Stroke in a 93yr old

[thereinmadnesslies]

FIL is 93. Yesterday he was v confused - regressing to childhood, sleepy and not himself. He'd recently been treated in hospital for a UTI and MIL thought that it had returned so she called an ambulance. They found that his resting heart rate was 40, so they took him into hospital. Whilst in A&E he had a stroke - obvious sypmptoms of face dropping on one side and couldn't raise arms.

When MIL and BIL left the hospital last night he was still being treated, so totally out of it. He's survived the night, but MIL got no further info when she called and visiting time is not til 3

What should we expect from here? Given his age, will they treat him or is this the end of the road? How quickly do they judge the severity of the stroke. What questions should we be asking?

Hiya. In terms of treatment. This will depend on the type of stroke it has been. Stroke can be caused by a clot or a bleed in the brain. A scan of his head should have been done so they know weather to give asprin or not.
In terms of this situation, it sounds like there may be more to it than just a stroke. A slow heart rate may have been the triggering factor and so they need to test for heart attack, and look at the drugs he is taking to see if they can cause slow heart rate.
The things that have the biggest effect in survival at this stage is making sure he is hydrated and fed any infection aggressively treated and his blood sugars and oxygen levels monitored carefully and corrected quickly.
With regards to severity. The worst type of stroke is the one that causes a dense weakness with vision and speech problems. At his age his recovery from this will be quite limited.
Strokes affecting part of the body and the face are less severe and he could recover well from them.
It sounds like he has a lot of problems that have contributed to the stroke.
Here if you need any more help or want to ask any more questions

Thanks mcqueasy, it's useful to know that a scan should have been done. I worry that it's the weekend and so things might not happen.

He has a pacemaker fitted, so it seems odd that his heart rate was so low. But the ambulance crew didn't think there was evidence of a heart attack.

I know 93 is a good age. I just want him to be cared for in the best way possible.

Heart attack cant always be seen on a heart tracing, he needs a blood test called a troponin t.
He should also have an urgent pacemaker check and be kept on continual cardiac monitoring till his heart rate settles and his pacemaker is found to be working.
AS for CT scans, it is the national standard that all potential strokes should have them performed on admission or within 24 hours (regardless of it being the weekend.) he definitely should have had it done
HTH

Thanks McQ, I really appreciate your advise.

Just had a text from DH saying its not good. I've read online that about one third of stroke sufferers die, one third survive with impairment of some sort and the remaining third recover BUT that outcomes in the over 90s are generally poor.

I guess I'll know more soon, googling is never particularly useful in these circs

Sorry to hear things aren't going soo well.
Those statistics aren't particularly helpful.
Stroke does not normally lead to death, it's the complications -infection, dehydration, malnutrition, immobility that do.
It sounds like he has a lot of medical problems just now.
Thoughts and prayers with you and your family x

DH is back. FIL is paralysed down on side, lost speech and he can't swallow. The CT scan showed extensive damage. DH has only spoken to a nurse but she was suggesting that there is little they can do - he won't tolerate a NG tube and can't swallow so they can't give as much meds/food replacement as they'd like. She also said that they expect another stroke or heart attack, but if that happens resus option are limited due to his general condition and the pacemaker (?!?) MIL is coping amazingly. DH said his goodbyes, we think there will be a phone call over the next few days

Unfortunately that type of dense stroke does carry poor chance of survival in someone of your fil age.
He should be getting aspirin per rectum (via the bottom) and this will help prevent further stroke.
A pacemaker does not stop someone being resuscitated however perhaps what she means is that should he get to the stage that his heart stops there would be very little they could do to start it again.
He may rally and settle, but the next 24 hours are crucial.
If he is getting asprin, fluids and close monitoring the only other thing to ask for is a to make sure he has some pain relief and anti anxiety meds prescribed.
Sorry it's not better news x

therein My thoughts are with you and your family.
This is all too familiar to me. My Mum had a stroke four years ago at this time of year. She was only 69. She didnt make it.
It seems a bit callous to say but try not to focus on what may happen but remember all the good times and what a wonderful long life he has had if the worst happens. I'm sure he wouldnt want it to ruin your xmas plans though it will be damn near impossible for it not to. If you have dc then focus on them and remember there is very little you can do, he is in the best place on the planet and will be getting the best possible care. The NHS were amazing with my mum.
((((((((hugs)))))))))