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How to periodically monitor COPD in an elderly person with multiple ailments?

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Practicing since : 2001
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My husband is 78 and has COPD, congestive heart failure, vascular dementia, multiple myeloma and Afib. He also suffers from chronic back pain due to multiple back surgeries starting at 26 and wears a fentanyle 12mcg patch. This has been reduced from 50 mcg due to the COPD. He continues to smoke. Stopping is not an option. He won't. The dementia gets worse every hospitalization. He is coughing more. The phlegm is clear not yellow. When yellow I took him to the doctor and he was prescribed an antibiotic. It got better then. At his last heart follow up, his doctor said his heart was strong but the air in his lungs was not moving around a lot. I believe that he is coming to the end. My question is when do I know to bring him to the ER. I know that as his COPD will progress, so will his coughing and phlegm. I would not hesitate to visit the ER or the doctor except that each visit makes his dementia worse. I am his only caretaker 24/7 and that makes everything worse. When do I need to be proactive and when do I let the course of his disease(s) run.
Thu, 10 May 2018 in Hypertension and Heart Disease
Answered by Dr. Ilir Sharka 3 hours later
Brief Answer:
I would recommend as follows:

Detailed Answer:

Welcome and thank you for asking on HCM!

I passed carefully through your question and would explain that the situation of your father seems to be really complex with all these disorders.

Coming to this point, I would recommend monitoring his blood oxygen levels periodically with an oxymeter. You can buy it in the pharmacy or internet.

In case of oxygen levels lower than 85%, I would recommend bringing him to the ER.

Another alarm sign to bring him to the ER would be in case of confusion (delirium) and agitation, which are common signs of demetia.

Also, if you notice swollen ankles and difficulty breathing, it would be necessary bringing him to the ER.

Fever, could be another reason for going to the ER. Infections and fever can precipitate his medical condition. That is why in such case it would be necessary bringing him to the ER.

Hope you will find this answer helpful!

Kind regards,

Dr. Iliri
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