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My dementia father was dying with fluid in lungs. He was breathing normally, wasn't agitated, wasn't sweating. Last time when I measured his saturation it was 87. Due to my dad's behaviour no family doctor prescribed morphine over the phone [house call was impossible and we got no place in hospice]. So dad appeared ok but I read that a dementia patient may look calm, ok, breath normally but still feel discomfort due to pulmonary edema. Has anyone ever been in similar situation when the doctor decided not to give opioids despite fluid build-up in lungs? Would appreciate your answers very much.

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Did hospice come out and do an assessment on your father, as if they did I'm quite sure that he would qualify for their help?
It sounds like your father should be on 24/7 oxygen if his oxygen levels are below 90.
Hospice will supply the oxygen concentrator, and any other equipment, supplies and medications(including morphine)that your father requires, plus they will have a nurse to come check on him once a week to start and aides to come bathe him at least twice a week. And all of it will be covered under your fathers Medicare.
You can either have his doctor order hospice care or you yourself can call and they will come out and do an assessment.

My late husband who almost died of aspiration pneumonia and developed sepsis and septic shock from it, continued to have fluid build up in his body until his death 22 months later. He was under in-home hospice the entire time and was prescribed Lasix to remove the fluid, which helped some. And he was also on 24/7 oxygen to help him breath.
So call hospice today(yes they're available 7 days a week 24 hours a day)and have then come out and do an assessment, and yes even if you've already called them. If you don't get anywhere with one hospice agency, call another, as most cities have plenty of hospice agencies to choose from.
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Reply to funkygrandma59
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He may not have needed pain killers. Morphine is used for ease of breathing and pain, Dad didn't seem to have those problems. Nurses can tell if someones in pain by their bloodpressure, it will go up. Pause Ox# has nothing to do with pain. Its how much oxygen is being saturated by the body. If your Dad was on Hospice, there is no calling of a Doctor to come visit.

Opioids are pain killers, not water pills like Lasix. Seems Dad had CHF and there is not much you can do in the final stage. The heart can no longer pump blood thru the system so no oxygen goes thru either. There is a point that giving oxygen does not help either.

I am sorry for your loss but he was on Hospice because he was dying. No measures are taken to keep him alive. Its comfort care. Seems from your discription, Dad was comfortable.
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Reply to JoAnn29
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Fluid in lungs is addressed not by morphine, but by diuretics which eliminate the fluid. Your father had a heart pump too week to do an efficient job. If he was comfortable there is no issue here. You tell us he was breathing normally without struggle.

Who told you that there was fluid in the lungs?
When they told you that there was fluid in the lungs, what did they suggest should be done about it at the time?
I do not understand your telling us "and we got no place in Hospice".

You told us "My dementia father was dying with fluid in his lungs". Did your father since die? If your father was no in discomfort there is really nothing to discuss, and our own experience of loved ones with weakened hearts and fluid accumulations are unique to us, and have no relevance for your father.

My condolences to you. There is much information of pulmonary edema online for you if you are interested in following the condition, it's causes, it's treatments. The reason I ask who told you that there was fluid is that "crackles" and "rales" due to pneumonia or fluid secretions poorly cleared may sound like fluid to the uneducated ear.

My best to you.
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Reply to AlvaDeer
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Sat of 87 means he needs oxygen. Acute CHF spells means another trip to the ER. No doctor will risk a license to treat CHF at home. The morphine is given by syringe for rapid treatment to reduce shortness of breath which he did not demonstrate. Even on hospice and even morphine may not be in his treatment plan. During these crisis it is best to get the patient upright for his low oxygen, then call an ambulance to get him the meds he needs to remove fluids.

And yes, I have seen patients in the ER who had no dementia go into cardiac arrest during a crisis and never complained about pain or discomfort.
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Reply to MACinCT
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