How do you care for an elderly person who is dying?

Well, if he has a good appetite and is still moving around and going to the bathroom, I would hesitate to say that he is “dying.”
His time may be growing near, but I don’t think you’re necessarily at the doorstep. Have you asked him why he doesn’t want to go to another medical center? Is it the travel time? Does he not want to be bothered with further testing that may prove to be useless?
What exactly is making him feel terrible? Does he have pain? Is he gaining/losing weight? What does his GP suggest?

Is he ready to allow you to call hospice? They were really helpful when my mom was dieing.

@ANef_is_Enuf his gp is suggesting the same meds and routine, which he is getting. My father feels the gp doens’t know his business and isn’t helping. He says he cannot stand the drive, which I don’t understand because he would be seated which he is now. I cannot tell what is making him feel terrible. He is getting his meds, exactly as prescribed, he can liken his illness to a ‘hangover, 100 time plus’. I don’t know what to do. He doesn’t want me to call the country doctor that has been treating him. He doesn’t have a specific pain- just a general ‘terrible feeling’ and will not get up or change or shower except to go to the toilet

ps and he sleeps all the time and I must wake him for meals and meds, on occasion he gets up himself and goes to the toilet, just behing him, with his walking frame

If he feels like he’s going to throw up, I can understand why he doesn’t want to drive. :-(

My suggestion would be, try to make him as comfortable as possible, and let him live his life on his terms as much as possible. He has lived a long life. Help him to make his departure graceful.

You might be able to get a hospice nurse to drop by now and then.

You should consider talking to his GP about depression.
Hospice would be nice, but most places require a diagnosis with a prognosis that will cause end of life within a certain time frame. However, you can look into services in which a health aide or a nurse can stop by the house every once in a while.

Also, see if you can get him to tell you stories about his childhood. You will wish you had if you don’t. I know you don’t know him well, but this is your chance.

he is on an antidepressant- how do I find out about hospice? he isn’t specifying why he will not make a short two hour drive but for the winding roads- he is telling me about his life- he seems so uncomfortable it is sort of scaring me
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@ANef_is_Enuf Many of the hospice will now come to the home and if need be will send their staff doctor to make the diagnosis. One of our local home hospice is owned and run by doctors now.

@trailsillustrated Hospice is the way to go. If you can convince him. All you need to do is call a home hospice provider and they will answer any questions or concerns you may have.

how do I find that? google it? is that what it’s called? thankyou so much @SpatzieLover

Yes. Here in Wis, ours is literally called “Home Hospice”...My guess would be you’d have something similar where you reside.

If you need assistance, you can also call your local Health & Human Services office. They’ll put you in touch with a social worker for your dad, and will literally walk you through the entire process and help you to complete any forms.

We’ve had to care for all of my elderly relatives. Calling hospice has become old hand for me at this point.

lurve to you @SpatzieLover , tis not the first time you have aided me. thanks again )

@trailsillustrated I wish you and your dad a peaceful last journey together. Hospice has a way of removing the stress and the pain while allowing dignity to remain.

Please keep us updated.

@SpatzieLover i am really scared. he is on 02 and some sort of medication there. I am terrified that he is going to die. I don’t know what to do. It seems close. This it out in the middle of nowhere, paramedics have come here countless times.

@SpatzieLover that may depend on the company, so you are probably right. However, many will not be covered under insurance or even offer their services without a prognosis that suits their policy. I worked in hospice for years, and locally they all carry a policy about the condition of the patient.

In that event, you can still find services in which a health aide or nurse will come to the home. Either way, having professional help may give you some peace of mind in knowing that you are not alone in keeping an eye on your father and his health.

Medicare covers Hospice services.

@SpatzieLover I have an oxygen dosimeter and a blood pressure cuff here. I’m going to hook up both- I am by myself, this is a really small community in the back of beyond. I’m going to start calling now- thanks again

Have you gotten a second opinion? That is what I would do is he does not like or trust his doctor.

Are you in the United States? I was thinking you are out of the country. If so I don’t know that they would have hospice.
I was in your position earlier this year and it is a very hard job to take care of your loved one by yourself. It will take a toll on you as well. What we did was to hire 2 women to come in and help during the day to take the pressure off of us. They came in the morning to get my mom up feed her, give her the medications, do a few minor exercises with her, such as twirling her ankles, lifting her legs from her chair to help with circulation. Can you afford, or your dad afford to find someone to help if you can’t get hospice?

We all die and at 88 death is more imminent. I am 66 and it is inevitable that I sometimes think about illness and death. To me the most important thing is that I don’t want to die in a hospital. I want to die at home in my own bed, or perhaps doing white water rafting, but no way in a scary stark sterile hospital.

