedency for medical people to assume depression is the cause for behaivior and the diagnosis rather than a symptom of something else that might be simple and easy to fix. I have, on too may occasions to call coincedence, known something medical was going on based on my moms mood and or behaivior. Often in the hospital but because I know her I am able to see the diffrence, for the nurses or providers in and out of the house it looks like behaivior typical for elderly paitents. My brother and I have picked up on 2 or 3 UTI's and 3 or 4 times she was retaining fluid in her lung or systemically well before any obvious outward physical indications developed. Once in fact I took her in knowing she had a UTI but according to the doctor her test was negative, the very next day she was tested at the hospital for pre-op and they found a UTI. Now I'm not saying your situation is the same I'm just saying that you know your grandfather and it's the people around a person, the people that know them well who are most likely to notice changes first. Trust your instict about something being off. It sounds like this has been going on for about a year in some shape or form any chance he is due for a yearly check up? That might make it easier to get him to the doctor and then you could give the doctor the heads up about your concerns or just the differences you have noticed either at the appointment with GF in the room if you have that set up and relationship or by sending or leaving a message prior to the appointment if that's more appropriate. Of course if he doesn't have a regular primary or go to the doctor on a regular basis this doesn't work as well.

If a regular check up doesn't work and he isn't mentally impaired then your probably going to have to find a way to reason him into it. Recognizing that a big piece of his resistance to getting checked out is likely fear give him some of the other simple options that might be going on, the ones with simple fixes and stress how much better he might feel quickly if they find and treat some of these things. Maybe even talk about how letting something simple and fairly minor continue untreated can lead to something more major or chronic and the longer it goes untreated and the more symptoms that pop up the more likely it becomes that eventually when something major (related or not) happens the medical providers will want to treat those symptoms individually rather than part of the same root problem. For instance they might want to put him on antidepressants long term for depression or tag him with dementia when those are really symptoms of a minor infection or perhaps a minor CVA both of which can be overcome. Just examples here, I'm not diagnosing anything but I have found when trying to get my mom to go along with medical treatment or an appointment she doesn't feel is necessary or doesn't want to do (usually because it scares her for some reason) it usually helps to talk about the things I thin are scaring her as things I had thought of and the things that are more likely or the remedies that aren't as bad as she's thinking. Putting it all out on the table so to speak for her along with the possible treatments and stressing the positives of figuring it out and treating it. Not in a "controlling" way like saying you have to do this or that and not pleading with them, at least at first but giving them the options/possibilities that you know about, in my case often including the info I have already gotten from communication with her doctor or doctors and or their staff (I have to admit sometimes I'm selective about what I share) and when I sense it's time I back off and let the topic change giving her some time to digest what we have talked about. Difficult topics often take 2 or 3 conversations with time in between and my brothers and I often let each other know when the topic is tough and important enough so that we all talk to her about it individually. For us so far this method of talking her through a topic and leading her to at least going along with and seeing the need to do what we know she needs to so getting her on board has worked and is far better than the alternative of figuring out how to make her do something. That may not last and there are things, like the sleep doctor, she isn't coming around about but I also pick my battles and that just hasn't gotten to the top 3 on the list yet so admittedly I haven't worked it very hard. When worse comes to worse making a doctor the heavy often works too but one has to be careful there because you don't want to give them another reason to avoid the doctor either.

Sorry wrote this yesterday and thought I had posted it but I just clicked on the tab and found it was still here...
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Blood in his urine is considered a medical emergency, If he waits, it could only get worse, especially with no diagnosis. Think bladder cancer or prostrate cancer.
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You need to call his primary. This could be prostrate cancer or bladder cancer which both can be cured if found early.
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I would have to agree that your Grandfather has a medical problem & needs to be seen by a Doctor for a professional assessment. At age 78 I would tend to think first of UTI...older people become quite confused with a Urinary Tract Infection in addition to blood in the urine & urinary incontinence. I would also be thinking BPH....Benign Prostatic Hypertrophy...which causes blood in the urine & incontinence and difficulty passing urine due to swelling of the prostate gland located at the head of the bladder. Third thing that comes to mind is possibly a  Prostate Cancer. Has he had a PSA blood test done recently? This would help to diagnose prostate cancer. When caught early, prostate cancer is quite treatable.
Depression is not uncommon with all of these issues due to fear, loss of control over bodily functions & isolation from other people. I strongly recommend medical intervention to diagnose his obviously upsetting symptoms. I should add that Dementia can cause mobility problems (yes!), poor decision making, depression & forgetfulness. But one thing at a time here...he’s not an OLD man! Start with the urinary incontinence & blood in his urine first. Then see if further assessment is required. An appointment with his Family Doctor will suffice to get the ball rolling...surely he will agree to a simple appointment. Good luck!
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My Mother is 85 and she has these ups/downs. She was in the hospital a year ago this past December and spent the entire month of December there. She had an extremely bad UTI, yet my sibling refused to accept it as the prognosis. Our daughter is an RN and when I told her what happened, the 1st thing she said was Mom, Grandma has a UTI and it is going to effect her dementia in ways we haven't seen yet. When I told her what this sibling(s) had done, she became furious.

