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My 89 year old father just got out of a week’s stay in the hospital that left him weak and needing help to do almost everything in life. He lives in an assisted living home with my mother and until he went into the hospital he was totally independent. Suddenly now he can’t seem to find a reason to continue to live. It makes me so sad to see him this way. He has always been the most positive person I know in life. Now he says he has nothing to look forward to except death. Any ideas?

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If this is "suddenly" it could be depression due to last illness; speak to the doctor with him.
However, by the time my Dad was in his 90s he was over it. He had had a wonderful life. He was exhausted and wanted only to sleep. He was able to discuss this with me, and I had many patients as a nurse who were able to discuss with me that they were exhausted now by life and ready to go. They told me they couldn't talk honestly with families because "they don't want to and won't hear it".
So my advice is to talk honestly with Dad about his feelings. Tell him that he may be ready to go and you can understand that but that you are not ready to lose him; ask him if there is anything you can do to make him look forward to a bit more time with you. Be certain to honor his wishes about end of life, as that's what he is looking at.
I, as a nurse, am now a RETIRED nurse of 80. I know personally what many of my patients felt. I have had a good life. My children are approaching retirement age. I have seen much and done much and traveled. I am well and able still (happily) and I can still get around, but I am ready. There is no upside to the inevitable losses of aging. We lose out balance, our eyes, our ears, our ability to tolerate food, our stamina, our skin elasticity, our breathe, our hair, eventually our minds and all that makes us us. There is no going back from that long slow slide down. It is daunting. Many of us are ready, after a long life lived.
Talk with Dad, and with his doctor. Ask if a mild anti depressant might serve as a bridge over this last illness, and a willingness to go on a bit. Accept the truth of what your Dad feels, would be my advice. It would be such a gift to him. I will never forget my last honest conversations with my Dad. They were a great gift to us both.
My heart goes out to both of you.
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help2day Oct 2022
Alvadeer ~ Wow. There is so much truth to what you say. You have put this so eloquently. "Tell him that he may be ready to go and you can understand that but that you are not ready to lose him". My Mom started the "death talk" when she was in her mid 80's and it was so depressing because, while I tried to console her and be upbeat, it was like talking to the grim reaper. My Dad was even worse. While death did not seem imminent, at 80 yrs of age, he told my MIL that he "wouldn't be here by Christmas." This was in Sept. He had COPD. He was prescribed an inhaler that he would never use. After his death, I found prescriptions for the inhalers that he would fill still in the bags unused. Honestly, he was a negative person all his life and looking back, I think he willed himself to die. He was in the hospital ER with shortness of breath in November on his 80th birthday, no less. The last photo I have of him was him sitting in the ER bed with a birthday cake that his sister brought to him. It was so sad. He died the day before Thanksgiving of a heart attack in the hospital, only 7 days after he was admitted. It was awful as my Mom expected him to "get better" and come home. He didn't want to talk about death or his wishes. I'm positive he didn't talk to my Mom about it. He was afraid to die.

My in-laws were just the opposite. It was so refreshing to have these "death conversations" with them because, while no one WANTS to die, they were very positive, yet pragmatic, about the end of their lives. I've chosen to be positive, like them, when talking to my own children about death. Death is a part of life. Everyone will face it.

You're so right. We get to an age (with our various ailments) when we're just done with living. Our bodies hurt and there's really nothing to do about that. Some elders stay totally engaged in their waning years but others (like my parents) just want to go. They were so depressed about it. It's hard as a child to accept those feelings from your parents, but as I age, I'm getting it.
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Jeannewc, if the family hasn't done a Family Tree, now would be a good time. People love to answer questions about their past. For example, my Dad had ridden horse back to school 1-12 grades. The school had a barn where the student's horses stayed. That was so interesting.

After my parents had past, I got interested in doing a Family Tree as I wanted to know more about my parent's own cousins, aunts/uncles. Oh how I wished my folks were still around to answer questions, and to help identify old photos.

I bet your Dad would love to hear "Dad, I need your help on some research". Worth a try.
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help2day Oct 2022
That is such a great idea. I so wish I would have done this with my Mom. However, my Aunt (Dad's sister), did come over one time to sit at the kitchen table with my Mom to identify some relatives in black and white photos on Dad's side of the family (he had already passed by that time). My Mom was already forgetful by that time and my Aunt was invaluable. Wish I would have done this sooner than later.
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Why was he not sent to rehab to help get his strength back? If he didn't want rehab, why was "in home" not set up?

A week in a hospital can be depressing. Its a change in routine and there can be delirium involved. Elderly do not do well with change. Maybe a trip to his PCP would help. Don't wait for that "see ur primary in 2 weeks". When my Mom was in the hospital they screwed with their meds. Mom was on 80mg of B/P meds when she went in with pain from a back fracture. They upped it to 160 mg. I asked why at discharge, they said because of the pain, the fracture was repaired so no pain any more. Mom couldn't get off the couch. PT said her B/P was very low and called Moms PCP and he took it back to the 80mg and she was back to normal.

