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Me and my siblings don’t know what to do. Our 70 yr old father's health is deteriorating before our eyes. What started out a few years ago as just numbness in his right leg, and “ dropped foot” (can’t pick up foot) he constantly falls. He blew it off as a pinched nerve in his neck. Now, he is incontinent, hands are almost incapacitated, can’t grip, looks clinched, extremely thin, hardly can walk without assistance, always cold, can keep his head dropped for hours, like tripod position, and refuses medical treatment. His speech is fine, memory is good. He denies pain, and says just numb. We feel we are neglecting this by his defiance. Since not having a PCP, and no diagnosis, can we take him to an ER ? We are desperate. Please advise ..

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Dad has an appointment for advanced urology for his hydronephrosis bilaterally, and his pre surg consult and I was just notified by my brother who is taking him that dad called to tell him to “ terminate all appointments “ he is done. I’m furious, sad, disappointed and downright losing my mind. “ he is an adult who makes his own decisions” I get, but if he hasn’t even had a doctor his whole life is he really well enough mentally? To make this choice? I filed FMLA and now if he don’t go tomorrow, that’s out the window to help him randomly. Lost isn’t the word... this sucks
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bundleofjoy Mar 2021
hugs!!! i hope your father is better!!
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He doesn't have a doctor that can give you an assessment? Maybe minor emergency can but you risk having him taken in by the hospital if you go to the er. It sounds like you just need a written assessment & could quality for long term hospice due to a permanent condition. Hospice does not mean imminent end of life. Medicare covers it so it's free with supplies such as depends, toilet risers, medical supplies, even hygiene such as shampoo caps, nail clippers etc. Hospice can schedule visits to stay with him so you can have a break. Good luck!
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AlvaDeer Jan 2021
Kelkel, please read the OP update below. This gentleman has had all the tests now and the outcome is sad indeed. Our thoughts go out to this family.
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Surgeon says he could do surgery but as of today, due to his health conditions, will die during surgery. We have to now see a cardiologist and a pulmonologist to medically clear him. Highly unlikely this will happen
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Daughterof1930 Jan 2021
I’m sorry that the hits seem to keep on coming. Will the doctor order hospice care for dad? It was a godsend for my dad. There was no cost as Medicare pays for it, all meds and medical supplies were furnished, along with nursing support and bath aide. It’s not around the clock care but still a huge help.
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I’ve followed your post and am sorry to hear the news. But also glad you’ve gotten some answers and know definitively what he’s dealing with. I wish you all peace moving forward
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Mazinmets9 Jan 2021
Thank you so much. It’s a relief and a nightmare.
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Mazinmets: Oh no........what a terrible set of dx's to be given! What is the prognosis?
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Mazinmets9 Jan 2021
Thank you for your compassion. He has atrophy of his entire cord. He is partially paralyzed. They believe the surgery will certainly not reverse where he is now, but with myelomalacia, his next phase is when the phrenic nerve is compromised and can no longer breathe on his own. We are hoping they can do surgery to at least relieve the compression so that does not happen. Friday we see surgeon. We expect the worst and pray for the best at this point.
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Grim diagnosis came today after his C spine MRI came back as myelomalacia due to chronic compresssion of nerves in c3-c5.
also aneurism found on Brain MRI, pneumonia on his cat scan and hydronephrosis in both kidneys.
self neglect comes back to haunt you, as he never addressed one problem over 30 years he is now faced with overwhelming health issues. Thank you to all of you that helped.
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ZippyZee Jan 2021
Which one problem did he not address 30 years ago if you don't mind my asking?
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He Has a MRI of lumbar spine and cat scan for chest scheduled for next Saturday. 1/9. Then a neuro on the following Monday. We should know more very soon.
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Update: he has an appointment Wednesday, tomorrow the 30th! He has agreed to go. Will follow up with his diagnosis! Thank you everyone for helping me push to get him the help he needs!
total relief!
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Definitely needs to see a doctor - perhaps neurologist to get things going. If you take him to an ER and he denies any pain, there's a good chance they'll just send him home. With the covid thing going on, it's possible you might be able to set up an online appt with a neuro dr. I would suggest doing videos that show his hands, his dropped head, etc.

Since he can communicate, has he told you what he thinks has caused him not to be able to walk anymore, to get to the bathroom, unable to grip things or require so much help? If he can't come up w/ a good answer, tell him you don't know what it is, and tell him what you said here - what you see when you look at him. Ask if he plans to continue to go downhill without even asking a dr what it might be or if he would like to try and do something about it. You might add on that if he continues to decline, he could end up in a facility when none of you can lift/manage his care any longer. If he is of sound mind, he may be content as he is to waste away.