I went home in late January to do a welfare check on Mom, Step-father and the home condition....OMG!!!

Mom was not at home when I arrived. I went to various places that I knew they would go grocery shopping, having her hair done etc. I went back to the house and the neighbor walked toward me like I didn't have any business there (my out of State plates) with an attitude that he was going to tell me where I could go.

As soon as I asked him where Mom was, he told me that she had fallen and taken to the hospital that morning. What time? 6:00 and not a call or text from this sibling. I was at the house around 1:00pm.

I went to the hospital and so totally surprised my sibling (what good times) and asked her why I hadn't received a call or text. She was too busy to do that since they had just moved Mom from the ER to her room (as I walked up to said sibling).

Prognosis? Mom had a bad case of UTI which caused her to lose her balance along with the mental issues that she had in December. NOW this sibling accepted the prognosis.

What I am really trying to say is, yes your Grandfather is giving up on life. In his mind, what does he have to live for any more? My Mom goes through this all of the time!

Men do get UTIs just as well as women. He may also have kidney stone issues. Mom too, uses the special panties and the doggie training pads underneath her when she is sitting, which is more than she should. She falls asleep during my phone calls to her or when her brother is there to check up on her. She has diabetes and this sibling thinks that calling Mom to see if she has checked her blood or taken her insulin qualifies said sibling as 24/7 caregiver.

The next time Grandpa loses his balance, call the EMTs right away. He will not have a say about going to the hospital as his blood pressure may be too low to leave him at home.

Tell his doctor what is happening about not eating, sleeping and most definitely the falling. Get the Medical POA for Grandpa too. It will need to be done with a Notary present and with his full knowledge of what he is signing. The hospital has Notary services too, so if he is in the hospital....go for it.

Last resort, go to the Family Courts and get either Guardianship or Conservatorship. There is a difference so be sure you know which is best in Grandpa's case.
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Shanin as to your father's issue. He NEEDS to see a MD ASAP. Blood in the urine is a serious symptom that should not be ignored. He may have an ongoing low grade infection that could account for his symptoms or he could have cancer. My father had blood in the urine and ignored it for 6 months. When he finially went to the Dr. he had stage 4 bladder cancer. This is nothing to mess with.
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Medicare placed into law last fall 10/17 that when someone is in the hospital and they are on Observation status the hospital must inform the patient and the responsible party. The problem with observation is that they don't cover "self administered drugs". That is any medications the patient would take on their own at home. Includes all orals and some injectables like insulin. You are not allowed to furnish or take your own meds, they must be from the hospital. Also a 3 day hospital admission is required for anyone going to rehab after being in the hospital, observation doesn't count for this. My mother went though this. She was admitted to the hospital, on day 3 the insurance said it had to be changed to observation. She went on to need 2 weeks of rehab to get back on her feet. I had to fight the insurance for over a year to get this fixed. They switched it back and forth 3 times during that time. I'm not really sure if telling them to admit and not observation would work. Sometimes they have specific guidelines that direct them on a patients status. This is an issue that Medicare MUST address as it is causing a great deal of problems for patients.
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lucyinthesky, this sounds like a hospital problem to me. The hospital we always request (there are 2 choices) local to my mom has always been very good about knowing what needs to be done for Medicare to cover, they would automatically admit her rather than "observe" if that makes the difference in Medicare paying, her doctors are all very good about this too and of course they take her supplemental into consideration as well. But without that, either trusting the hospital or her primary to keep an eye on those things the only thing I can think of is you will have to stay o top of it by either being up to date on all these details (yikes!) or making sure you ask every time they go over their "plan" for her care with you if it's all covered by her insurance and if not what other choices are there that would be. As I think about it the other safe guard is typically with hospital stay "plans" they do a break out of charges the patient will incur that someone needs to sign before moving ahead so the patient (always sign for her or as POA if she can't sign for herself) is accepting the financial responsibility and the hospital has someone to bill. Reading that should send up a red flag when they are doing something that isn't covered by Medicare or her supplementary and clue you into asking for other options that will be covered. Again this probably varies by hospital and by state (what is required legally) so if there is more than one hospital in her area to choose from it might be a good idea to make a few calls and find out what their policy and procedures are concerning admission/care plans and billing. You might check with her doctors about preferences as well as privileges and reasons for them, then if you find a reason to, make sure hospital preference is clear for anytime she needs to be transported (post it on the fridge with other emergency info for EMS) or admitted to hospital or ER.
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If he's urinating blood - he has a medical condition and needs to be tended to by physicians. I am not a doctor/nurse so I can't say more than he needs to be seen and evaluated.

