A new kind of question.

It's been a long couple of days. Donny hasn't been doing well, and taking care of him has me feeling ran down. The air quality has been bad enough to really mess with Donny's breathing. A few days ago (probably a week or a week and a half ago) he started having a really bad cough. I'm talking about coughing so hard that it's hard to breathe, and it lastging for 15 - 20 minutes at a time. He would cough until he puked. It was awful. So I started giving him some cough syrup. It sometimes helped a little.

And then a few days a go things got worse. On top of the cough Donny's mental function started to decline, he started hallucinating even worse. I kept on trying to treat him at home because I was afraid that the hospital would just send him home if I tried to take him in. Friday night things got really bad. Even then I was afraid that my last hope for help would turn me away, so I didn't take him in. I kept saying that if he wasn't better in the morning I'd take him in.

Around 10:00 on Friday night I was in the office when I smelled something burning. I decided to go investigate, but there was nothing cooking in the kitchen. So, following my nose, I went to the garage. I opened the door to discover that there was a considerable amount of smoke in the garage, and Donny was just sitting there. I hollered at Donny, since he was just sitting in the middle of all that, and then I went looking for the cause. It took me less than 10 seconds to realize that the microwave was running, and appeared to be the source of the smoke. When I opened it up, there sat my favorite mug, once full of coffee, now a smoky mess. It took 2 days of cleaning, but the mug is okay.

Donny obviously couldn't be trusted on his own, so I sat with him for quite a while. He was hallucinating really badly and was quite obviously out of it. Around 2:00 on Saturday morning my mom told me to go sleep, that she'd take a shift sitting with Donny. During this time he came in and tried to wake everybody up because he was sure that my grandma had said somebody had died and he couldn't remember who. He also woke me up to tell me that there were people in my car and I needed to go make them leave. There were a couple other times that he woke me up, but I can't remember what for. Around 5:00 my mom woke me up because she just couldn't deal with him anymore. He had left and had to be chased down the street 3 different times. At one point he had a lit cigarette that he was trying to put in his recliner. When my mom tried to take the cigarette away he hit her.

So yesterday morning I took Donny to the hospital. At 8:00 on a Saturday morning the ER isn't nearly as busy as I'm used to seeing. We waited for less than half an hour for triage, and he went straight to a bed from there. The ER staff wanted to know who had tested Donny's ammonia levels since I knew that they were high. I had to explain that I had said that, based on past experiences, I suspected high ammonia levels. That's when I got the sympathetic smile and understanding nod. It's a universal gesture that reeks of pity. What really shocked me was when his ammonia level came back at 64. That's barely elevated, it in no way is high enough to account for what was going on with his brain. But the ER did find pneumonia in the lower lobe of his right lung, so he was admitted for that. And I came home and slept.

So now we face the tough decisions. At what point can we no longer care for him at home? What resources are available if I can't keep him safe at home? At what point will the hospital take him? What do I do now?