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My Dad (72) has been bedridden for about 4 months. He had open heart surgery in September but had a set back in recovery due to stomach issues and was hospitalized for a few months and lost a significant amount of weight and was bedridden. He’s been in a SNF for about a month but because he has diabetic ulcers on one of his feet he cannot walk or put any weight while it heals. Physical therapy at the SNF has been working to with him to strengthen his upper body till he can be cleared for weight bearing on his foot. It’s a setback but we’re doing what we can. The big issue right now is a lot of days he doesn’t have energy and isn’t super motivated to do his exercises when he has no energy which is most days. He doesn’t dialysis 3x a week and understandably on those days he feels tired, but on the other days, he says he doesn’t have energy, I keep telling him that he needs to build his endurance and stamina up because he’s been bedridden for awhile. I know he understands but I think it’s hard for him to motivate himself to do it. Before all this my Dad was very active and independent. Now he is fairly weak, and unable to walk, and has no energy. How can Mom and I support him and help him motivate him so he can continue to progress?

My friend passed at 63 because of kidney failure from juvenile diabetes. Another friend at 70, quit dialysis and passed. He had type 2 diabetes.

I am with Grandma that this may be it for Dad. He has had a heart attack, is on dialysis and now has sores which probably aren't healing. I think Dad needs to make the decision where he is going from here. What does he want. Then you support that decision. It may be time for Hospice.
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Reply to JoAnn29
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Your father may now wish to discuss with you, with other family and with his physicians whether he wishes to fight to go on.
I am a retired RN 82. I would not wish to. He has a choice of placement, hospice or palliative care, being kept comfortable.

It is very difficult for a person who WAS actively independent and cannot be again to go through this and to tell you the truth, the statistical changes of his returning to anywhere near his former self is not good. Doctors will give you the blah-blah, but that's exactly what it is--blah blah.

I myself, were this me, would discontinue dialysis and go on Hospice care with the good drugs. I in fact have a second cancer, and Kaiser and I already have worked through and charted the choices up and to (including) access to MAiD. (Medical assistance in dying).

Discuss also with father whether he would consider seeing a psychologist or neuro-psyc for a try at anti-depressants. Be honest. Let him know without hard work and a whole lot of luck he cannot again be in home care. And tell him you understand whatever his wishes are, and he should feel free to share honestly with you where he is in his OWN head.

I wish you the best. He is young. BUT diabetes makes our organs a good two to three decades older than the norm. I think you are all already aware of that fact given the dialysis. I am surprised your Dad chose heart surgery; I would not have. He may be the "fighter to the end" and if that is so the best you can do is support him and his caregivers as their work their way through this.

My advance directive has to three decades now forbidden any dialysis, even temporary, so you kind of know where I stand. I have no fear of death and have helped many over that bridge. I DO fear a long and torturous ending and fly the white flag on that one pretty quickly. There are many with more courage than me in that regard, so it is, this, an individual decision. Just let him make it HONESTLY without baby-talking around the facts and the steps and the open discussion.

I am so sorry your Dad is going through this, and so sorry for your Mom and yourself. This is difficult to stand helpless witness to. More than difficult. I wish you all the very best.
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Reply to AlvaDeer
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OP is her currently in the SNF as a rehab patient? Or is he there as a custodial care resident? His “bed designation” of patient versus resident will make a difference as to just what this means for his responsibility cost to be in the SNF and for what the therapy staff can do.

which is it?
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Reply to igloo572
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This is difficult but he may have reached a point where this is it for him.
Is he in a SNF for his long term care and not rehab?
How optimistic are the doctors and the therapists that he will 1.) regain strength and 2.) walk again?
Have you talked to him about what he wants? Not what you or mom want but what he wants. If you have this discussion with him please be open and listen to what he says.
Depending on what the doctors say his prognosis is and what dad says he wants it might be time for a Hospice consult.
Please keep reading....
Hospice is not just end of life. A person can remain on Hospice far longer than 6 months. As long as the decline meets Medicare guidelines a person can be on Hospice for YEARS.
If the goal is to bring dad back home (if mom can safely care for him and she should have caregiver help) Hospice will be there to help and order all the supplies and equipment that is needed.

Side note because this is me responding....
If dad is a Veteran please see if he qualifies for any benefits from the VA . Contact the local Veterans Assistance Commission or your State's Department of Veterans Affairs or you can contact the local VA. Depending on where and when he served he may qualify for a little help or a LOT
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Reply to Grandma1954
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Persimmon20 Dec 1, 2024
PT believes he can regain his strength and walk again but he has to refrain from walking due to his ulcers on the bottom of his foot. Until they heal and he’s cleared for weight bearing, he uses a wheelchair to move around. He can still work on his upper body strength however and that’s what I’m trying to get him to do. He does it occasionally when I come to see him and I do the exercises with him. I haven’t talked about what he wants but I probably will need to. I do believe he wants to get stronger so he can do home, and get back to living life. We’ve talked about that aspect. But I will talk to him. He is VA so I plan on using it to get him and Mom home health care aide because my Mom needs it as well since she is his caregiver.
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I am sure he has been told that LTC is in the immediate future. If his mindset does not motivate him enough, then plan for the next step now. You must know the old saying that you can lead a horse to water....
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Reply to MACinCT
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Is he on meds for depression? He is relatively young to already need dialysis... Definitely work on the meds for depression and if he's already on them, maybe it needs to be reviewed or adjusted by his primary doctor.
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Reply to Geaton777
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Persimmon20 Dec 1, 2024
He is on anti depressants, he started them a few months ago but I will ask the doctor about adjusting them.
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Dialysis is very tiring .
You may need to face the possible reality that Dad is doing the best he can already . He’s been bedridden awhile , that’s difficult to overcome .

You need a backup plan for his care . Without progress he will be discharged from rehab . I would start looking at long term care SNF facilities.

I’m sorry that this has happened. Diabetes is a killer that has lead to his problems .
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