I would say be there, be patient and be empathetic. My dad died at 87, at home, in his bed, with his dog and us beside him. We kept him there when many said put him in the hospital. He was old school, did not like and was fearful of doctors and hospitals. It wasn’t easy to watch and I admit I am not the nurse type but thankfully I have a wonderful nephew and his wife who were in a position to move in and take over. If you personally can’t deal with nursing then find someone who can. But if it were me, I would not want to be forced to seek medical advice, maybe I just figure it is time to go.

Good luck, I know it’s not an easy thing.

In most US states, in order to be eligible for hospice, the doctor must determine that whatever is wrong with the person will likely result in their death within about 6 months. Most hospitals have hospice and often your county public health department will be able to tell you what is available to you locally.

As for the paramedics, if your Dad feels like his end time is imminent, he would be advised to sign a “Do Not Resuscitate” order or a DNR. If you have such an order, then the paramedics are called typically AFTER the dying event. If he still wants to be taken to the hospital in the event of progressing illness, then a DNR is NOT the way to go.

Depression is not uncommon in seniors (as mentioned above), but your Dad may or may not want to take medication if he doesn’t feel like he has a problem.

It might help you to ask really concrete questions. For example, when he says he feels like he has a super hangover, ask him, “Do you feel dizzy?” Or does that mean you feel nauseous? etc. The concrete, yes or no type question, can help you discover what he is not articulating in a way that you understand it.

By the way, if you are in pain, sitting in a moving, jolting car is very different from sitting in a chair at home. Ask him if the ride to the doctor is painful and then have him rate it on a scale of 1 (little pain) to 10 (a lot of pain). Or if it is that being away from home is scary. The concrete question thing can’t be under-rated for helping you better understand him.

I’m no medical practicioner, other than having been a medic for awhile in the Army, but if I were you, I’d call the doctor and suggest that your father might have a vitamin deficiency. At least those symptoms in older people have sometimes been due to that. Get his doctor to recommend either a good multivitamin, or perhaps a combination of “C” and B12, perhaps in megadoses.

UTI’s are also the number one cause of falls in the elderly.

Ask your doctor to prescribe a social worker for you. This is not the same as the social workers from the government, these people are specially trained to work with the senior population. My father went to a doctor who specialized in the elderly, and they had a social worker on staff especially to help with problems like these. I had a social worker talk to me about my dad over the phone, and I also had one come to the house once. Your doctor actually has to prescribe one.

@snowberry No presciption needed. We had to get one for my Great Aunt. HHS has them ready and willing. She drove out the same day we called.

If you can afford it, consult with a Senior Care Manager
Even if you just pay for an hour or two of their time, they can direct you to local resources you might not know exist. They really helped my daughter when my mother in law was dieing.

thanks for all the help and great suggestions. I am acting on them today- he has an apppointment with his doctor tomorrow- we are loathe to hire caretakers because in the past they have stolen from him. I’m just going to power on and try to get into an assisted living place. thanks again

@trailsillustrated Even if he gets into assisted living, depending on your state laws, Hospice care overrides their care. If he is deemed “actively passing” while you have him in the home, you can hire Hospice to care for him (medicare covers all or most of this).

Good luck with the appointment.

Here’s the deal regarding assisted living centers and nursing homes. Unless he is willing to move to such a place (and if he has the money to pay for it), you have to wait until he ends up in the hospital. Then you can tell the doctor the situation at home and that you can no longer take care of him properly. When he is discharged from the hospital he can be involuntarily moved into a facility. Otherwise, you are on your own.

Does he have money to cover the costs of an assisted living center or nursing home? It’s quite a bit higher than you might think. If he can’t afford it, all his assets will have to be liquidated before or at the time of the move. Ask your assisted living facility for the details regarding this, because they may vary from state to state.

This is precisely why I have my bottle of nembutal ready. I will not go to an assisted living or nursing home. I will die in my own home, my way, my time. I will not be shuttled off to make it easier for someone else. I will die first.

@rooeytoo easier for someone else. please know that this is someone my mother met during the war, who had a family at 19 years old and abandoned them all. I am not trying to make it easier for anyone. It is out of the question to expect now 50 something year old children whom he has had little to do with to drop everything and come to a far away place and try to manage a household, grounds, and medication with no training and little experience. I am trying to help my father, expect nothing, and think he would be better served in a community around people his own age, whom might share his interests, and staff whom might have some training regarding somewhat demented and disabled, fragile, elderly people. I , too , hope to never be in the position to require such, but it can happen. ps I have had exchanges with you before, and thought you very reasonable, intelligent, and grounded before this insensitive, selfish remark

@trailsillustrated – I am not trying to be hurtful, insensitive or selfish. I am simply stating the truth of how I feel. I do not ever want anyone putting me in a home because they feel it is the best place for me. I would take my own life first, end of story.

That is how I feel. I don’t know how your father feels but if he is 88 and lived on his own all of his life, he might be feeling similarly.

And I am sure you have the best intentions, I did not mean anything other than that. I just happen to be closer to your father’s age and feel empathic towards him.

