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salass34 Asked January 2022

Lost at what to do with elderly father. Any thoughts?

My 68 year old father fell and broke his hip last Wednesday. He had a partial replacement the day after. He suffers from Lewy Body Dementia, Parkinsons and Celiac disease. He is 6.2 and was maybe 125 lbs when he fell. His overall health has been declining this past year and has lost weight within the last few months. The day after surgery they got him to eat and he seemed very groggy and confused due to the anesthesia. The next 2 days he seemed more confused and agitated. They ended up putting him on a dysphagia diet because he was having a hard time swallowing. He has had issues with this for awhile. He has always been an extremely picky eater but the LBD has made it worse the last year. Over the last few days he has refused much of anything. A few bites of pudding here, a few bites of ice cream there. He flat out refused mashed potatoes, applesauce etc. I spoke to his doctor and she asked "how aggressive" we want to be with him. He has been extremely agitated and yelling alot. As hard as it is for me, I made the decision to put him into hospice care. Per his living will, he does not want to be kept alive per artificial means. His doctor basically said his body is in feed me mode and his nutrient level (not sure what it's called) is 2.2. I feel lost. I don't want my Dad to die but he is refusing to eat himself. He has not been up out of the bed since the fall. He refuses everything and fights with everyone and says he can't do it. He is cognizant at times and then other times he's yelling stuff that doesn't make since. I don't want to live with regret when it comes to putting him hospice but even when we did my Dad's documents he said he didn't want artificial means of being kept alive. To me a feeding tube would be considered artificial and his living will States he doesn't want hydration or nutrients. He says he's hungry but refuses to eat much. He also failed 2 swallow tests and is coughing alot after eating or drinking anything. I would just like some reassurance I'm doing the right thing. His LBD wasn't terrible. He knows who we are etc he just wasn't able to live alone anymore. His doctor said rehab was not an option for him. He was also seeing psych in the hospital and they tried different meds to help manage his aggression but they were not working.

BarbBrooklyn Jan 2022
I would accept hospice help, but also continue the search for appropriate psych meds.

Your dad is disoriented and possibly delusuonal due to anesthesia, surgery and being in an unfamiliar place.

Let him eat what he wants--ice cream, thickened shakes, puddings. Get them to order protein powder added.

He can come off hospice if he starts to improve.

Geaton777 Jan 2022
I'm sorry you are going through this distress. When my 85-yr old MIL got original covid while in LTC (May 2020) they put her on hospice after 4 weeks because she was just failing. Then, she improved and had a full recovery. Just saying that hospice does not always equal "the end"... sometimes it is the break that is needed. May you gain peace in your heart that you are doing your best in the circumstances, and that's all anybody can do.

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salass34 Jan 2022
Thank you everyone for your answers and prayers. My Dad went to be with God this morning at 250am. I'm grateful he is no longer suffering but part of me still feels guilty.
I was by his side when he took his last few breaths. This is the HARDEST thing I have ever had to do .
Isthisrealyreal Jan 2022
Great big warm hug! You have nothing to feel guilty about but, we feel how we feel.

Please be kind to yourself as you process the grief of losing your dad to such terrible diseases.
swanalaka Jan 2022
Salas, I am so sorry you ate going through this trial. Your father, at age 68, is still quite young to be in such decline. That's likely making your decisions even harder. But your father already made these decisions. He prepared a living will that states his choice not to be kept alive through artificial means. In my opinion, that is your answer, as hard as it is to accept.
Hospice has changed and isn't an indicator that a patient is about to die. They will make sure your father is clean and comfortable. And they will be available to help you as well. Hospice staff know very well the stress and second-guessing a family member goes through when they finally decide to bring them on board. They can help you.
In your post you mentioned your father has LBD and Parkinson's. He has been failing for a while. And on some level he seems to know that.
You said you did not want to regret your decision down the road. Remember, it was HIS decision, not yours. As a loving daughter you have taken the actions HE wanted. There is nothing here to regret.
Best of luck to you.
Isthisrealyreal Jan 2022
Exactly. He knew what was coming with his diagnosis and made his decisions so nobody else had too.
Countrymouse Jan 2022
6'2" and 125 lbs gives him a BMI of 16, which is severely underweight, and that was before he was hospitalised. The OP also states that her father has been having difficulties with swallowing for a long time, prior to the fall; plus he's celiac, which creates problems with absorbing nutrients; plus there are the Parkinson's and the LBD to take into account, both of which could be responsible for problems with appetite, swallowing and just mechanically being able to eat. Poor man.

Her issue is whether to consent to artificial feeding on his behalf. Her father has given directions that he is not to be kept alive by artificial means; but before she therefore rules it out she should also ask whether artificial nutrition in the short-term, with a view to reversing a PEG in due course (which certainly can be done), could reasonably be expected to deliver a major and potentially lasting improvement in his physical condition and his quality of life. If so, this becomes not about "keeping him alive," but about offering him appropriate treatment.

So I'd ask. If the chances aren't good enough she can still decide against it.
RedVanAnnie Jan 2022
Were you a nurse or in the medicalfield? You have some helpful ideas.
Tina2010 Jan 2022
I am sorry for what you're going through. My FIL was in Hospice for 3 months. He just passed away 3 hours ago. The key with Hospice is finding the " right one" just like you would a physician specialist. Interview them. Your dad is required to meet certain criteria or Medicare won't pay. He has to continue to decline. To meet Medicare criteria.

" You" have to be in the place of working with Hospice every step of the way. "Refusal to eat" can be normal in certain circumstances. But your Hospice nurses and Medical Doctor should be communicating expectations to you.

My FIL had no feeding tube at any point. I fed him by syringes. Then he refused all intake the last 5 days of his life. Per his wishes. His wishes were " pallative and then comfort care".

I feel completing " unfinished business".... telling him it's okay to go home was important. That his son, my husband, will love and take care of mom and he need not worry about her. His wife released him to go home. He passed away 7 hours later.

Our goal was to ensure he was comfortable. The last 2 years he was miserable.

swanalaka Jan 2022
Another thought for anyone reading this...
When preparing a living will it is important to really have a deep conversation. If someone says they don't want artificial means to sustain their life, ask how they feel about those means on a temporary basis. If there is a decent chance for recovery, a temporary feeding tube or ventilator or other method may be acceptable to them. It's an important discussion to have. And a tough one.
Sadly, Salass, from your post it doesn't appear your father has a decent chance of recovery. Follow his wishes and don't have regrets. You are a wonderful daughter!

Crazysue Jan 2022
It sounds like Hospice is the right choice for your Father. They will help you understand the dying process and keep him as comfortable as possible. You are definitely doing all the right things for him. Prayers and love coming your way.

Llamalover47 Jan 2022
salass34: I am so terribly sorry to read your update about your father's passing. Deepest condolences sent to you, dear salass. As you go through the grieving process, take care of yourself. Love ad hugs.
Love,
Llamalover47

Isthisrealyreal Jan 2022
Salass, I am so sorry that you are losing your dad so young. It is never easy to experience this loss.

God bless him for making his wishes known and taking all of that burden off of you. That is one of the greatest gifts we can give to our loved ones. He did well, be sure and tell him.

May The Lord give you strength, peace and comfort during this difficult time. May HE help your dad pass peacefully and be with him.

He is very blessed to have a daughter that is willing to honor his desires for his end of life. God bless you!

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