by Beth Whitman
Dad got the flu this winter. Funny thing was, it didn’t look like the flu. I thought he was just more tired than usual, or that maybe he had the mid-winter blues.
What I discovered, though, is that the flu looks and acts differently in older folks than it does in the rest of us. Dad showed none of the symptoms that we normally associate with influenza, at least not until AFTER he was admitted to the hospital.
Here is what his flu looked like: For three days, I noticed Dad getting weaker and weaker. He started out just lying in bed all day. He had no interest in activity, and he didn’t seem to have much of an appetite. To get him up and moving around, which seemed like a good idea, I had to walk with him the 20 steps out to his living-room chair. He didn’t have the energy to button or even zip up his pants. I asked him if he was okay.
“Yes” was all he said, but it wasn’t convincing.
He soon became incontinent because he didn’t have the energy to get to the bathroom in time, and then not even the energy to stand up and pee in his portable urinal. He had also lost all interest in consuming fluids.
By the third evening, when it was time for him to head into his bedroom, I went over to help him stand up. He was slouched in his big stuffed chair by the window, and seemed unusually extra-tired. I asked him if he wanted to be wheeled into the bedroom. He nodded, and then coughed a little. So I brought a wheelchair over to where he was sitting, and put my arm around his back and gave him my arm to lean on, but he was just dead weight. He couldn’t stand up — even with my help.
I called my neighbor, Steve, and asked him to come over to help me transfer my father into his wheelchair. The two of us were able, with considerable difficulty, to move him into the chair.
But that minor struggle helped me make an important decision: we weren’t going to wheel Dad into the bedroom after all. It was time to take him to the hospital.
We drove Dad to Waldo County General and wheeled him into the emergency room, where they hooked him up to IV fluids, took a nose swab and performed some other tests to find out if there was anything heart- or stroke-related going on.
The tests indicated he had the flu but was otherwise okay. We decided to admit him to the hospital, even though he barely had a cough and had no fever at all. But that relative tranquility was short-lived. By the next morning, Dad’s fever emerged, along with a terrible hacking cough.
Later that day I was talking to a nurse friend of mine, thinking how fortunate it had been that Dad was admitted to the hospital before his fever and cough began. What she told me changed everything I thought I knew about influenza in older folks.
“The problem,” she explained, “is that older people sometimes no longer have the ability to mount a fever. So the flu virus is running rampant in their body, and there is nothing resisting it. The lack of fever is what makes the situation more dangerous, not less.”
I went from feeling like I had been fortunate and appropriately cautious in catching Dad’s illness early on, to realizing I had actually just caught the virus in the nick of time and maybe even a little on the late side!
Had I waited any longer, and acted any later, it might well have been disastrous. In other words, rather than congratulating myself for being Ms. Proactive Caregiver, I was actually lucky — as was my dad — that I finally got around to getting him the help he most assuredly needed.
Dad was in the hospital for three days. On IV fluids the whole time.
When he came home, he was weak, but definitely gaining strength with each day. The biggest challenge, I soon discovered, was keeping him hydrated.
He was still not so interested in consuming fluids, so my task was to find ingenious ways to get him to drink. I served him every manner of fluid with straws — the bend-y kind — so it would be easier for him to imbibe. Indeed, almost everything I served him, I had already dosed with extra water (apple cider, root beer, orange juice, whatever). More often than not, meals were soup. Every time I came in the room where he was resting, I picked up the most recent glass and asked him to take a sip. And I did this before I did anything else — before cleaning up, giving him a meal, even saying good morning. I wouldn’t even wait until he was upright before putting the straw into his mouth and encouraging him to take a sip.
I organized neighbors to come by every hour for visits. Their first task after saying hello was to hand him a glass of fluid with a straw in it and say, “Here, Arthur, have a sip.”
One of the neighbors, Ridgely, got really expert at it. She cajoled, pleaded, made deals, and found creative ways to achieve her goal. Here are some of the details:
Ridgely asked Dad what his favorite drink was, and went out to get it for him. She made smoothies, floats, any concoction he wanted. She went out in the snow to get chocolate soda with vanilla ice cream!
In fact, the snowfall this winter was up over the window, so she made a deal with Dad that if he finished his glass of fluid, she would go out and dig the snow away from the window to give him a view.
She would play simple games with him (cards, rock-paper-scissors, anything) and if Dad lost, he had to take a drink.
Ridgely’s efforts were much appreciated and got Dad over the hump. He went from an emergency hydration project to just a regular elder in need of constant reminding. I continue to be vigilant about how much Dad is drinking — or not drinking — so I keep the house filled with bend-y straws, and I still cut his favorite juices and sodas with water.
Once Dad reached the level of being well hydrated, it became much easier to keep him that way. It’s the climb back into healthfulness that’s the hard part. But you have to stay on the alert. Dehydration in the elderly should never be taken lightly.
Beth Whitman lives in Maine and is a member of Belfast Cohousing and Ecovillage, a developing community on the coast of Maine focused on multigenerational living and sustainability.