Just had a palliative care assessment, YIKES! Any guidance?

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Hey ~~ Had my talk w/ a nurse yesterday. They assessed dad. I think I'll wait for awhile to start Pal Care. I said his legs have been hurting him for awhile b/c we went on a small walk along the Missouri River, which he grew up on. He has been a bricklayer his whole life and his legs are getting tired. I have been giving him Advil. I asked if I could have some Tramadol or Flexeral to help his legs feel better. YIKES!! She said it will be Morphine they will start prescribing! Then she asked if he was anxious or depressed and would he need help w/ that. Did I read most of those posts here correctly that stated Morphine and Ativan are the last resort for people on hospice care? I picked him up after his supper last night to go get a RB Float before bed and he wanted me to take him by the local senior center to try and dance to the big band! Is this someone who needs morphine? Am I reading too much into the M&A combo? Am I Thinking he's better than he really is? He wanted a used bike from the GW the other day so he could ride to the pool 3 blocks away. His legs are too sore, so "No", but is this a man who needs Morphine and an anti anxiety combo? Should I ask for a second assessment as dad had slept thru the whole interview? I had given him an Advil and he felt better and fell asleep just when she got there for her appt! Dang It!! He is so fun and happy for every day he's given. He looked like Dead Man Sleeping yesterday! LMK if anyone has a few minutes. Thank you all you dear people!

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ImSoTired1 - Your description of your dad's illness gave several hints that you may be dealing with a common, but poorly diagnosed typed of dementia, Lewy Body Disease. Dementia, hallucinations and stiffness (Parkinsonianism) are three of the major symptoms. If he has LBD, typical anti-psychotics, ativan and morphine are dangerous for him. Check out the LBD website https://www.lbda.org/category/3437/what-is-lbd.htm
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Many people do not understand the need to have drugs like morphine and Ativan available in the home for immediate use. That is not to say they have to be used, but conditions change so rapidly at the very end. If someone is suddenly in terrible pain there are not many places that have 24 hour pharmacies. This is the reason these medications are included in things provided by hospice, sometimes on admission. The alternative may be to watch your loved one screaming in pain throwing themselves around or becoming violent until the pharmacy opend at 9 am the next day.
I totally agree that narcotics and anxiotitics are not good drugs for the elderly for routine use but if the condition demands it they are very valuable.
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Imsotired1, your profile says that your dad has dementia. Is he able to understand and make his own healthcare decisions at this point? Has he made his wishes known or signed an Advanced Medical directive? Do you know what he wants regarding continued medical treatment. I'm just trying to figure out so many doctor office visits if he is seeking Palliative Care. I thought that meant a decrease in doctor visits.
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Google vascular vein specialists in your area; vascular veins are easily treated. PAD, however, may require outpatient surgery in a hospital because this procedure removes the blockage in the legs. Surgeons do this procedure. Call your father's PCP and tell them your concerns of potential varicose veins and/or PAD - and tell them that your father needs a leg ultrasound so what do they need to do to make this happen. If your father does have a blockage in the legs, then this can possibly become life threatening. I'm not trying to scare you. I'm just letting you know it's very critical to get your father to doctor now for a leg ultrasound. Google/read-up on varicose veins and PAD to educate yourself before the appointments. Good luck!
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Thank you caregiving ~

I will get him checked out for that. I've been to the dr's office like 7x's the last 2wks.

It seems like we never get the real answers. He is DONE w/ drs he has said again.
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Has he been evaluated already for poor circulation/varicose veins/peripheral artery disease? If he hasn't, then you should consider taking him to the doctor for a consult. PAD is painful when walking even at short distances.
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My husband was on palliative care and then hospice. I found lots of benefits to hospice care. Palliative care didn't seem to offer much. In a sense, all dementia care is "palliative" -- we know there isn't a cure and we are just trying to manage the symptoms.  I think it might be more helpful for other health conditions. 
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When we put my mom on Hospice, the first thing they did was deliver Ativan and morphine. I told them she didn't have any pain, they said it was standard practice, "just in case". We have never used it. We also don't use Ativan because my son in law, a doctor, said it was the worst for older patients. We still have Seroquel, which he says is best if the psych drugs, so that is what she gets. I told them that when it was gone, if they wouldn't provide Seroquel, which she takes a small dose of and works well, that I will just take her off hospice. They are nice, but it really doesn't provide much relief. CNA bathes mom twice a week, nurse comes and takes vitals once a week, social worker comes once a month but just chats. We can do all of those ourselves.
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I discussed Palliative Care with my loved one's doctors. I wasn't aware that there was any special benefits, forms, etc. I thought it meant that we were on the same page as providing my LO with comfort care. This means, no cancer screenings, no surgeries unless it's mandatory for her comfort, and minimum medication to keep her comfortable. We decided to stay on hypertension and cholesterol, but, I'm weighing that now, since she now has profound dementia per her doctor.

If there are any other benefits or procedures, can someone chime in about it?
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I know from reading on the site that there are benefits that go along with Hospice such as funding of aides, nurses, in home doctor visits and supplies, but I haven't read of any comparable benefits in palliative care. I'm just curious, what would the advantages be if he had been accepted?
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