@rooeytoo , I just wonder where in australia you expect to get nembutal. Thanyou for your views as a middle aged,probably childless, yank woman in a small town. I think I answer for my whole family by saying with all due respect PO.

ps. this isn’t about you. it isn’t me asking people what they will do in old age. It’s me asking about my direct situation such as being in a very remote area caring for a fragile, elderly person , far away, with no training and no real knowledge. We all have ideas, how we want to age, how we want to go, but that was not my question. Nobody asked you for your exalted opinion on how you, specifically, want to leave this life. That’s not what I was asking.

Wow, I thought I apologized above and I truly thought that how I feel might help you to understand why your father does not want to go to a medical center. I thought fluther was a place for opinions and feelings.

So again I apologize, I did not mean to add to your burden. I will take my exalted opinion and leave your question.

By the way, google nembutal, it is readily available anywhere in the world, or from your local veterinarian, or Dr. Death.

he he. thanks, @rooeytoo , no hardies. really. bout the nembutal? for my own self!!

Now, now, children. Play nice! Heh!

@trailsillustrated

You may have to take him to the doctor against his wishes. : (

Note: This started out as a private communication between @trailsillustrated and myself, but my note to her got too long and I think this information could be of use to others, so here it is.

I understand that Doc wants him in a “carefully chosen” assisted living center, but did the guy mention what the parameters are? If he didn’t specify, you will be shopping in the dark. And before you sign him up, check with the governmental agencies that oversee them. Unless the facility is brand new, it’s important to understand that every such facility will have some problems. You will want to eliminate all the ones that have the most judgements and/or investigations.

When shopping for an assisted living center, it quickly becomes a case of “you don’t know what you don’t know”. I’d look at the quality of the food. I used to work in an assisted living center, and one of the perks of the job was that they fed us, but they skimped on quality. Some of the food was overdone and was too hard for me to chew, let alone an old person! They used cheap cooking oils, and after a while I noticed that it hurt to kneel down and stand up again. I stopped eating there and I felt much better.

For a short time I put my father in an assisted living center/nursing home/rehab place that had him roomed with another guy. From the first day Dad complained that his roommate was too loud and yelled a lot, but because the guy never yelled when I was there, so I didn’t believe my dad. Turns out the man yelled all night long and much of the day and as a result Dad didn’t get any sleep. When I found out, I made them move him. I was afraid of making too much of a stink because of the possibility of reprisal, so I did not report the facility. Looking back I wish I had.

I worked in another assisted living center where the people who cleaned the rooms and the dining tables did not do the job properly. Instead of spraying the rag, they’d spray the area they were cleaning with a sanitizing cleaner. The result was that when they cleaned the bathroom sinks, sanitizing cleaner hit toothbrushes sitting close by. In the dining room, instead of removing all unused plates and silverware, they left them on the table and sprayed the area where someone had just eaten. Some of that spray hit nearby drinking glasses and plates. Of course the sanitizer was clear and it dried before those items would be used again, so nobody ever knew or cared.

When shopping for a facility for your dad, if you ask intelligent questions regarding these sorts of things, perhaps you can avoid problems such as I have encountered.

@snowberry

I HATE the idea of ever going into a home! I told my children that if they ever tried that with me, I’d kill myself.

@CaptainHarley Yeah, I didn’t want to do that to my father! He bought the house and we all moved in together. I intended to take care of him to his dying breath. But he started thinking (and insisting) that I was stealing from him. In this litigious society there are so many attorneys just waiting to hear a senior say that their kids are stealing from them, and I just could not risk being sued because of some shark taking advantage of me and my father that way. It’s really sad.

@snowberry

Agreed. I realize that some older people become very difficult, whether due to vitamin deficiency, Alzheimerz, or other health issues. So far, I have no indications of tending that way, thank God! I take vitamin B12, C, and others, and try to keep active and have a healthy diet. Other than that, there’s not much more one can do. I definitely do NOT want to become a burden to my children! Since my wife is a nurse, I’m hoping that she will be able to manage me later on. She avers that she wants to, should it come to that. I tend to believe her.

@CaptainHarley – you have repeated what I said above, ie that I would use the nembutal. At that point you interjected with the gratuitous, belittling remark ”.. Children, play nice.”

I assumed my idea of suicide was against your religious principles thus you made light of the exchange. Now it is evident that is not the reason, so the question is, why would you interrupt a serious discussion with such a trite remark?

well, he’s not a bad old guy, and not completely gone leave of his senses. Our problem is that he has a rather large, rural estate and the care we have gotten in the past has stolen from him, or stocked their own larder on his account, or stolen his pain medicine, on and on. He married his last caregiver, whom we found out had a criminal record for the very same type of folly. I can’t stay out here forever. I have my own life and issues as do my sisters. We are just tyring to get to a place that we can manage without a very long trip and stay over. Thankyou all for your input and opinions. Again, this isn’t a question about end of life. It’s more of a question about how do cope with elderly parents. @snowberry thankyou very much for your insight

t

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