Chf and 92 yr old mother

[nymima01]

Good evening all! My 92 yr old mother has chf and afib. She seems to be having a difficult time of it lately and is very tired especially in the morning when she gets up. We saw the cardiologist recently and her afib has been acting up too. She has tachycardia many days. (She has a pacemaker for syncope for almost 8 yrs). The doctor doesn’t want to put her on amiodarone and I agree. She takes 40 mgs of lasix, Eliquis, metoprolol, magnesium, and Lipitor. What would help her at this point? The cardiologist seems to be just managing her condition, but she is getting more uncomfortable with her symptoms. The only symptom she doesn’t have is a cough. But she has crackles and rattles, and breathes heavy when sitting. Walking is getting difficult for her. It takes her a while to get up and dressed in the morning. Is there is anything that can be done to help her feel better. What is happening and what can I do?

[Love100cats]

Listen to your mum. Do whatever she thinks will make her feel better. If she just wants to sit in her nighty in a comfy chair , so be it! Dignity comes from being listened to and if she has had enough poking and prodding let it be. You are doing what is right for her now so don't beat yourself up. Just carry on caring as best you can. X

[MichaelJH Heart Star]

I think the main task now is to make her as comfortable as possible. Medication can be an issue in advancing years as the liver and kidneys can struggle to breakdown and flush out the byproducts if the medication. My late mother had Parkinson's and bad arthritis. Her medication had to be simplified in her latter years as her body could not cope with drugs like Naproxen. Good luck, and hopefully a happy medium can be reached in the New Year.

[Nathan53]

Hello - It can be so hard watching a loved one become frail and tired. I think you already know that some things just can't be fixed but it's natural to seek to make things better for a loved one. Undoubtedly I think your Mother's age and heart failure will be the major cause of her fatigue. I observed this with my Mother who was in a similar situation. Like Michael says sometimes medications result in stronger effects on the frail / elderly. I know that metoprolol and lipitor can make you feel very tired. I built a really good relationship with one of my Mum's GP's who over time reduced the dose of various meds as she agreed that although she was on the correct dose according to the drug maker etc it may be too strong if the person was frail maybe not eating well etc. It may be worth a medication review without seeking to mess about too much. I agree that making her comfortable can be the best maybe elevating legs when sitting and changing position frequently moving around if possible. If your Mum struggles to eat? soups soft food complan type drinks etc. It's about looking at what your Mum would like really, of course I am sure you already do that. With my Mum there were times when I think I was too preoccupied with her diet etc etc but our best times were when we had fun doing crossword together karaoke on YouTube etc. Often Ill and elderly people don't want to focus on keeping well but want some distraction as well. This is a lot from my frame of reference please don't think I am over suggesting as I can tell you love and care for your Mum. Best wishes to you all

[nymima01]

The doctor has eliminated 2 drugs about a year ago. Digoxin and Tykosin. They were just not helping her at all any more. She only takes the Lipitor 3x a week and it helps here cholesterol levels. One thing with her is that she ALWAYS has an appetite! She has never complained of not being hungry. She has complained of feeling nauseous, but it doesn’t last too long! Lol. She still looks forward to meals. She doesn’t cook anymore however and relies on us. We don’t use salt in our cooking and we make a balanced diet for ourselves and her.

I just don’t want her to suffer if I can help it. The doctor is not doing any further Doppler or echos on her because he feels even if he finds a valve problem, she can’t have surgery anyway, so what is the point of all the tests. I guess I had to agree. He still does her ekg and checks out her pacemaker to see how often she is in afib. It is quite often for a while now and her heart seems always to be racing when we are there. That is alarming to me and her doctor doesn’t like it either, but amiodarone is out. Now he wants to see her every 3 months at this point.

[nymima01]

Her liver enzymes seem to be okay. Is that what we should be looking at? Her kidney function is at 38 gfr.

[Nathan53]

Liver enzymes is a good marker for assessing whether statins are causing a problem so your Mother is ok on that score. It's good that GP has put her on Lipitor 3 times a week instead of daily. A lot of GP's wouldn't have thought of that - it's still an effective dose. Gfr level would be regarded as low for a younger person but seems ok for a 92 year old. Is your Mother able to keep well hydrated - because of the heart failure it's a balance between not becoming dehydrated but also not consuming excess fluid. You really have thought of everything I think your Mum is fortunate to have you look out for her. Look after yourself too.

[nymima01 in reply to Nathan53]

TY. I just have to remind myself that we’re not looking for a cure at this point, but rather keeping her comfortable. Her cardiologist nicely reminded me of that last time we saw him - with a wink and a nod.

[Chappychap in reply to nymima01]

"your Mum is fortunate to have you look out for her. Look after yourself too."

Very well said Nathan.

[nymima01]

Up-date: I see I wrote this 4 months ago when Mom was starting to suffer a lot from chf. Now, 4 months later, she is on Hospice. She’s went downhill quickly after I wrote and she was assessed for hospice and she was accepted. They are wonderful and I feel like she is getting quality attention. And she is staying home in her own home. I live close by, so I will be involved in her care too, but we are no longer racing around from doctor to doctor to find some sort of relief for her symptoms. I understand and so does she why she was having the symptoms. It is easier to deal with this now. It is a hard reality, but we both feel well cared for now and not so anxious.