Expert: Margot RN BScN CGN - 6/1/2006

Question
My Dad, 86 yrs old, is under my care and living with our family.  He has mild Parkinson's and cronic pain in the throat and right foot.  We have been to Specialists aboout the cause of pain, but have not been given definitive answers.  The pain control medicine is 12mg hydromorph contin morning and night, with 2mg dilaudid when there is breakthrough pain, maybe twice per day.  He consistantly is losing weight, and has dropped from 180lbs. to 120lbs. in the past year.  He has difficulty swallowing and is now on a soft diet, and only eats a small amount twice a day.  He has no bowel movement for a couple of weeks and then seems to eliminate a great quantity at a time.  We have a RN visit monthly to evaluate.  His vitals are holding steady withBP 110/55 range with pulse about 85.  His lips are often bluish and fingers and toes cool from time to time.  He goes into periods of disconnection, but always knows me and the rest of the family.  He is extremely non-communicative and at times will not answer questions.  He does not watch T V anymore or engage in any stimulating activities.  Often he needs help to walk as his balance is unsteady, even with taking sinemet.  He is totally incontinent, and needs assistance to bathe, go to bathroom and sometimes eat.  My question is "I am exhausted and emotionally drained..  I don't want his final days to be in a nursing home, but how much longer can I expect to have to care for this dear man?"

Answer
Hi Jayne and thanks for writing,

I am very concerned about your Dad'scondition, especially the ack of BMs - this needs to be assessed and treated immediately. You should have him admitted to hospital for pain, medication, neurological and dietary assessment. Then I would recommend you get him admitted to a home for two weeks resite so they can care for him and you can rest.

Wishing you all the best,

Margot