Edit: Saw other posts discussing your father is alcoholic?? The loss of use in arms, legs, etc is probably going to be alcoholic neuropathy. Definitely needs to see a neurologist. I back pedal on my answer about going to ER now. If he is still drinking a lot, catch him on a really bad day and call ems or take him yourself to the er. To get him in, discuss the loss of limb use, weakness, etc as something you are seeing now and worsening at this time. After they get him in and turn his care over to a neuro dr, then get in to the real timeline so you can find out what his options are and if he needs to be dried out in a rehab - or - perhaps he has no interest in stopping.
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Yes, those symptoms should not be ignored. He has something serious going on. An ER visit would be a start. They may admit him for observation or give you a consult with a local doctor for follow-up. Make his appointment for him and take him.
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My hubby has dementia. He is at the stage that he cannot make decisions for himself without harming himself. However.......... He fell and injured his leg . The paramedics came and he had difficulty raising his leg so they suggested that he go to the hospital for evaluation. He said he did not want to go to the hospital. They said if he refused to go that they could not take him. I explained his dementia to them and they said it did not matter if he had dementia or not. If he refused to go that was his decision regardless of a dementia diagnosis. So, they left. I had to get neighbors to help lift him and get him into the car and drive him to the hospital because he could not bear weight. It was not an easy task. Ended up that he did not fracture his leg or hip but did have a severe bruising of hip and leg. Our laws are sometimes counter productive to the needs of the client.
Sandy
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Beatty Dec 2020
How hard for you! And for him... making a poor decision that meant waiting longer for treatment.

My relative has refused EMS transport too. But EMS did override that once when a head strike was evident.

A friend's Father has suspected dementia & fallen multi times this year, refusing treatment & transport each time. His wife could not lift him alone, but neighbours now say no more, as does daughter. She no longer attends. Last straw was when son refused to lift him. Told him to stay on the floor for the rest of his life or accept EMS help. His wife provided a blanket & served snacks while he sat on the floor. After sitting in his own filth for about 6 hours he finally gave in. Another time he gave in earlier as he was lying down & couldn't manage to eat & was hungry. Another was 12 hours - had refused EMS but wife called again & again & they monitored him over the phone. Came for him when he couldn't talk properly. That was confusion with UTI, dehydration & poor kidney function.

So very hard. Strength to you Sandy.
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Alcoholism leads to liver failure which leads to encephalopathy--an inability to think 'normally'. Alcoholism slowly but surely kills. It's a nasty death.

SIL is a GI doc and lot of his patients are end-stage alcoholics whom he cannot help, as they don't want to stop drinking. He's pretty 'over' trying to get them to dry out, esp the elderly ones. The damage is done and is usually irreparable.

Your dad sounds like he is end stage alcoholic poisoning. Not much you can do. A Dr. or ER would simply work him up, maybe keep him for a day or so and then send him back home.

I'm sorry for you--it's awful.
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He can refuse to seek medical treatment (if deemed competent). He has that right.

He does not have to right to insist YOU or your siblings fix his issues; help with falls, with incontinence problems, house him if he can't look after himself.

I had cleaned up one too many incontinence problems. I suggested my relative tell her Doctor about this worsening problem (refused). I sought a referral to a specialist clinic (she agreed). She saw the nurse but had denial over the problem, would not take the advice (diet, medication, products, behaviour). So.

The Social Worker told me;
Advice.
Let them choose.
Let the consequences be their own.

When we went out she expected me to fix any incontinence issue. So I no longer take her out. When coming to my house she expected help. So she is not invited to my home. When I got calls for falls/mess I told her to call EMS, if she did not, I did.

Tough Love was not a concept that came easy to me, but I have a clear conscience that this was the best way to provide help.
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CharlieSue Dec 2020
Me, too, Beatty. My mom calls life alert about falls, because I didn't come; couldn't lift her. She called me once or twice about messes, but I can't, just can't do that, so she calls one of her several paid caregivers. I've been there when her weekly nurse comes, and she showtimes; also at the doctor's. Like you, I've learned to stay at arm's length, partly so that she will do what she needs to and go into care before she gets really hurt - so far no dice, but still hoping. This tough love is tough stuff, but so necessary.
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Hi Mazinmets9. I’m sorry your Dad is sick and not accepting help. Have you thought of having a home visit by a social worker with experience in alcoholism? Maybe he would be more accepting and then possibly a home visit by a visiting nurse? If he doesn’t care to change depends maybe depressed? I’m sorry I don’t have much to offer but I don’t think you have anything to lose. Best of luck.
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Thank you so much for all your compassion and wonderful answers. You have helped me a great deal. I will copy all answers and send to my siblings in an email and see where we go. I think I have chosen to give him tough love and take him to an ER. Hopefully once in the caw of a physicians, he will understand why we did this. Thank you again, his forum is amazing❤️
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From what you've described, if he is an alcoholic he is likely suffering from alcoholic neuropathy. Of course if he continues to drink, it will get worse. I echo the advice given by others in this thread, and of course he should be fully examined by a physician, but based on what you've described, my first thought is he's suffering from alcohol related nerve damage. (I have some personal experience with this).
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Mazinmets9 Dec 2020
I was thinking neuropathy also, but he said zero pain. His nerves must be so shot.
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Unfortunately, since you mention your father is an alcoholic, he has chosen his life and also his death. He may not want medical intervention b/c then he would have to stop drinking in order to rehab, etc.

