My dad is 88 with CHF, CKD and ALZ. His recent doctor visit revealed a BP of 80/40. His BP meds have been discontinued, but he only took a tiny amount. Hospice wasn’t discussed, but I wonder if we should. His appetite is still good. Sleep has increased quite a bit. Cognition varies, but is substantially worse lately.
Has anyone seen vitals like that and how did it go? We are deciding on POLST preferences now, based on his Living Will.
My dad was on Lasix in NV, moved to AZ and his new cardiologist was horrified that the current doc wasn't monitoring his electrolytes, especially the potassium. My dad did way better getting these levels brought up. He didn't need BP meds anymore as a result of this.
He wasn’t up to continue the 2 hour trip to the out of town cardiologist, so pc is monitoring. His last recent potassium was normal and his labs are good, except his kidney decline. He has afib too, that used to be controlled with meds. Cardioversion worked at one time as well. We are really honoring his request for comfort care now. He has no patience for hospitals. We understand the reality.
Anyway. His geriatrician stopped the BP meds. Shortly thereafter, dad went on home hospice. The nurse would visit and measure BP once per week. Usually it was quite low, but sometimes near normal and this was an indication of a good day.
I recommend no wrist devices or finger devices for measurement, only arm. Omron makes the best measurement devices which are now about 45.00 on Amazon. Take BP and record daily before medications. Always ask MDs what measurements BP meds should be "held" for (not taken).
When BP measures too low a big glass of water will help blood volume rise and repeat measurement in about an hour. Be sure senior with low BP doesn't become dehydrated.
Other than this, report changes to the doc. Good luck. You will find some people esp as they age have a more "labile" BP, or more "changeable". Normal for elders to a certain extent.
What numbers can a senior likely encounter long term once they reach 80/40.? I realize you have no crystal ball…..just wondering if he will continue with that 80/40 for the near future. Do many heart patients live with that? I’ve read the organs aren’t getting proper blood flow.
I may need to arrange for wheelchair use in the house. He uses transport chair when we go out. He’s been using rollator in the house. He does well drinking fluids through the day.
How do you know when there’s fluid? His doctor stopped the fluid pill he was taking 3 days a week.
After Hospice your dad passed away in 7 weeks. Was there anything in particular that brought that about or it was just the normal course of his CHF? Did he continue any meds after Hospice, like statin, blood thinners, heart med for Afib, etc?
My dad is 25 years post quadruple bypass and multiple stents. His relatively good health over all those years is amazing, but the last few have been rough. Very poor quality of life now. I appreciate the input based on your experiences.
He has had multiple falls due to weakness. He usually just folds down on the floor. No hard falls or fractures thank goodness.
I think you should discuss hospice care with mom's doctor. My mother's cardiologist was reluctant to bring it up because he didn't want to be seen as "giving up" on her. That might be why your mom's doctor hasn't discussed it yet. But hospice was a great help to her and to us, and made her final days pain-and-anxiety free for her, which is all you can really hope for.
Good luck. I know how hard this is, and my prayers are with you.
I would do the hospice right away, since your Dad has other profound health problems as well. My Aunt had no other health issues, not even cognitive or memory issues -- just a very very worn out heart.
I wish you wisdom and peace in your heart as you make decisions.