by francy Dickinson www.seniorcarewithspirit.com
Dear Francy; Dad has had a cold for a week and today he is so weak he is unable to walk. He refuses to go to the hospital. I am unable to lift him and I have called a cousin that will take an over night flight to come and help me. What should I do?
OK, first Panic is not a word to use that does not get attached to calling his doctor for help and/or taking him into the ER. So remember, if you are that scared you need to be calm and take care of the situation with a call to a medical adviser and get him help.
Now, the options: One he has a mecial directive that says no hospital or resusitation. This is your honor to protect, but a cold never says I am dying to me- (it says; I’m sick, tired and weak – I need some meds to make me better. I may need some fluids and I may need some physical therapy to recover my legs)but I think that dying is low on the list of what will happen with a cold unless you ignor it and it goes into pneumonia. So, if I were in the house, I would call the doctor’s office. (who would probably just tell me to send him to ER)
I would take him to ER and they would give him fluids, check his vitals, and put him on a program to recover his legs again. The least I would do is call the local Fire Department and have the medics check him out. I would not wait by the door for a relative, I would take action now. You are the care giver, your dad is too sick to make calls or decisions. So, use your intuition and react in a safe and appropriate way to give him care.
After that has been addressed; I want to assure you that many older seniors with different health challenges have problems with their legs and the slightest infection can take their energy down fast and that will keep them from walking. As they get fluids and meds and recover, they get their legs back again. So, do not immediately think he is off his feet for any permanent time period. It may just be a passing side effect of the body fighting an infection or other conditions in the body.
DO NOT ALLOW ANYONE TO STAY IN BED WITHOUT WALKING FOR MORE THAN A DAY! If someone is on doctor’s orders to be in bed and the doctor understands they are in the bed full time and can not get up – that is the exception. If they are simply unable to walk or stand without falling, they need to be treated by a physician and not you. They need to address what ever is bothering the senior that has produced this weakness.
Let’s go forward. Your dad has gotten some meds and has gotten his fluids and oxygen levels up. He has his sugar level in order, he has seen a doctor or nurse practitioner and he is back home. But he is still really unsteady and needs you to help him move around. You have a bad back or are very tiny and you are worried about caring for him in this state. Then you have to have him placed in a care center until he gets strong enough to meet the standards of your own home care. It maybe a week or a month in the care center but the doctor will write a prescription for it, just like a medication so the insurance can cover the cost. The care center will give him Physical Therapy to walk, monitor his vitals and get him strong again. If they can not do that, then he has moved into a new stage of care and you have to decide on the next step.
If the doctor or nurse has him back home and he is simply wobbly and can stand but not without you next to him, walk but not more than a few steps. This would mean that he has been examined and is on medication to take down his infection or handle his health challenge and he is on the mend. You will be asked to help him stand up and move him to the commode that will be placed in his room. You will have to help him up from the commode and get him back in his chair. An in-home nurse can be sent via the doctor to help you learn how to do the assisting so it will not harm you. Very small people, can handle larger bodies if they are taught how to move them.
He will have to do all the exercises that the Physical Therapy person has given to you. They usually have a sheet with the exercises printed on it. You and your Father will have to do those exercises a couple of times a day for his legs to get strong again. Older people lose muscle strength really fast and they need to re-gain it right away so it is not a permanent situation. Even if he is very ill with heart problems or cancer, he needs to move for as long as he can. So he will have to do the exercises that the professional PT person designs for him. You will have to assist him until he gets strong enough to be on his own.
If he falls on the ground – do not even try to pick him up. Call 911 and the fire department will come and lift him to his chair or bed and check him out. If they think he has injured his body they will transport him to the hospital. If you do not want him transported or given resuscitation you have to have a piece of paper posted on the wall that releases the medics from their duty of rescuing the patient and doing all they can to save him. This paper is called A Do Not Resuscitate Order/Agreement (or DNRO form). This is not his living will, it is a special piece of paper that has to be from his doctor. It would be signed by the patient, or his Power of Attorney and the primary doctor that you use for his care. It’s usually a green piece of paper and I posted mother’s in her bathroom door, so I could easily show it to a medic crew. If mother went into the hospital I took it with me in my hospital pack. (You will find my hospital emergency workbook package on the products page of my website www.seniorcarewithspirit.com it is a beauty and will really help you go step by step through Emergency Room visits.)
If your dad knows he is facing a life transition it is time to call Hospice. That is a terrific service that will come into your home and help you as well as your dad through the process of dying. It is used in the last six months of someones life and is paid for via medicare and all you have to do is ask your doctor or look up Hospice in the phone book. They will come and do an assessment of your dad and then give you an outline of all the things they can do for you. So you can be released from some of the stress and just be his daughter, instead of a care giver.
Remember, older people get weak. But they also recover. So be really clear on what your dad needs to do around the house for you to give care. I told mother she just had to walk, I could not lift her for any length of time. So, she was very good about walking after each of her little strokes and illnesses. She knew I could help her for a few days, but not on a permanent basis, so she responded with lots of exercise to keep her legs working.
Thank you for all you do for your dad, I hope you will go to my website and read about my Care-Givers Workbook 101, it has helped so many family members give top notch care to their seniors. Thanks francy