I need advice about poorly Dad

[mears]

Never mind all the pish about breastfeeding on mumsnet just now - I need support about my poor Dad.

He is 87 years old, has Alzheimers and has an ongoing respiratory problem thatmeans he is nebulized 4 times a day.

He developed a probable chest infection last week (mainly in his throat) for which he has had 2 differnt antibiotics. The antibiotic he is on just now he reactyed to badly in the past - developed thrush and felt very depressed. He has been put on this again by a new GP to the practice and has been on it 5 days with no improvement. Gp was out yesterday and started him on steroids but actually wanted to admit him for oxygen - he is breathless on exertion.

I would like the antibiotic changed to one he usually responds to and would like to avoid admission. He gets very upset and disorientated in hospital. Last time he was in he has a urine infection so was in a lot of pain.

My main worry is that perhaps he is not going to recover from this infection and would be better staying at home. However, is that the wrong assumption to make? How do I know that?

Unfortunately I am sick myself at the moment with some sort of virus but I need to go over there and speak to the doctor who is coming out.

If he has to be admitted then I want him admitted straight to a ward. Last time he spent 4 hours on a trolley in A&E and I am not having it.

Unfortunately I am feeling like sh*T and will have difficulty keeping a cool head. I just feel a huge fight coming on...

[jangly]

Could you phone his doctor and ask for the antibiotic you know worked for him before to be tried again. Say you want to avoid hospital admission if at all possible.

[noddyholder]

If he is not responding he may need IV antibiotics which do work v fast but obviously that means a hospital stay.

[RTKangaMummy]

Oh dear

Sorry to hear about your dad

Is there anyone who can help him at home until you are feeling better?

Do you have any other family?

Hope he won't be put in A&E



4 hours on trolley

[jangly]

I mean, catch the doctor at the surgery before he leaves out. You might be able to deal with it more calmly on the phone.

[anorak]

It's so difficult, isn't it? My lovely 81 -year old next door neighbour died a few weeks ago. He was fighting cancer but actually died of an acute respiratory infection. His wife and daughter were horrified because the doctor who told them there was no hope for the cancer 10 days before he died was streaming with cold when she sat right up close to him and told him. They have complained.

Yet being at home could mean he doesn't have the immediate attention and specialist equipment he might need. Can he have oxygen brought to the house? Problem your being ill at the moment as I guess you will be loathe to nurse him yourself.

I guess all you can do is weigh up the pros and cons - standard of your hospital - availability of care at home - risk of infection - etc, and then make the decision that seems right to you at the time. I don't envy you, it's a rotten call to have to make.

[mears]

He probably does need IV antibiotics. Mum spoke to GP this morning saying what I had said (he knows me well )

He reckons Dad needs to be in.

My concern is that perhaps he is dying and we should leave him in peace? Such a dilemma. He hates hospital so much

[mears]

I am the only daughter close by. I realise he should get specialist care if there is any chance of improving. However, I don't want him to die in hospital if that is a possibility
Just need to say it to someone really...

[Clayhead]

Do you have Hospital at Home in your area?

My uncle had this last year and it really was wonderful - allowed him to stay at home (what he really wanted) but have excellent care.

It is for the terminally ill though, not sure if that's your situation.

[Smurfgirl]

I know a lot of people in your position make the choice not to have their parents admitted to hospital, hmm, it is difficult watching them getting worse, knowing that you could be doing something, but they seem to be a peace and most of the time the family has made the right choice.

Have you disucssed with his GP (or does he have a DN) about him not getting treatment? How advanced is your dad's Alzimers?

If he needs admitting the GP should do it straight to the ward...most of our residents when admitted go straight to the AAU.

[jangly]

If, apart fromn this chest infection, he is generally well and active, then perhaps a short hospital stay, for treatment, would probably get him back on his feet again. People go well into their nineties these days. I would say take the best care the doctor offers to get him right again.

[jangly]

Sorry, forgot about the ongoing problems. It is really difficult.

[mears]

I have phoned my sister who lives about 20 mins away and thankfully she is on a day off. She is an ITU nurse. She is coming down.
If he needs to go in then fair enough, but there is no way he is going through A&E as per policy.

My poor dad is not in good health and does not enjoy life at all. His Alzheimers is progressing but he gets upset because he is aware of the fact.

