Recovering from pneumonia

[premier]

My dad had a very severe bout of pneumonia about 6 weeks ago and the time we thought we’d lose him. He’s 80 and also has heart issues and Parkinson’s. He was reasonably mobile before this, was able to get about at home and he had the energy to go out once or twice a week. He was in hospital for 3 weeks and when he got home he was ok but then after 10 days just went downhill again. He got another infection (he refused hospital) and since then has been in bed. He’s nearly finished another round of antibiotics. He has carers 4 times a day and alas I’m not local (about 50 miles away) so I’m going back and forth every 2 days just to keep an eye on him.

He was referred to the frailty team over the weekend so also has nurses going in (which was an extra later of reassurance). I saw him yesterday and he seemed a little improved. He was at least sitting up but was still in bed. I helped him get dressed and he was just so skinny (presumably muscle loss) and even though he’s drinking and eating ok, he’s very much diminished. I suppose he might bounce back from this but it’s hard to tell! The GP has been ok and been out to see him twice. His bloods and sats are ok, he’s just completely wiped out and wants to sleep a lot of the time.

Just wondering, is there anything else I need to ask for from his GP? Maybe OT support or something else? I wish I was closer so I could pop in every day but I can’t. I’m happy he’s getting good care though. He’s state funded (no private funds) but I’m wondering if there’s anything else I need to be asking for to ensure he’s getting everything he needs?

Does he have a blue badge for parking and is he claiming attendance allowance?

My neighbour in her 50’s had pneumonia, it also knocked her out for months. I would say it was 6 months before she was fully recovered. You can apply online for Attendance Allowance, it’s not related to how much money you have, so definitely do that to help pay for some of the carers fees.

Yes, we have a blue badge (he doesn’t drive any more but I use it to ferry him around when he’s well) and he has Attendance Allowance. Most of the house stuff is sorted - he has a cleaner and a service who does the washing and ironing. I do his medications (pharmacy doesn’t do blister packs) and I have LPA should he become totally incapacitated.

I guess I’m wondering what more I can do to help build up his strength? He’s mentally quite resilient but I don’t like seeing him all tiny and skinny (he was previously a very well built man). Should I ask for a community OT or physio? Not even sure if that’s a thing.

Do you have an elderly care dept of the council - ours is called “homecare and reenablement” or “access 1st” where you can ask for an assessment or request OT and community physio?

it’s hard @premier I’m in a really really similar situation right now. Big hug x

Wonder if I’d be able to get that via Adult Social Services. My experience with them so far on other issues is that they just keep passing me round in a loop to different departments but I’ll give them a call and see what they say.

@premier might it be worth a quick call also to the hospital ward he was in? Say you’re struggling with follow up and do they have a number for elderly services you can have? If they arranged a homecare package for him pre discharge that dept could be a good place to start xx

My relative spent 3 months in bed in similar circumstances. As PP said it is a very long recovery when elderly. When he felt well enough to get up, had lost mobility. Physio would have probably helped but we don’t have opportunities to visit daily and get it done and his motivation to move was low.

It's a long recovery and it's unlikely he'll get back to where he was before.

How's his nutrition? Is he getting enough calories? We used calorie dense nutrition for my mother, and now my father. Put full fat milk powder in everything, Nestle do one called Nido, available in Tesco. GP can prescribe fortified drinks and puddings.

Watch out for skin breakdown if he's in bed a lot. Does he have an airflo mattress topper?

The problem is that one incident at this age usually unleashes a catastrophic cascade of other issues.

Sorry to be negative but this has been my experience with my parents and relatives. It's mentally and physically exhausting. Please remember to look after yourself too.

Thanks all! Yes I’m realistic about him returning to previous level of health but I’d certainly like to see him back up on his feet.

When I visited yesterday, I changed the bed
and did it with him perched on the side of the bed. Every time I wanted to move the sheet, I asked him to stand up using his walker - it was my little way of getting him to move a bit. He was wiped out afterwards but at least I got him stretching and moving a bit. I’ve just spoken to him this morning and he’s sounding a little stronger. The carer was able to get him to the shower which is an improvement on this time last week.

As for calories, that’s a good point. He’s used skimmed milk all his life (advice he was given years ago after a heart attack) but I recently switched him to semi skimmed. I might push that to full fat as even those extra calories in a few cups of tea are probably going to help. He also likes some of the Complan shakes.

Try sitting him up in a chair rather than lying in bed all the time. Better for breathing and respiration. Also easier for intake of drinks(flask of tea)and snacks. Air cushion.

In our area we have a reablement service for 6 weeks where the carers encourage the person to do as much as they can for themselves, rather then just coming in to do that task for the person, it also has physios, Ot’s, dietitians etc so the person is rehabbed from all angles if that makes sense.

It can be accessed via the GP for people who are already at home. Might be worth looking if his area has anything similar?

Alas, his bedroom isn’t big enough to accommodate an armchair so I bought him a big u-shaped cushion to get him sitting up in bed. He has a through-floor lift which goes from bedroom to living room but he still feels too fatigued to go downstairs. I’m working on encouraging him to do little things every day, starting with sitting up in bed for longer periods.

The Airflow mattress topper is a good shout too! When I helped him change yesterday I did check for an areas of broken skin and I’ll ask the carers to keep an eye on it too.

Can you move his bed into a bigger room where he has space to sit out, perhaps a kettle and toaster so that he can start to do bits for himself? I’ve heard it called a ‘micro- environment’ for a friends’ dm who was in a similar predicament. They used the dining room as it was big enough for the bed, chair and other bits that she could build up to using.