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Adrian

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Hi All--

Things seem to be going downhill at the moment. My dad has now been on Tarceva for 9 days and we have no sign of a rash. His appetite is terrible and his fatigue and weakness continue unabated. He seems to be getting confused quite easily lately--words get garbled and occassionally he says things that don't make sense. It is taking longer and longer each day for him to get out of bed...it is 3 pm and he still hasn't gotten out of bed today.

Here's my question: How do we get him to shower? It took us four hours of begging for him to muster the strength to get up and to take a shower....he hadn't taken one in 5 days...He is just so weak but at the same time, he doesn't seem to be at the point of taking a sponge bath etc....

Any ideas on what to do? We are really sad and really scared right now.

Thanks for your thoughts.

Best,

Leslie (It says that I'm Adrian because I'm writing from my parents house---and the computer won't let me log in as myself.)

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The taking a shower may wear him out. You can go to the drug store (or Walmart)and get a shower seat so he can sit while showering. It would also help for him to have a hand held shower head. I did this for my father after he had a stroke two years ago and it really helped him. It took me all of 10 minutes to change the shower heads and assemble the shower seat.

I hope your father gets stronger soon. I will keep him in my prayers.

Susan

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Leslie, I'm really sorry you folks are having such a rough time.

Let's look at the strictly physical part of the problem first.

Getting to and from the bathroom: Do you have a walker that your dad's been using or could use? A wheelchair? In his weakened condition I think he should probably use one or the other, hopefully on a temporary basis. Without one of those for security he might have a (fully justified) fear of falling with the possibility of injury and the certainty of embarrassment.

The shower: Is there a seat in the shower, and is everything he needs within reach without having to stand? Grab bar(s) conveniently located?

If all those aids are in place, then something else must be going on which might be hard to identify. I'm sure you've considered possibilities such as new brain mets, drug reactions, insufficient oxygen, etc. One thing my dad had was "mini strokes" sufficient to affect his vision and his mental processes without any of the one-sided muscle weakness typical of more extensive strokes. My father-in-law would become totally debilitated (unable to stand, talk, or respond at all) with a relatively small elevation of temperature. Bring it back down a couple of degrees and he was fine again (fine for age 92). And I believe it's common that with some degradation of mental capacity (mild dementia), one of the first things to disappear from a person's radar screen is personal hygiene. Not saying that's where we are, but it's a possibility.

Though I doubt if laziness or stubbornness is part of the picture, your comment about "four hours of begging" makes me wonder. All I can do is put myself in his position. If it was clear that I had lost some mental capacity, I would be matter-of-factly escorted to the shower and assisted until finished. If I was resisting for some unknown reason, I doubt if there would be any begging. My sweet wife's eyes would flash and bore laser holes into my skull, and if that didn't work, she'd get the help of our 300-pound neighbor who got frostbite in the Korean War and is still tough as nails (though a real softie when it comes to kittens, puppies, and injured birds).

Gosh, Leslie, I don't know what else to suggest. Maybe one sponge bath would cause him to realize the old-fashioned way is best...

2-3 hours later: I read this over after returning from an appointment and thought wow, Ned, those last couple of paragraphs were a little blunt, don't you think? Yes, I guess so, sort of like talking to a family member, but I'm sure you'll take it in the same spirit as given.

Aloha,

Ned

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And a call to Oncologist to amke sure everything is ok might be in order. I know everyone is different but not sure about the fatigue Level he is experiencing. There could be a lowered state of Red Blood cells which causes the fatigue. Aranesp or a transfusion would ficx that. Just a side note!!

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Maurice experienced extreme fatigue when he first went on Tarceva. He was unable to get out of bed until about 4pm each day. After about 2 - 3 months of this it dawned on me that he was pretty good from about 4pm to 8pm each day and that seemed to be his strongest time of the day & so we asked the onc if he could take the tarceva at night & sleep through the worst of the fatigue. It has made a difference. Most days he gets up at a reasonable time ( 8am ) and is fine until about 11am when he goes & takes a nap for an hour or so, then gets up until about 3pm and takes another nap.

Tarceva has to be taken on an empty stomach so we set a small alarm clock for 11pm and that's when he takes it.

He also needed a shower stool during that time but doesn't need one now. Good luck with Dad, I hope this helps

wendyr

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All--

Thank you so much for your kind thoughts and words of wisdom. We have a wheelchair, a walker, a shower stool, arm rails, a removable shower head...we have it all. He is just so incredibly weak--that everything is hard right now. He stayed all day in bed yesterday and is barely eating anything. Last night, he said that he thinks he might be dying...and that he might need to let go soon.

Ned--You never have to apologize. You have been like family through this journey...nothing is too direct in this house.

Keep us in your prayers.

Leslie

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Leslie and Adrian, I want to let you know that I have been thinking and praying a great deal for you, your family and your dad. I am so sorry that he is so very weak right now, but I am very hopeful that this is a temporary setback and that he will have more energy soon. The important thing is that all of you are there for him. I know this must mean a great deal to your dad. Shelley

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Leslie,

lots of prayers for your dad and your family right now. It's so hard. Just make sure to tell his onc. everything and be sure he isn't dehydrated. Sponge baths work ok until his strength returns.

Just know we are all here for you and saying lots of prayers that your dad regains some strength soon.

((hug))

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ok... I know this is gonna come off sounding mean or cold hearted but really its not. its meant to protect you and your dad.

while we younger folks shower everyday sometimes even 2x a day for older fols it isnt necessary. old folks if they are doing little to no "work" can easily get away with 1 -2 showers/baths a week barring any "accidents". everyday you or the caretaker needs to go in with some Aloevesta http://www.cvs.com/CVSApp/cvs/gateway/d ... iveCat=499^Query=aloe+vesta^SEARCH.x=56^SEARCH.y=6

this is a cleansing foam that doesnt need to be rinsed off. heat the bottle in some hot water so it doesnt feel cold. put some wash cloths in warm water. ring cloths out an either aplly AV to skin or to the cloth and and hit the odor causing area "PTA" under arms, genitals, and behind. do this EVERYDAY esp if your dad is spending more time lying in bed. BEDSORES can happen very quickly (overnight in some cases) use the time to look for these spots darkened discolored swollen red angry areas. these areas usually appear in bony areas. and can break the skin in hours.

bath/shower time wears a person out so dont be supprised if they wanna sleep when you are done. and dont be supprised if at some point they dont care anymore about a shower...its not something the "care" about anymore. we want to take care of them an think its totally necessary and its not...as long as someone is doing the skin check and being sure he is cleaned with the aloe vesta. which can be used all over the body and can even wash the hair with it.

LOOK FOR AND PREVENT bed sores... they are the fastest ticket into a nursing home I know. and to top it all off the last thing you want is some busybody telling you you are neglecting your dad. and calling protective services.

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