I am going to freshen up and go over but I won't accompany him to hospital.
Will update you when I get back.

[cazzybabs]

mears you offer so much support here i just wanted to let you know I am thinking about you and your family. There is never easy answers to life!

[tortoiseshell]

Sorry to hear this mears.

[Marina]

Do please update us. I'll be thinking of you. My parents (80 and 76) are in the process of moving back to London to be closer to my dsis and me for precisely this sort of future scenario - they are over 300 miles away at present and we miss them, but also worry about neither of them having an advocate on the spot should anything serious happen to them - it's bound to sometime.
Mears, hope you feel better soon too.

[RTKangaMummy]

Glad your sister is going to help and is able to got there

[noddyholder]

would it be possible to ask the doctors to let you know if the iv drugs are working or not and then you can decide to bring him home where he is happier.If the hospital cannot do anything to improve his condition then I agree he is better off at home

[Tiggiwinkle]

I do sympathise with you mears. My own Dad died at the age of 82 (almost 3 years ago now) after suffering from COAD for several years.
He went downhill after suffering a slight stroke-developed a chest infection and then had fluid on his lungs for which the GP prescribed diuretics, without proper monitoring. He then lost his mobility-I am sure as a result of potassium deficiency from the diuretics-and only then did they admit him to hospital. He died a few days later from heart failure-but I wish he had been admitted at the start of the infection and have always wondered if he would have had a better chance...
But we never know what to do for the best in these circumstances do we?
Just follow your instincts is the best advice I can give, I suppose.

[yoyo]

Mears - so sorry to hear about your Dad. We have a similar problem with DH's father who has dementia as a result of brain atrophy following removal of a tumour 5 years ago. He has been hospitalised several times over the last year with infections (generally chest, once pneumonia and the last one was a severe UTI). Every time we get that phone call we think "this might be it" and although it is awful to admit it we have thought it might be for the best. My MIL would always want him admitted as he is so difficult to manage (she has cancer which complicates things even more). He is dreadful in hospital and begs to go home - my MIL sits with him all day because he can be so hurtful if she doesn't. He weighs 7 st so is exceptionally weak. It is so very difficult when these situations arise but I do not think there is an easy answer. Will your Dad stay at home however the Alzheimer's progresses? Sorry this is rambling - my DS is very demanding today and I'm finding it hard to concentrate. I just wanted you to know that I understand how you are feeling. I do hope he is treated quickly if admitted.

[WideWebWitch]

No advice but thinking of you mears.

[Tissy]

mears, your GP could request a domiciliary visit from the geriatrician involved- that might avoid the need for a hospital admission.

As for the 4 hours on a trolley thing- dreadful I know, but both acute hospitals in the area are in the middle of a bed crisis at the moment, so may be unavoidable. If he really does need to be in hospital, then it would certainly speed things up if you or your sister were with him (in uniform ) when he arrives. Make it clear to whoever will listen that he needs to be in a bed soon. They'll probably hurry it up just to shut you up !!

Hope things get better for all of you

[mears]

Well I am back and dad is still at home

He isn't as bad as I expected but the GP did want to admit him. She admitted herself that as she only met him yesterday (his own GP is on holiday), she doesn't have a lot to go on.
She has reluctantly changed his antibiotic to Augmentin which he usually responds to. He is on a nebulizer called combivent (2 combined drugs) and last time he was admitted it was changed to separate to individual nebulizers of the 2 ingredients, so we have done that. GP will review tomorrow and says if he deteriorates he will need to be admitted against our wishes. Dad said 'no bloody way am I going to hospital'.
I feel reassured after seeing him that
a) he is not dying and
b) he does not need admitted yet.

My sister is going to help mum today and tomorrow as I don't want to be around too much till I feel better.

I am glad you saw this Tissy because should he need to be admitted there will be one almighty rammy if he is not fast tracked through A&E .

[jangly]

Sounds like you did well, Mears. Hope things go on ok.

[suedonim]

Glad the news is positive, Mears. When my dad went into hospital he was put into a sort of assessment ward. It was horrible, so noisy and no one trained in geriatric care. But the geriatric ward was fantastic, couldn't fault them. I hope your dad gets well soon.