You can't save a person from himself.

This has to be extraordinarily difficult to witness, I'm sure. I'm sorry you are going through such a terrible ordeal and that your father is behaving in such a selfish manner.

You are not 'neglecting' him; he is neglecting himself. You have tried everything within your power to help him; HE is the one who's refusing the help.

If the event happens that he falls & you can't get him up, THEN you can call 911 and have him taken to the ER for an evaluation. If he's of sound mind, he'd have to consent to treatment, of course, putting you back at square one. But if he's broken a leg or a hip in the fall, there will be no other choice BUT to get treatment. And you go from there.

Wishing you good luck and Godspeed with such an unfortunate situation. Sending you a hug and a prayer as well.
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This is breaking your heart, and you are all lovingly seeking a solution to this problem, but before you go any farther with any approach that presents itself, DO NOT ALLOW HIM TO MOVE IN WITH ANY OF YOU.

As it sounds based on what you’ve written THE ONLY bargaining chip you have is insisting that you have a diagnosis and treatment plan before you will consider allowing him to live with any of his children.

No, NOT what ANYBODY WANTS TO DO to a dearly loved parent, but you MUST do a shift to DO FOR HIM. Surely it is beneath HIS DIGNITY to allow him to continue this way.

You have tried reasoning, acceptance, kindness. Nothing had succeeded in getting him help. Lay out the facts with as little emotion or judgement as you’re able to do. You love him dearly and his presence in his present condition is causing you all unmanageable distress. It’s a medical evaluation or you will all withdraw your assistance and leave him to his own devices.

If matters tragically deteriorate to that point, then the call to your local adult protective agency.
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Mazinmets, I think you hit the nail on the head when you mentioned his alcoholism.   I won't pretend to guess how or why this happened, but it would impair his judgment, especially if it comes to making decisions on how to proceed.   He might be drinking also to avoid the realities of his declining health.

With a dropped foot, I think it's only a matter of time before he has a significant fall and ends up in the hospital.   (My sister suffered a dropped foot when metastasized cancer affected her ability to use that leg and foot.   I've witnessed how difficult it is to balance and walk.)   If he's been drinking, he's not attuned to balance or safety, and one serious fall could seriously send him to the ER.

Have you thought about asking local police to do a welfare check?   If you explained to them ahead of time what the issues are, they might determine he needs to be taken to a hospital ASAP.

The corollary issue is how his lack of hygiene may be affecting yours.    No one should have to live with that kind of lack of care, and you don't want to end up sick and in the hospital yourself.
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Your father needs medical care and he needs it badly. That he is in denial to this extent is NOT normal and competent behavior.
I would say that yes, it is time for desperate measures. Tell your father that if he will not go to the ER you will call the EMT ambulance and have him transported there for diagnosis. That this started two years ago and has had no care in all this time is bad news. Do not delay.
To be frank, his refusal to seek help is at this point is indication of incompetence in decision making to transport him.
You could also report him to APS as adult in danger, and try to let them handle it.
You are up against a person who is in deep denial. Explain everything to them.
If seeking help in this manner, first speaking to him about ER, and second ambulance, third being APS does not work I have utterly nothing else to advise. If he refuses all care I would then withdraw my care, and tell him to call only when he understands he needs medical help and diagnosis. This will come to a head with a fall soon enough, and then transport will be done.
This could be anything from nerve to tumor to chronic illness, but without medical care you cannot begin to guess.
The EMT can refuse to transport someone who appears to be competent in own decision. But you will have done, then, everything in your power. Don't continue to enable this denial. Two years has led to this. It will go downhill from here.
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Mazinmets9 Dec 2020
Thank you very much. What you have said is what I presented. Ambulance .. to definitive care and at least we know he is safe and going to get a diagnosis. I do fear him refusing to go, because then we are left to watch him die slowly as we smells terrible, urinating on our furniture, depends exploding and leaking out his pant leg. The only “ help” he wants is to live with me so I can basically get him what he needs, but I am refusing until he is seeks medical attention and gets a diagnosis. Epic stubborn and arrogant. It’s very upsetting
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Well, you're a volunteer EMT and you know the rules: if he won't consent, you can't force him to go to an ER. Neglect doesn't come into it.

What does he say about his mobility issues and incontinence? Doesn't he want to give himself a chance of some improvement in his condition, or do you think he has no belief that it would be possible?
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Mazinmets9 Dec 2020
He is in complete denial. He “ is fine” I think if he cared, he would have seeked attention a long time ago ~ could be due to his alcoholism ?
he doesn’t even shower after wetting himself, refuses to let us help him
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