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My husband hates to take his diuretic because of the excessive urination. If he doesn't take it, he gurgles when be breathes, and the lymphedema in his legs gets worse, causing leaking wounds.
His cardiologist is okay with him not taking it everyday, but wants him to take it at least 3 times a week. I'm lucky if I can get him to take it once a week. His wonderful caregiver can usually get him to take it, but if I try, he gets ugly. Do I just let it slide, or do I make an issue of it? Is dying from CHF worse than dying from dementia?

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Only you can now decide, as POA, when it is a case of hospice and accepting that the heart pump is failing. If you are seeing both "gurgling" (which indicates there is left heart failure and the lungs fill without diuretics) and lower peripheral edema (which indicate right heart failure and inability of heart to pump fluids up to be eliminated) then you are looking at a truly failing heart pump. There is no answer for this other than addressing the symptoms. So that, without the diuretics your husband will be in distress from breathing. Eventually something called "flash pulmonary edema" can happen in which case the lungs fill dramatically and QUICKLY. This can lead to death. If hospice is chosen and there is air hunger and distress your husband would be medicated below the level of feeling this distress. His death may thusly be hastened by some minutes, hours, days, weeks or months, but not drastic amounts of time; as I said, this heart is failing.
Only you can make this decision. If your husband is not taking his medications, it is time to level with the doc and tell him you now want hospice, and you accept he is at end of life, but you cannot accept the daily torment he is in, and you are witnessing as a helpless bystander 24/7. I have said this now twice today. I am a retired RN. I have witnessed many deaths and I have ZERO fear of death. What I do fear is our torment and torture BEFORE death.
I wish you the very best. You have reached the land of there being no decision that brings joy. Of no "fix it" solutions.
Dying of CHF without hospice? Yes. It isn't good. It is basically "drowning". And dementia? It can be a daily torment to the one living who faces loss upon loss, including even the loss of "self". And a torment to the loved one who stands helpless witness to it all. My heart goes out to you. These are hard decisions. Ask to interview and consider hospice now, would be my advice.
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My husband too was on a diuretic either daily or every other day. He at the time was able to swallow it, but as I remember, it was the kind that you could crush as well. Perhaps just crush it up and put it in some of his food. At least then you will know that he is taking it, even if he won't. My husband had a supra pubic catheter at the time as well, so it didn't matter how much he peed, but I would not have wanted him to drown in his own fluids. There's a fine line for sure, as taking the diuretic, does help remove the excess fluids, yet it also lowers the blood pressure as well, and you have to be careful with that. It's a kind of damned if you do and damned if you don't. I wish you the very best.
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What’s HIS incentive for taking it? A treat? A movie? A walk? A visit from a fun friend (or puppy)?

Have you tried a fancy calendar with his obligation days marked clearly, so that he can CLEARLY identify the days when he has to suck it up and “SUCK IT UP”??

Sadly, this one is SUPER close to my heart- I lost a VERY DEAR LO who was not encouraged to do the meds, and the wounds ultimately hastened her death. Hope you can find some GREAT BRIBE that will do the trick!
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Maple, does he have a urinal that he can keep close by so he doesn't have to make a trip to the bathroom so often?   Or even a commode?
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He'll likely die of CHF before any dementia kills him. The question is when?

My mom has CHF and has been taking Lasix 3x/day since 2014. It pretty much brought any outings to an end. Only taking it a few times a week would have been a dream.

In spite of the diuretic, he'll still get the edema, so if he doesn't take it at all, he'll essentially drown in his own fluids.

I agree that it's time for hospice to make him comfortable. They won't cut off the meds, but neither will they force them on him. You just don't want him to suffer.
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