I'm a caregiver for 94 year old grand uncle, who just started dialysis

[kasey]

Good morning,

Thank you to anyone who reads this!   Earlier this year, I stopped working and moved in with my 94 year old uncle who broke his femur and was getting out of a 3 month rehab after surgery.  (He broke his femur when standing up, NOT from a fall).  Until that point, he was independent and living alone.  After he recovered from surgery, his mobility was greatly reduced, to the point that he needed a full-time caregiver to help with normal daily functions. 

In the last 3 months, he has deteriorated significantly.  His mobility is virtually gone, and standing with the help of a walker has become very difficult for him.  Walking is out of the question.  He is now on a semi-permanent cathedar (I am not sure what it is called) which has helped reduced night time callings for me from 3-4 down to 0-1.  Until two weeks ago, he had virtually stopped eating and drinking as both made him sick.  He was also very itchy, and in places itching himself until he was almost bleeding. 

He finally allowed my brother and I to take him to the doctor, and as most of you will likely guess, he was in acute renal failure.  He was hospitalized for 6 days, receiving 5 dialysis treatments in the hospital.  He was then sent home, and we are now doing 3 days a week of outpatient dialysis.  We have done 2 so far.  This is very hard for him, as just getting in the car is a herculean effort and he is a great risk for a fall. 

Does anyone have any thoughts on prognosis regarding dialysis for such an elderly man?  He turns 95 in January.  After researching dialysis, I am a bit surprised the doctors have prescribed dialysis for him.  I am all for extending life, but I feel that quality of life supersedes this.    In the near future, he will need to have the temporary cathedar removed and a more permanent port put in.  Any type of surgery for someone this old seems a bit scary to me.  Does anyone have any thoughts?  How long can someone this frail and elderly live with dialysis? 

One of his doctors was doom and gloom and said this was the beginning of the end, and one of his doctors really encouraged him to think he would recover from this and I fear this attitude was a bit unfair and overly optimistic.  My great uncle is choosing to trust doctor number 2 and he is under the impression dialysis is a temporary treatment that is being done only to get his kidneys back on track. 

I have a call into this second doctor today, but any thoughts would be greatly appreciated. 

[justagirl2325]

Sorry for your uncle, that's a tough situation.

I can only answer for myself.  And I should state I'm not on dialysis but I am a wife of a 43 year old on dialysis.   If I was 95 I would not let a doctor treat me with dialysis.  Hell no.

I saw them do the same thing to my grandmother.  Doctors wanted to perform surgery on her at 96.  In a nursing home, mostly blind and deaf and couldn't function or get around on her own anymore.  I mean, come on, at what point does it become abusive to the patient.  I was thankful that she passed away in her sleep 2 weeks before their scheduled surgery.

[kasey]

Thank you for your comments. 

My grand uncle is going along with what the doctor told him, and the doctor seems to have painted a rosy picture.  I watched my mom die from terminal cancer after fighting for 2.5 years and it was just awful.  The last year she was like an experiment, procedure after procedure, surgery after surgery.  My grand uncle has been relatively pain free and healthy until this year.  He has all his marbles.  He watched his wife (my grand aunt) pass away at home 6 years ago from pancreatic cancer and he has a wonderful view of hospice.  We even talked about hospice while he was in the hospital this past turn and he was fine with it, if it was time to call them.  But this doctor has led him to believe that he will get past this.  My uncle now even thinks he's going to walk again.  He can't even button his own shirts at this point. 

I feel like I am stuck in the middle.  Everything I read isn't wonderful regarding dialysis at his age.  I am also concerned financially.  I am currently living off my savings, and if this continues for more than 6 months or so, I will need to go back to work and he cannot afford full-time care, nor does he want to go into a home. 

[Darthvadar]

Hello Kasey...

  to IHD....

I too was a carer to my late mum... So I really 'get it'...

Hope to see lots of you... We're a friendly bunch!....

Darth... Moderator...

[MooseMom]

It sounds like you have a 6 month time slot during which a lot of decisions are going to have to be made.  Since you have said that your granduncle has all of "his marbles", then after 6 months of dialysis, he will have a better idea on what he is or is not willing to tolerate.

I personally have my doubts about any physician who encourages a 95 year old who now needs 24 hour care to proceed to dialysis without discussing all of the pros and cons.  But I do not wish to disparage anyone.  Still, I do not understand how exactly "recovery" is being defined in your granduncle's case.

I wish you both the best of luck.  Who knows; maybe he will be fine on dialysis.  But if he is not, I'm sure he will let you know.  I'm glad he has had good experience with hospice care.  That's an option he may have to consider at some point.

[Michael Murphy]

In my center there is a 90 plus year old patient who comes in three times a week.  He recently went through a several month bad spell where he was not his usual self.  His care givers still brought him infor every session.  In the last month he has been improving. And at Monday's session he was his old self spent the first hour flirting with the nurses.  He seems to be enjoying himself again.  It was good to see.

[Simon Dog]

I have a 14.5 year old dog.   My criteria for keeping him alive is simple - does he still enjoy being a dog?    I'd apply a similar standard to people, although unlike dogs, proactive termination is not an option in most states.