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I have been the sole caregiver for my Dad for about 6 years now since he had his pacemaker implanted and stopped driving. He's 91 so that is a milestone right there!
Around the beginning of April, he started to decline sharply. He was no longer able to take showers by himself, lost his appetite, slept most of the day and other little things that just showed up. I took him to his primary care physician when it started to happen, and she had no clue as to what was going on. That was about the time he started to talk about dying and hospice so a few weeks later she referred him to it. Now we have a nurse coming in the house once a week and a CNA twice a week for showers. Dad has gotten over his shyness so on Saturdays I give him a shower.
Right now, the biggest fear is pneumonia. Dad was a smoker for over 70 years before quitting cold turkey when he got the pacemaker. He has a lot of congestion in is lungs because of his heart shutting down, I guess. The nurse told us this morning that if he did get pneumonia he would die. So, we have him on a nebulizer and one of those suction devices. The problem with the suction device is that my dad would have to use it because I could hurt him. He tried it today, but his cognitive skills are slipping away and he's a bit leery (as am I) about using it.
The hospice nurse said that he didn't have to use it if he didn't want to because hospice was more about comfort care.

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I am so sorry about your Dad's decline. You have done a wonderful job caring for him for the last 6 years. Please know that you are doing all that you can for him in this phase of his illness, and utilize the Hospice nurse and doctor for medical questions and recommendations. Prayers are going out to both of you.
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Reply to JanPeck123
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Congestive heart failure is likely more the cause of the "congestion" and difficulty breathing. We all do die of something, and pneumonia, before antibiotics, was once called "the old person's friend".
You are currently facing down the end of life and I am so thankful you have end of life care in place with hospice. The goal in now medication for comfort. Whether it is pneumonia or that failing heart pump or sepsis, something will come to usher your Dad out in all likelihood. I wouldn't worry about that 5 month thing. He is almost certain to continue to qualify for Hospice care. I wish you the best and comfort and peace for your Dad.
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Reply to AlvaDeer
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When my dad was on home hospice, the wise nurse we were blessed to have told us suction was mostly for families as it did little for the patient but made the families feel they were “doing something” and helping, when actually it was of little value. The sounds of fluid are uncomfortable to hear but not necessarily harmful. Pneumonia has long been nicknamed “the old man’s friend” as it has been known as a pleasant way to die, certainly compared to many other ways. Hospice days are hard, I remember them all too well. Hold dad’s hand and try to treasure the time left. Don’t let the medical details bother you, what’s going to happen will happen just as it will, no matter what. I wish you both peace
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Reply to Daughterof1930
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Just allow your dad to be as comfortable and pain free as possible without making your life or his more difficult by trying to use the suction device. Hospice gave me that suction device to use on my late husband, and while it worked initially some, it wasn't worth the aggravation that it caused him.
If your dad has a lot of congestion, ask the hospice nurse to order the scopolamine patches that they can put behind his ears to help with that. Those worked pretty well for my husband. They put one behind each ear.
So I will just say enjoy whatever time you may have left with your dad, and leave nothing left unsaid.
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Reply to funkygrandma59
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lealonnie1 Jul 30, 2024
OP may want to get some Xylimelt lozenges for dad because dry mouth is very real with Scopolamine patches.
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Doll, Make the most of the time he has left. Care for him, talk about happy memories, and keep him comfortable. There is not much else left to do at this point.

I wish you peace as you go through this difficult time.
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Reply to Hothouseflower
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I agree with Margaret. The goal of hospice is to provide as much comfort and dignity as possible at end of life — not to extend it. When hospice begins, you shift from trying to diagnose, cure, and treat disease and keep the patient alive, to keeping the patient comfortable. Make the most of whatever days he has left.

If he can’t use the suction device, don’t worry about it. Concentrate on what kind of good memories you can make with him now. Just reminiscing about good times, watch a favorite movie of his or listen to songs he really likes. Look out the window at the birds. Ask him what was his favorite treat when he was a little boy, like maybe root beer float or jelly beans. If you can, find him whatever it is and enjoy a bite with him.

Sounds like you have done a fantastic job caring for him. He is very lucky to have you. He is also fortunate that he lived this long after smoking so many decades.

PS my dad had dementia and a lot of really bad physical issues, and died in hospice from aspiration pneumonia, which came on from coughing and breathing in his own saliva. No one could have prevented that. Once it set in, he got morphine every two hours around the clock. There was no point in trying to aggressively fight the aspiration pneumonia. I was truly grateful that it took less than 48 hours from onset to his passing. As Margaret said, if not that, something else would have gotten him. Best wishes to you both.
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Reply to Suzy23
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Doll, it’s good that you posted this under ‘end of life’. Your father is 91 and has serious health issues. You say “the biggest fear is pneumonia”. Don’t be afraid, one thing or another will take him, and many of us would think (for ourselves as well as for our parents) that the sooner the better when we are very ill, so long as it is not painful or distressing. Make him as happy as you can, and look after yourself – but don’t fear what is inevitable in the near future. Love to you both, Margaret
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Reply to MargaretMcKen
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