Last night, dad was more lucid, so he was left w/ the hospital.
This AM, they called Jenn and indicated that he'd stopped breathing, so they put a tube in him after not being able to wake him. He woke up as they were putting the tube in and fought pretty fiercely, so he's restrained and tubed.
This morning, he was completely out. No eye response, and some funny faces. He was basically hallucinating/dreaming and replying to himself.
His kidneys had failed, and that's likely the cause of the whole issue, because w/o kidney function, the morphine couldn't be peed out. He was also dehydrated (Cause of his last kidney failure) and undernourished. The nurses said they think it'd been happening for some time.
The doctor asked if he had a living will or a physician's directive. He said we needed to decide, since everything else was being done by machine, that if his heart began to fail, would he want to be resuscitated.
Jenn said dad had told her he didn't want heroics, but on the other hand, we found an approval form from the nursing home with him signing that he did want to be resuscitated, so basically, normal amount of resuscitation, but if he's dead with machines keeping things going, then that's that.
As this point, we were pretty freaked out. Was was scared, but he couldn't really be coherent enough to know what was going on, other than his throat was blocked (tubed). No tears, but some fearful looks sometimes.
See, I saw him Tuesday, but didn't have daily interaction. His groggies and such were thought to be the shift to morphine, and the staying up so long that day.
Well, people at the nursing home admitted to having witnessed his rapid decline, and no one called us. Some of the nurses hinted at this being a recurring problem. I looked online, and this place, IHS of Arlington, has various complaints for neglect and harmful neglect, as well as health code violations. We're looking at alternatives.
So anyway, he got dialisys today, and some sedation to let him sleep. This evening he was more lucid. He can't see or focus, but he can move his eyes. He has pupil response. He is responsive and makes apropriate gestures. He still has a catheter, arm restraings, and a breathing tube.
Immediately after dialysis, he was a little responsive. His pupils were still small, but responsive. He wasn't really coherent, and he did pee a little bit just prior, but not enough to count. They're going to do daily dialysis, which kept us from being quite so freaked out, because they were acknowledging that his condition was improving and had hope.
He slept for a little while, and was awake later. He's a little dry mouthed, but ok.
He slept more, and I visited mom, Jenn went home to do some schoolwork. We met back up there about 8:30, and he woke up from one of the monitors.
He asked me where he was, and we told him, and he was a little relieved. He recognized us by voice. He cracked a little bit of smile at a couple of jokes, and rolled his eyes at another. He was concerned about having to pee, and we let him know he had a catheter. I asked if his back hurt, and he said no, so that's good. I think he's still heavily doped. His BP vaired. Sleeping, it was as low as 88/49, which is low, but common for him. When a little panicked, it was around 130/80. Just needs more strength. He didn't remember seeing us on Tuesday, so he's at about 5 minutes, which is better than before, which was about 5 seconds.
A couple of times he tried to cough, which doesn't work very well when intubated. He doesn't fully grasp having a breathing tube, and got kinda panicky, and a tickle, and ended up throwing up. He had to be suctioned, but in the end, he calmed down enough to go back to sleep.
The nursing staff is ok, but he'd have been there with a mouth full of bile if we hadn't called them in.
I want to check and see what levels of blood gas they're looking for before letting him off the ventilator, because he normally doesn't get over around 80%, just because of his sleep apnea. I think an oxygen mask will be sufficient once he's become more coherent. I didn't check while there.
He went back to sleep eventually, which is good, and I hope that the monitor doesn't panic over his low BP and wake him up again. He needs good sleep and another round of dialysis I think before he'll really be in reasonable shape.
I'm not sure, but I may not go to work tomorrow either.