Help with so many questions

[jdk]

hi, my dad has end stage CHF (congestive heart failure) is 89 years old and has a pacemaker.  i live up north and he and my mom live in florida.  his internist has done all he can to manage his kidneys but his BUN is high and sent him to a nephrologist.  the nephrologist said he should go on peritoneal dialysis.  he told them to call a nurse and she would come talk to them about it.  this is all the info. they were given.  i will be down there in a week and told them to wait to have the nurse come when
i can ask questions.
i have read up on dialysis and do not know how they are going to manage what is involved.  my dad is very weak (needs a motorized chair to lift himself) and uses a walker.  he falls asleep in the chair 50% of the day. 
i don't believe my mother can be his primary caregiver and do the prep for the dialysis. 
right now, neither of them know what is involved in doing dialysis and i am very worried about how they are going to do it and what will be the quality of his life - given that his main problem is the heart.
any advice, suggestions or opinions on this would be greatly appreciated.  i will be talking with both the internist and nephrologist when i am done there and need to know exactly what i should be asking,
thanks so very much!  sorry this is so long.

[Sluff]

I'm sorry for your Fathers health deteriorating. I have no way to help you with medical advice, but I'm with you on the fact it's more than your Mother can handle. Have you thought about hospice care?  My advise is to do what your Father would want and think about what his future quality of life will be. My prayers are with you, you have some difficult decisions ahead of you.

[del]

hi, my dad has end stage CHF (congestive heart failure) is 89 years old and has a pacemaker.  i live up north and he and my mom live in florida.  his internist has done all he can to manage his kidneys but his BUN is high and sent him to a nephrologist.  the nephrologist said he should go on peritoneal dialysis.  he told them to call a nurse and she would come talk to them about it.  this is all the info. they were given.  i will be down there in a week and told them to wait to have the nurse come when
i can ask questions.
i have read up on dialysis and do not know how they are going to manage what is involved.  my dad is very weak (needs a motorized chair to lift himself) and uses a walker.  he falls asleep in the chair 50% of the day. 
i don't believe my mother can be his primary caregiver and do the prep for the dialysis. 
right now, neither of them know what is involved in doing dialysis and i am very worried about how they are going to do it and what will be the quality of his life - given that his main problem is the heart.
any advice, suggestions or opinions on this would be greatly appreciated.  i will be talking with both the internist and nephrologist when i am done there and need to know exactly what i should be asking,
thanks so very much!  sorry this is so long.

You have a lot of issues to think about.  Your father's heart problem is probably going to make dialysis somewhat difficult.  From our eexperience dialysis is often harder on older people especially if they have other problems besides kidney failure.  It is a dicission you have to make as a family and your father if he is able should be the main person to make the decision.  Will be thinking of you.




Edited:  Fixed quote tag - Goofynina/Admin.

[jbeany]

I was talking with my doctor about how many patients he had who were interested in joining a home hemo program.  There are a number of them, but quite a few of his patients are in the same situation your parents are.  The caregiver is not in the best of health, and will probably not be able to do the necessary care.  He said a number of them wouldn't be interested in home dialysis because the 5 hours in center is the only break they get from taking care of their spouse. 

You have to help your mother decide if travel to and from the dialysis center would be more or less of a burden than doing pd at home.  Perhaps you should have the nephrologist see about getting you an appointment with one of the social workers, who could tell what options are available to transport your father.