u/ClubControlla

My dad is currently not doing great. He has end stage heart failure and kidney disease. He was moved to a renal ward after being admitted with some sort of unspecified UTI.

The doctor has had a chat with my mum and I preparing us for his likely death.

Since yesterday, he seems to be experiencing terminal agitation. Today, he has removed his clothes, removed his canulla (which was used for pain meds and saline), trying to remove his catheter, doesnt want anyone to touch him or even be around him. He's refused to have cream applied for his itchy skin (which he usually likes).A hospital chaplain came to see him today and he aggresively sent him away.

I contacted the hospital palliative care team who said they'd go to see him but I'm not too hopeful. My mum is very against comfort meds because she thinks they'll just put him to sleep/speed up his death. His sister is flying in from another country to see him amd won't arrive for two days so she doesn't want to risk putting him into a permanent sleep before his sister has a chance to see him (the sister has had four months to visit since he started declining but that's another story.). My mum is in denial generally and up until yesterday she was heavily pressuring him to eat/drink (despite his clear distress.)

Is there a way to help/deal with these symptoms? Any practical tips or weaker medications that won't put him into a deep/permanent sleep?

Edit: I just arrived at the hospital and the (understandably frustrated) doctor was telling my mum that witholding the medication is cruel. He said they want to treat him with 1.25 Midazolam. She's resisting because a nurse friend of hers is telling her that every patient she's seen who's been given it is dead within three days.

She's agreed now I think

I’m on day 20 of Elvanse/Vyvanse 30mg and trying to decide whether to go up to 40mg or straight to 50mg (my doctor offered 50).

Initially it helped quite a bit with anxiety, mood, emotional regulation, fatigue, brain fog, and initiating basic tasks like phone calls/admin/simple meals.

Bigger/more complex tasks still felt impossible to start and I still had that paralysed feeling with things like applications, studying, tidying, cooking proper meals/meal planning, etc. The executive dysfunction didn't really improve at all.

Also by week three most of the positive effects seem to have faded (I now just get a slight reduction in anxiety), and it now only lasts about 6–7 hours before I crash and feel exhausted/anxious/irritable. I didn't have a 'crash' at the beginning.

So now I’m wondering whether 40mg is worth trying first or whether it sounds more like I’d need 50mg anyway. Did anyone here find 40mg noticeably different from 30mg? Or was 50mg the point where it properly started helping with initiation/executive function?

I appreciate any advice!