A very recent stress test confirms he is functioning at 30% of his heart's ability. His pacemaker's battery was replaced a week ago, it only lasted three years, so that tells you it was working overtime. They usually last five to seven years. He finally revealed last night that he is upset that "no one told him" he was that bad off, he thinks I knew about it (I did not not until the cardiologist read the results.) Dad is wanting a miracle from the doctor, it is difficult to discuss the issue with him as he gets agitated pretty quickly. Dementia is also getting worse. Any suggestions on how to cope with this phase? I have a sense that I will find him passed away in his chair one of these days from a major heart attack, he also has a sense of doom now. I know it's coming, but I don't think you are ever really ready. Thanks for listening. . .
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Other options: advanced illness management programs (they are like pre-hospice) exist in some areas. Palliative care consults can be hard to get in outpatient setting but often are available during a hospital stay.
I always tell people getting palliative care help doesn't mean giving up; it's just getting special help with symptoms and with talking about what's going on.
Good luck! Leslie
ps: agree with the others: 30% is not a horrible ejection fraction and it's better to go by symptoms, how much he can exert himself, whether he keeps needing hospitalization, etc.
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Have you considered having hospice come in and evaluate him. I doubt he will agree to it but maybe you can be in the vicinity of their office one day and get him in for a chat. Death from CHF is rarely fast and dramatic rather a slowing down of the body till he just fades away. Hospice can do a lot to improve his comfort, provide equipment and help with his care. Above all they will tell you and him the truth
My Dad is quite cantankerous (sp?) with some dementia and depression, too. What helps Dad is socializing with friends who visit him in the nursing home. He, also, has a counselor that comes to see him on a weekly basis. I bring my dog when I visit Dad and that puppy seems to be therapy for everyone.
As Eyerishlass says, what a Dr says is certainly not a death sentence. There's a lot to be said for an individual's will to live.