My Dad.

[Addie]

aren't dogs remarkable, tho? i wonder if they know how wonderfully therapeutic they are for us humans at times....

I think they do. That is why they pine for their owners when they are taken away. They think they are the only ones who can cure them.

 

[LPBeier]

Well, we didn't take the dogs up on the weekend as Dad has taken another turn. He is sleeping a lot and when he is awake he is very demanding and needy.

He called me at 6:30 last night because he didn't have any Kleenex. I said I would pop by (15 minutes away) but would just park in the 15 minute parking lot, bring it up and kiss him goodnight. When I got there two aides were trying to make him comfortable and he rudely dismissed them saying his daughter was here. I ended up staying for 45 minutes listening to him complain about everything and when I said I really had to go he just said "Fine, then go". He wouldn't let me kiss him and as soon as I made two steps toward the door he pushed his buzzer. I am told these mood swings are normal and I am trying to take it in stride but it is so hard to see him like this.

He is eating and drinking less and so we have a call into the care coordinator and doctor about having him assessed for hospice. We still have the outside worker coming up 7am to 1 pm and that is helping take pressure off the unit staff and us.

 

[DaveSoMD]

They are going to check all his meds aren't they? These mood swings might be an interaction between meds or they might be being magnified by them. Like Rx steroids really really can have a effect on a person's mood and cause mood swings and anger.

Just a thought....

 

[LPBeier]

It's a good thought Dave. Thanks my friend.

They are monitoring the meds on a regular basis. The Hydromorph may affect his moods, but is the only thing that is keeping his pain levels down. They have a PRN of Ativan but they don't give it to him soon enough and he is totally convinced it doesn't work (part of the mood swings). They were going to talk to the doctor about changing that to an injectable as he has a butterfly port in his arm already for the hydromorph.

I just got a call from our worker as she is now off duty and he is very calm and sleeping so far today. She told him I would be there at 4 and he said that was good.

 

[DaveSoMD]

That's some strong stiff (Hydromorph). Giving the other in liquid form would help it take effect faster. Let's hope they get that worked out. At least he is resting for the moment and getting some sleep.

 

[LPBeier]

Yes, hydromorph is strong stuff. Two friends of mine that were "being kept comfortable" were given it at the end of their battles with cancer.

We are still awaiting the results on all the tests they insisted they do. The chest and stomach xrays have not been done but I don't see a point because he would have to be taken across the street to the hospital for these and the trip, whether by wheelchair or ambulance would not be easy on him.

 

[DaveSoMD]

Did they want the xrays because they suspect something or trying to rule things out?

 

[LPBeier]

They want a chest xray to see how his COPD is - whether it is progressing or staying the same. I think they also want to make sure he isn't aspirating anything into his lungs.

They want a stomach x-ray to find out why he is having so much pain there. We have known for a year that he has prostrate cancer but because of his age, the early stage it was in and his other health issues, they didn't want to treat it and he agreed. Now they just want to make sure it hasn't spread to the stomach and/or other areas.

They have said all the tests are just to see what is going on and whether treatment will help or delay the inevitable.

 

[PrincessFiona60]

They need to work on getting him the Ativan sooner, by the time he is anxious it's almost a little too late. He should be able to have 0.5 - 1 mg about every three hours without it snowing him.

 

[LPBeier]

They need to work on getting him the Ativan sooner, by the time he is anxious it's almost a little too late. He should be able to have 0.5 - 1 mg about every three hours without it snowing him.

Thanks, PF, that's how I feel, and it is good to know I am right.

I want to thank EVERYONE for letting be blab on about all this and for your encouragement, help and support. With family and staff I have to be the strong one who looks after everything but inside I sometimes just need to get it all out - my questions, fears, frustrations. Hope I don't bore anyone. I just need a place to let it all out.

 

[PrincessFiona60]

Heh! His doctor would be tired of me by now...I've done End-of-Life care for 12 years now, I'm still the expert in our facility and work with our MD's to get what the patients need for comfort. Hydromorphone does not last very long in the system, it's a fast acting, fast leaving pain medication. He should be on a long acting like MSContin (twice a day) and the Hydromorphone for breakthrough pain. The Ativan more regularly will also extend the effects of the pain medication.

 

[Addie]

LP, if you couldn't come here and let it all come out, we wouldn't be very good caring friends. I don't care if you fill up five pages with just one post. You just need to know that you have all our hearts and prayers. It is not easy to stand by being and feeling so helpless while a loved one is so ill.

 

[DaveSoMD]

Hydromorphone does not last very long in the system, it's a fast acting, fast leaving pain medication. He should be on a long acting like MSContin (twice a day) and the Hydromorphone for breakthrough pain.

That's what I know it being used for, Brian got it for breakthrough pain after his knee and hip replacements.

 

[taxlady]

I don't reply much to this thread because I really don't know what to say. Know that I would give you hugs if you were nearby and that I am sending caring vibes in your direction.

 

[PrincessFiona60]

That's what I know it being used for, Brian got it for breakthrough pain after his knee and hip replacements.

Yes, there are better choices for long-term coverage. Starting and stopping pain medication is detrimental, which is what happens if you are giving short acting pain meds. You don't get the benefit of long periods pain-free. By the time you can have it again, the pain is already hard to overcome.

Delirium and confusion can be caused by pain; long-term, scheduled coverage will stop those peaks and valleys, lessening the mental effects pain can have.

Younger people can handle pain better, they have ways to cope that the elderly do not have. We start medicating as soon as someone reports pain @ 4 out of 10, function is being effected by 5 and higher.

 

[bakechef]

This brings me back to September with my dad, it sounds pretty much the same.

It was the hardest thing that I have had to go through to date.

My thoughts are with you, stay strong.

 

[LPBeier]

I don't reply much to this thread because I really don't know what to say. Know that I would give you hugs if you were nearby and that I am sending caring vibes in your direction.

You just spoke volumes! Thanks TL.

 

[LPBeier]

This brings me back to September with my dad, it sounds pretty much the same.

It was the hardest thing that I have had to go through to date.

My thoughts are with you, stay strong.

Bakechef, if this is what you went through then my heart goes out to you. Thanks for your words and thoughts.

 

[purple.alien.giraffe]

Hi LP. Just wanted to let you know you're in my thoughts and prayers. I hope your dad and family all find comfort of mind and body and peace in your hearts.

 

[bakechef]

Bakechef, if this is what you went through then my heart goes out to you. Thanks for your words and thoughts.

I live 1000 miles away, so my mom took the brunt of it. My dad became very needy and easily agitated, sometimes violent. This was so far from his normal personality, he was the most easy going, loveable guy that you could ever meet.

My mom lived at the hospital for the last two weeks. I drove home, not expecting to see him alive, but he was still holding on, and was able to mutter out a "hi Mikey". Within hours he was no longer responding to anyone, just very uncomfortable and irritable. The nurses there were fantastic and kept him as comfortable as they possibly could.

My heart aches for you, knowing what you have to go through. It's amazing how you find the strength to cope.