But giving up? That's hard to say - not everyone lives to see 80 and his body can also just be worn out. While my DH reached 96 (so far) - he had 3 sisters pass before they reached 65, one brother that passed at 73 and 2 sisters that 'almost' made it to 95.

If I had to guess, I would think that some infection caused him to sleep more and eat less - but again, I am not in the medical profession. I am just a wife and helping my DH.

The only thing I can say is that he needs to be seen and evaluated. It might be time for an ambulance to take him to the hospital. Or, at least call in HomeHealth and they will evaluate his needs and see that they are carried out.
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Good advice from those who have answered previously...of course your grandfather may be concerned about being entrapped in the medical system and subjected to tests he does not want to undergo. It's amazing how quickly our lives our taken out of our control. I'm concerned it could be more than a UTI, maybe even prostate related...is it possible he knows more than he is letting on to you? I have seen people who have been very elder (far older than your grandfather) increase to sleeping so much they are awake few hours. Sometimes this is just their way of fading away...but if it is too soon, that's another matter. You don't say how old you are, but I have been a young granddaughter concerned about a grandparent. What do your parents say? Is it possible you are being protected out of love? If this is critical, hospice might be appropriate and would allow him to leave on his own terms...but again we don't know that. Somehow you are close enough to know about blood in his urine. You might want to talk to his MD if you can, maybe someone can make a home visit (Visiting nurse?) just to do a preliminary and non-threatening visit. Doing anything will help in some ways...The not eating...clearly not good for whatever reason, and no doubt contributing to weakness, possibly the balance and falling issues. 78 years is still pretty young these days...He's lucky to have you:-) I bet you're his favorite!
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meallen
Mom just spent 2 da in the hospital & I realized she was an Observation pt at first. It did however change to an admission thankfully.

But how do you be sure or direct them that this must be an admission up front without the worry?
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If he goes to the ER, you want him admitted, not held for observation. Medicare won't pay for observation, IME.
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UTI is a possible cause, along with medication changes. Forgetting to take them or doubling up because you forgot.
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Blood in his urine could mean that he has a urinary tract infection. This could explain why he is being irrational as infections can impact cognition and make seniors appear to have dementia symptoms.
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I would question if your grandfather is competent to be making decisions about his healthcare. Sometimes people who are mentally not able to use proper judgment with their health care can self neglect. But, if he's still competent, it's really his decision as to whether he seeks medical attention. All of the things you describe do sound alarming though. Does anyone in your family have Healthcare POA for him? What do the other family members say about it? I might consult with an attorney to find out what your options are if things continue. At least, you'll know what proof you need, if things get worse and he still resists medical care. What's so sad, is what if it's something treatable that could make him feel so much better?
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Your situation sounds very difficult. I have a couple thoughts: he might be depressed- does he live alone? He might be in pain, sleep could be a way to avoid it?
He may be very sick and since he refuses to see the doctor, do you have mobile physicians in your area? He might allow a house call as it’s not such a production as going to the Doctor’s office. He could be very embarrassed by his incontinence. Blood in the urine is NEVER a good thing. And sadly, sometimes we have to wait for a medical crisis or emergency before our loved ones will allow us to help. Hang in there.
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Yes, it does sound like he is giving up. It also sounds like he is pulling you down with him.

The next time he falls, or has any kind of crisis (I'd go with bloody urine if had to), call 911 and have them try to convince him to go to the ER. From there he'll probably be held for observation and if need be, admitted for treatment. EMTs tend to hold much more authority for sick elders than adult children do. Good luck and keep us posted!
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