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CareBare Asked October 2020

Dad (100) has major heart failure and stage four kidney disease. I feel like he isn't always treated well in the hospital. Advice?

Most of the time he handles it well but when he is not feeling well he struggles. I call 911 to take him to the hospital to help him, for instance get some fluid off him. My observation is I feel the hospital just looks at him as an 100 year old and they don’t have to bother to make any effort to do anything. If I ask questions and they have said “well he is 100 there is not much we can do”, I had one cold spirited doctor just say “he has lived a long life, just be happy about that”, I do not want to hear that, I know he deserves the same concern and care they give a 30 year old. God has blessed him to still have life in him and when I take him to the hospital I need them to give him 100%. He is still in his right mind, he is kind and gentle to everyone and a good person and treats me and those he comes in contact with with such kindness. When he is feeling good he still gives his all so on the days when he is not feeling well and needs doctors care I expect them to care about him no matter his age, give their all and do their job. I have been nice and smile but I’m tired of it and feel I need to speak up. Am I wrong for feeling this way?

NeedHelpWithMom Oct 2020
I’m sorry. It’s hard. My mom constantly says that people forget about old people. She is turning 95 next month.

It’s sad. I hope you will find doctors who will treat him with the dignity, respect and compassion that he deserves.

Best wishes to you and your dad.

JoAnn29 Oct 2020
Good answers from everyone. We just wear out. AZt his age cannot have heart surgery. Two major organs are giving out. The heart can't get rid of extra fluid and the kidneys can't filter out the toxins as well either. Other than draining the extra fluid, there is not much anyone can do for Dad but keep him comfortable. It a great thing that he has been with you this long. Count each day he is with you as a blessing.

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notgoodenough Oct 2020
Oh, Carebare, you have my profound sympathies. I just lost my 86 year old mom to CHF and kidney failure. I know how painful it is to watch; I totally understand the "good days/bad days" roller coaster of care and emotions.

I am sorry the doctor was so abrupt with you. Some doctors don't have a great bedside manner; some just view our LO's as a "system" - digestive, circulatory, respiratory, etc. - I think sometimes they forget there's an actual living breathing person with emotions and people who love and care about them attached to whichever system they're concentrating on. Especially hospital doctors - they see the patients for such a relatively brief period of time, there's no time to establish a good doctor/patient relationship. And some doctors have a really, really hard time acknowledging to themselves that there comes a point when all of their medical training and practice just can't fix certain things. And we hope so much that things can be "fixed", because if it can't, that means the end is near.

In answer to your question, no, you're not wrong for feeling the way that you do. You love your dad, and you want what's best for him, and you're not ready to say good-bye, and there is nothing wrong with those feelings. CHF is such a difficult progression to watch. In her last weeks, my mom complained about being so very tired; she really thought she wasn't getting enough sleep, when in reality she was sleeping off and on 20 hours a day. It wasn't a lack of sleep, it was the weakening of her heart that made her so exhausted. And my mom's cardiologist tried so hard to keep her going, even putting her on a 24/7 IV drip for a heart medicine, which she absolutely hated. She finally had enough, and we called hospice. I was blessed to have another 10 weeks with her, 9 of which she was pretty much herself.

I think as long as dad has the fight in him, you go on being his advocate. But - and I say this very lovingly - make sure he's fighting because it's what HE wants to do, not because he thinks YOU want him to. It seemed my mom held on until both of my kids told her they would be ok, and they understood her decision to refuse further life-prolonging treatment. Not soon after, she passed peacefully.

I send you prayers and (((hugs))) as you continue this journey with dad.

AlvaDeer Oct 2020
He deserves the same care as a 30 year old, Carebare, but the truth is that his body will not react in the same way that a 30 year old body will act. You ARE lucky, and as is HE, to have had such a long life, to still have some good moments on good days, to have ONE ANOTHER. He is really quite REMARKABLE, says this old Nurse. And were I not retired and you came in I would congratulate you both on this remarkable life.
But were you to honestly ask me, as I gave the best care I could/same care I would give a 30 year old, what his prognosis was? I would tell you gently what you already know. CHF means a failing heart pump, too old to pump efficiently anymore, and no cure for that. Our parts wear out just like an old car; but we are less easily fixed. Then there is that second system, the kidneys. When that trifecta of heart, kidneys, lungs all become too worn out, there is nowhere to go but to the peace of rest. At 100 your Dad may be more tired, and more ready for that than you can imagine. My Dad in his 90s was SO TIRED, and told me so.
You should be so proud of your Dad. And of YOURSELF for this loving care.
I hope you don't think that the Medical Folk acknowledging that they are helpless in the face of time and body parts that have given their all means they don't know that your grief on loss of your Dad is still a profound grief.
But that said, there is a real difference in the loss of a life long and well lived and loved, and the loss of a thirty year old Dad who will not see his son grow, who will not see the world change, who will not make the passages we make.
In a sense I also want to ask you to acknowledge and celebrate the remarkable life of this remarkable man, and to reconcile with what is inevitable, and what you are already preparing for, already in a sense grieving.
My best wishes out to you both. Enjoy each precious day left to you.

Midkid58 Oct 2020
You're not wrong for feeling that way--but you do need to understand that, realistically, at 100, he HAS lived a long life. He probably presents, to doctors, as a VERY aged patient, and it's not that they don't CARE, it's that, well, he has outlived the normal lifespan by almost 20 years. They do not see a lot of over 100 yo patients!

And they are correct that in a 100 year old man, there isn't much they can do. He is probably a myriad of co morbid issues and trying to pin down what is currently bothering him has to be a real challenge.

Drs today are exhausted, depressed and frustrated just due to the pandemic. Not that they don't care--they are stressed out.

My SIL is a dr and wow, his personality has taken a hit during COVID. Usually very easy going, he's anxious and tense. He still is giving 110%, as always, and I worry about HIM burning out.

Don't paint all drs with the same paintbrush--you know what they called the person who graduated last in their medschool class? DR! You get the kind and thoughtful with the jerks. If you're unhappy with an ER docs attitude, ask for a different one.

Your dad deserves the care his body can handle. At a certain stage of life, a lot of the care they can safely receive becomes moot. It's not personal, it's actually, safe practice.

I assume you are the one who takes dad to the dr? Just be his advocate. Go ahead and speak up. Ask WHY they won't do this and such for him. You have a right to know, and maybe if you understand, you won't be so upset.

MJ1929 Oct 2020
Doctors can be pretty darned tactless, no question. However, what they aren't spelling out for you is that they simply can't do for a 100-year-old what they'd do for a 30-year-old, because he couldn't tolerate the same treatment.

When my dad was diagnosed with liver cancer, his doctor was more blunt. He told my dad that treatments he'd try with a younger person would kill my dad. Mind you, my dad had no idea he was even sick and he was healthy as a horse prior to the diagnosis. His doctor told him he'd have anywhere from a month to a year, but there was nothing to do for him. He was gone in six weeks.

Your dad's body will eventually not be able to handle the big doses of Lasix or whatever they give him to get the fluid off him. The fact is, he IS a 100-year-old man, and he HAS had a good, long life. Dying is part of life, and denying that will only cause you terrible grief. Sure, do what can be done if that's what he wants, but don't expect him to be treated like a much younger man because he just isn't. He's winding down. One hundred percent for a thirty-year-old isn't going to be 100% for a one hundred-year-old.

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