My grandma, who is 80-something (87? 88? 89?) has a congestive heart, and has already had at least one heart attack that I know of, albeit many years ago. She's supposed to take meds for that as well as high blood pressure (and a dozen other things, but these are the main ones I'm concerned with at the moment) every day. She won't. On a good week, she might take pills three days, but it's usually only one or two.

The visiting nurse called yesterday and informed us that grandma either has pneumonia or her heart is starting to seriously fail, because she's coughing and short of breath even with her oxygen (which she is supposed to wear 24/7, but most often only wears a few hours per day). The doctor hasn't seen her, and hasn't made an appointment to see her, but he called in a prescription for an antibiotic in case it's pneumonia. Which she's supposed to take twice a day (what are the odds, right?).

So if it's not pneumonia, and it really is her heart failing...would you be able to guess on ballpark odds that mom will go up there someday soon and just...find her? I know you really can't say, but her doctor's a freaken wingnut near as I can tell, and the visiting nurse isn't much better. We ask them, and they say she shouldn't be this sick given the meds she's on, no matter how many times we explain that she won't take them.

Gah. Hope that made some kinda sense.

It makes a lot of sense.
Pneumonia usually has fever , chills and lethargy.
CHF has no fever or chills. Both will cause cough , shortness of breath , fatique. CHF will usually cause weight to go up one to two pounds and the legs or addomen will swell. Pneumonia does not. Two simple tests can tell the difference. A chest xray and a test called the BNP. It is a rapid blood test used to discriminate the difference between the two diseases. No way should this be treated over the phone unless they simply aren't interested if she survives. Drop her by the friendly neighborhood ER and get your answers or get a new doc.

This is the impression I get. I told mom she should take her in, but they're apparently starting to get a reputation at the emergency room up there (grandma quite often is going to die because she's in so much pain, and mom's over it so she just takes her in when it happens). At this point, we're not convinced that SHE cares if she survives, but according to the legal system, we can't force her into a nursing home or even assisted living without her consent, and she refuses to go.

She hasn't gained any weight, she's losing it steadily. But she also doesn't have a fever or chills (at least, not outside the "normal" chills she gets). She sleeps apparently something like 10-12 hours per day, but she's done that for about eight months now.

You know, the more I think about this...I realize I don't actually expect you to have any answers. I'm just frustrated and wanted/needed to talk some of it out. I honestly don't know how much more of this the family (mom in particular) can take.

We're looking at new doctors...but there aren't a whole lot who are accepting new patients, particularly when the new patient is that old and has her kind of problems.

Thanks, M...at least I know there's somebody who gets it.

Halfway there...the social worker and visiting nurse have stated that she belongs in a nursing home. If we can get her wingnut doctor to "prescribe" that she go there, then it can be done. But that involves getting him to say legally that she's a danger to herself and can't make her own decisions, short of a competency hearing.

Mom's a wreck, I'm a wreck...hell, the whole family's one big train wreck at this point.

Any ideas what we should do/say to the doctor to convince him? I can't get a reading on him at all, so I have no idea if he's one of those strictly by the book guys or if he'll fudge a little in the best interests of the patient.

Ask him to perform a MMSE ( mini mental status exam) to determine competency. They don't take even ten minutes and can be done by any doc. It will hold up in court if challenged. If the score is low enough , she can be certified incompetent to make decisions and a guardian can be appointed. Then nursing home placement can be done. If all else fails call DHR and ask them to evaluate the home situation.

Thanks, I'll pass that along. I guess mom talked to him this afternoon, and he thinks she's going to end up getting pneumonia (whatever that was before wasn't either pneumonia OR CHF), and from the hospital she'll end up getting placed in a nursing home for good. He doesn't want to commit himself to saying she's not competent...quite the opposite. He told mom that she's capable of making her own medical decisions. Apparently not eating, not getting dressed, not getting out of bed (she sleeps something like 17-18 hours per day now) and not taking her medicine isn't incompetence, it's something else.

I'm at the point where I truly think it would just be easier if she were gone. That's a horrible thing to think, but it's how I feel. The sooner the better.