End stage of CHF for my dad?

[emptyboxcars]

This may be too difficult to say what stage he's in, but this is about all I know. My father and his wife have no desire to see the doctor often or know a prognosis. He is on oxygen full time and has been for a couple years. He's on coumadin and a number of other meds (won't really share with me the specifics). He has had two heart attacks and went to the docotr each time a full 24 hours after the heart attack. His last heart attack took place about 6 years ago and was diagnosed with congestive heart failure then. He is 77 years old.

At this point, he has liver damage, kidney damage, edema, dyspnea, nausea (from meds) and rests a fair amount throughout the day. I live out of state, but he sounds somewhat breathless on the phone these days and his memory is failing. He repeats himself now, not realizing he's already said something (no dementia/Alzheimer's, but from limited oxygen supply). He has told me he bruises very easily. He says that just squeezing him too tightly will cause bruising. He also started having some kind of ovewhelming infection in his gums (says it's due to low oxygen circulation) and they ended up doing surgery adn pulling all of his teeth. Now, however, he can't wear dentures because they've had a difficult time stopping hte bleeding in his mouth and every time he puts the dentures in it's simply too painful and makes him bleed. So, on top of hte nausea, he's stuck with a soft foods diet. This has not helped him emotionally/mentally nor physically. He hardly eats anything anymore. A year and a half ago when I visited him and he had his teeth, he ate 3 potato chips for the whole day. Now, as I understand it, he eats even less if that's possible. Despite this, overall, his mood is chipper, but he definitely is struggling with depression over having lost all his teeth and being in so much pain, etc.

I'm just wanting to prepare myself and find out if he's in the end stage. I tend to think he is, but it's just so hard to know since they go to the doctor as little as possible.

Is there any way you can tell me based on this info.? I know for sure it's either Stage three or four, but I just would like to prepare myself emotionally if he's nearing the end. I hate being so far away and knowing that I might not make it to see him before he dies.

Also, how do they typically die and might there be enough time for me to fly out there (6.5 hr flight)?

THank you.

[traumaRUs, MSN, APRN]

I am so very sorry for what you dear Father is going thru. It must be so hard being so far away.

No one can predict or even state with certainty what stage he is in. However, with the multi-organ damage you mention, I would plan a trip to see him sooner versus later.

Both of my parents are gone now and I appreciated the time that I had with them BEFORE they died. I wish you the best.

[emptyboxcars]

Thank you for taking hte time to respond to my thread and thank you for your kind words. My mother died when I was 6 years old and I was very close to my father growing up. I am only 33 years old and hate the thought of both my parents being gone. This will be especially hard since I grew so close to my father all those years. I already have planned a trip for mid July, but just want to emotionally prepare myself for what I might see in a couple weeks when I see him and prepare myself for a realistic timeframe for his death. Thanks again.

[ccweisbard]

I think it would be very difficult to tell what stage he is in, it may be even more than just the CHF, it sounds like he has some COPD to me. I honestly would make a trip sooner rather than later because he sounds like he is really struggling. My dad died when I was young and I would've done anything to see him one last time. You might prepare yourself for the worst, that way if it isn't as bad as you prepared for, then you are better off, but if it is then at least you are ready. Good luck to you :)

[nursej22, MSN, RN]

I am sorry for what you and your dad are going through. If indeed your dad is end-stage, he is at high risk for VTach which could result in sudden cardiac death. I hope he has made his wishes for end of life clear to those close to him and his doctor.

He will probably become progressively more SOB and may begin to have angina at rest. I hope he will go back to his doctor if this occurs, because good medical management could make the end of his life much more comfortable and ease suffering. Would he be amenable to hospice?

Best wishes

[nursel56]

So sorry for what you are going through. My mom is in a similar very unstable situation due to multiple respiratory issues. When things start to go bad, it seems to go like a cascade, so I keep my phones nearby all the time, but I have to keep time off work to a minimum at the same time. Sending cyber-hugs your way. {{emptyboxcars}}