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80 year old dad has been increasingly sleeping over the last 18+ months, physically inactive to the point he can barely walk outside the home. He sleeps up to 18-20 hours a day, barely leaves the house. Has been checked by cardiologist, pulmonologist, gerentologist, ophthalmologist, etc to screen for other possible causes of no energy. No issues except for sleep apnea have been found. He will start treatment for that. the family would like to see him treated for depression and PT started for him to gain some strength. His dr says he is mildly depressed but doesn’t like to prescribe meds for it.
When we try to get him to walk he says it hurts and he refuses. He basically sleeps in a recliner all day and watches cable news.
we are worried he eventually will be immobile.
any ideas on how to proceed? He’s very guarded with sharing information on his health.

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Why does it hurt when he walks ? Has he been to a doctor about that ? Maybe that’s partially why he’s depressed .

Hopefully having the sleep apnea addressed will help to some degree .
He is 80 though , a decline in energy will happen .

Is he willing to take an antidepressant ? If he is , then get another doctor’s opinion about that .

Ultimately you can lead a horse to water ……..
It may also be time to look at some assisted living facilities . Perhaps life is just getting too difficult for him , and he needs help with daily life and perhaps live with people his own age who understand each other .
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llkain Nov 18, 2024
Yes, he’s recently been checked by several doctors, he says it hurts to walk. He has not been physically active for years. Drs have told him to start walking.

He & my mom plan to stay in their home. She is 79 - quite fit, still works, works out, etc.

I read that depression can physically manifest too..,
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He’s still very sharp. Not worried about cognitive issues right now.
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The sleep apnea is likely a giant reason for this.
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Sleep apnea is not something to be trifled with. Chances are he’s gotten little to no rem sleep in years since he’s developed it.
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llkain Nov 19, 2024
This is making sense. He was just diagnosed with it. Hopefully he can be treated for it soon.

maybe that led to the depression too…
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Even if he went to a different doc who was willing to prescribe meds for depression... would your Dad even agree to take them?

He's depressed so he is sedentary. Because he's sedentary, he has no energy and it now hurts when he walks because that's what happens when you're 80 and stop moving... like the Tin Man in Oz. You seize up and it's a lot harder and takes longer to get back to your former abilities.

In her early 80s my MIL had chronic back pain from a prior broken back injury (and her not doing her PT) and also memory loss. We moved her to AL. She eventually refused to get out of bed for no other reason than probably depression and the beginnings of dementia. We tried everything: more PT, a progress chart, a poster with her sons' faces on it, reason and logic, begging. She became bedridden and for more than a year she even refused to do anything socially or even eat with others on her LTC floor. It's an excellent facility so it felt like such a waste. But then the staff just kept patiently encouraging her and now at 89 she participates in everything, from her wheelchair. It is what it is.
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Perhaps it's time to bring hospice on board, or even just suggest it to him that you're considering it.
That may be enough of a wake up call if he's not quite ready to throw in the towel yet to have him seek the help he needs.
And if it doesn't work as a wake up call, I would bring hospice on board as "failure to thrive" would qualify him for their services.
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Does he listen to his wife? The one who plans to age in place with him, the one who caregiving for him will mostly fall on when he becomes completely immobile? Seems mom needs to inform him clearly she’s not aging in place by giving up her active life when he’s refusing to do anything to help himself. Not convinced if you found a doctor to prescribe med for depression that dad would take it at all. The family surrounding him needs to realize worrying changes nothing and make clear if he won’t try or make changes, he won’t be aging in place at all
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Wait and see how the treatment for sleep apnea goes, because that is MAJOR. You say "just sleep apnea" but it can ruin any sleep to the extent that the person is ALWAYS absolutely exhausted, especially at his age.

As to the mild depression, if this continues it is worth trying a low dose anti depressant as the more "off his feet" he gets, the weaker he will become, hence the vicious circle of weakness leading to more weakness and less "will" to move.

I am 82. I sympathize. I am very active, care for my home, my garden, shop, cook, walk, and etc. But there are days you wish you could just stop. In his 90s my dad admitted, good life that he had had, he was OVER it and just exhausted, longing only for sleep and the "last good long nap". It happens to us. We do simply have it eventually all become just too hard, and we long to crawl under a good feather tic with a pretty duvet and go to sleep. It is something one must actively fight to stay involved with life. Stay involved! Hey, why do you think I am HERE, pounding away on the keyboard, pretending I am "still" a nurse and a caregiver and can STILL help.

Such is life. All complicated. You have done all the right things. You have got a diagnosis. Wait until treatment (not easy one as most seniors hate the apparatus) starts, see if it helps. And I am one who might consider forcing the issue on low dose anti depressent. Just a tiny bit of gas for the engine.

ULTIMATELY it is up to Dad. We all make our own decisions on this end of life stuff. When we are ready to pull in the sails and batten down the hatches and crawl into the easy chair, just LET US. After you tried what could be tried, just let us, OK? We have HAD our lives. It's OK. Not your responsibility to make us happy, or well, or active, or involved, or even to make us care. Just be there to say Hi. Give us a good book. Make our favorite casserole. Send chocolates. A picture you remember. Chat with us and get on with your own life them. That time after Dad leveled with me that he longed only for the last long nap, and got out of bed just for my mom, he and I would lie on his bed chatting. He told me so many stories of his life; he told me the worst thing he'd ever done in his life; the thing he never stopped remembering (so small a thing). They were our BEST TALKS and I remember them to this day. So just chat with Dad. That's all. Don't push him. Don't worry in his face. Just leave him and don't negate his thought, his wishes. And don't enable him; let him fetch his own coffee (if that's safe; but you get my meaning).

Good luck.
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