Ask the Nurse at the AL if Dads present meds were adjusted by the hospital or new ones added. My DH never had high B/P until he went in the hospital for AFib. They were able to get it under control. At discharge I asked why B/P meds. Was told because of the AFib, I said no AFib now. Waited that 2 wks they recommend, Dr. told my DH he should not be walking and took him off the meds.
The Hospital Drs do not consult with the patients primary.

If Dads meds have been adjusted or added to, this maybe his problem. If no "in home" therapy was set up, I'd get that done too. The Nurse maybe able to help u with this by calling Dads primary. She will need an order from the primary to change meds and set up in home which is paid by Medicare.
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Hopefully you will be able to do at least part of this with the help of the staff at the AL.

If there is a social worker available in the Al where your dad resides, ask for their recommendation for the psychiatrist who sees residents there.

I was surprised to learn that several of the residents in my LO’s facility received psychiatric services, and she was seen by a very competent, gentle person who after learning a little about her from me, her POA, interviewed her with me present, and prescribed small amounts of geriatric approved medications and saw LO every couple months.

The change was gradual, but heartwarming.

There was a planned schedule of activities at her AL, including music, arts and crafts, religious activities for all major denominations, and LO’s favorite, cooking!

If your dad had any enthusiasms or hobbies previously, bring small reminders with you to his residence, maybe a magazine about whatever he liked before. See if you can think of adaptive ways of restoring his interest.

Music is very healing, and one of the easier ways to provide some sensory input when depression is a problem.

Bless you for being sensitive to his situation, and big hope that you’ll be able to come up with some solutions!
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i know it's hard to see a parent depressed but these things take time. if he just got out of the hospital and the loss of abilities is new, he has to process the grief of having lost so much of his normal functioning. the only thing you can do is love him and let him know you are there for him and you care. he may come out of it gradually and naturally, but if it goes on for weeks he may need some antidepressants prescribed by a geriatric psychiatrist. just know that you can't give someone else a reason to live, you can only love and support them until they find it themselves.
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My dad dealt with this at around the same age. A small daily dose of Zoloft was a big help in having him be more positive and content. He had no real side effects, just a better attitude
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All the reminders to acknowledge your father's feelings are so important. Listen to his sadness. Do not try to talk him out of his feelings. Expressing those feelings to you and anyone else who will listen without judgement will help him come to terms with his situation. He may begin to find some glimmers of joy with a little more time. Do not try to force a more positive attitude. Let him talk even if it is uncomfortable for you to hear. We too often want another person to be happy and positive to make ourselves feel better.
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So sorry...
Listen to him.....
Be present with him...
Affirm his feelings....
As painful as it may be to listen to his " laments", it is important to give him permission to voice and vent as he needs to .....as long as he is safe.
Call his faith leader, pastor, rabbi, priest etc. and be sure that they are in regular visits with him. If he does not practice a faith, perhaps a local chaplain or a social worker .
If he is a veteran, perhaps enlist VA veterans support.
Illness brings grief and what is called " spiritual distress", "the loss of meaning, hope, purpose and direction". It will take time and energy and patience as his " new normal" evolves and accepts the present. It is not clear from your note what diagnosis or prognosis your father has. In addition to being sure that he is receiving the physical exercise other recovery needs met,( as he is able) it is vital that he have opportunity for conversation on his topic of choice, perhaps with you, other family, his faith leader, others, stay hydrated with water ( as his physician directed plan of care allows), read to him from books or papers of his choice, offer sound nutrition choices per physician directed diet, offer options for him to be helpful to others while he is aging/ or in recovery perhaps he can send cards or notes to veterans or some other outreach doable from home. Love him....aging brings so much change....and change wroughts grief .....grief from past is often relived, present grief and, grief about the future, the unknown
( anticipatory grief)
Get grief support for him and YOURSELF......your self care is equally important.....

Your father is grieving his decline.
You are grieving his decline.
All of the many physical, emotional, spiritual changes happening to him
( and you , although different) bring a fragility and uncertainty. Getting help and assessing both your needs with professionals will assist you both as you tread the waters of aging and illness.....
Peace.
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Does he like to read? This can be an endless treasure trove of time to pursue this interest and perhaps extend his current knowledge, if he likes to read. If he has any expertise in an area others could benefit from, he could also start a blog or a website and share his wisdom and knowledge with others. If and when he gets ambulatory, he could join a church group if he wants direction in life.
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RedVanAnnie Oct 2022
While he is this depressed, he is unlikely to give any attention or energy to reading.
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I agree with having an honest but sensitive conversation with him about how no one gets out of here alive (per AlvaDeer's very wise thoughts).

I agree to consider meds for mood, which may help him be more willing to do rehab, if this is an option. Your mom benefits from his improvement, too.

It is still all very fresh, so give him (and yourself) a little time to come to grips with his new normal.
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