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I am scared . He is in a nursing home for his care, they are on lockdown because of Covid 19 . He is depressed and just wants to come home and die. My heart is broken. What makes it harder is I am in Florida , he and my siblings live in Pennsylvania. And two of my three siblings need to "grow up" a bit and stop being selfish. They focus on the money , how much things cost, (which I know is important) but my brother does not want to help, my middle sister barely helps, my oldest has very broad shoulders and is caring the weight of everything. I help as much as I can but I live in Florida and I am battling some of my own health issues.
We have a meeting tomorrow to discuss my father's continued care and they tell me he qualifies for Hospice. I am scared this is the end, he refuses and further transfusions.

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I know you don't really want to hear this, but depending on where he is in his diabetic complications, hospice may be the best option to avoid a lot of future suffering. The anemia may be because he is no longer producing enough blood anymore or it could be from a small bleed in his colon. The ulcers may be from the anemia, but they could also indicate some end run diabetic issues too. I've known some aging diabetics who came to deeply regret prolonging their life through multiple complications and amputations. His life long companion is gone and if his quality of life is diminished too, then maybe it is time to accept the end has come.
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I'm so sorry you are going through this. Please take what I have to say as just another perspective. I believe it is a legitimate choice for a person who is terminal and is done suffering the ravages of illness/age, to choose to end treatment and turn to palliative care. Being depressed does not negate that choice, especially when there is no hope of recovery.
I also believe that we as loved ones should honor that.
It is clear that Dad is accepting the idea of death and that he wants a say in how that plays out for him. Instead of trying to talk him into continuing treatment maybe you all could tell him you will support him with love, if that is his choice. Ask him how he wants to spend his days and assure him you will do what you can to help him.
I hope this does not offend.
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Is his depression being treated?

Does he have a living will? Does he expect to be kept alive with extreme measures or prefer to let nature take it's course?

Is he competent to now decide to not do anymore transfusions? If he's competent, I think he's allowed to make that decision.

I agree with comment on finding out WHY is he anemic? Instead of keeping on doing transfusions, why is it happening? Perhaps there is a less invasive treatment that can help keep his numbers up.

Going home to die is something many people say they want, but I'm not sure if it's always a good idea. Is there someone that is able to take care of him if he goes home on hospice?

79 isn't wicked old but he does appear to have a lot of issues and it might be valid for him just to be done with it all. Sorry.
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Welcome Kathie!
You say dad is depressed. Is that being treated?
I think the isolation and restrictions going on right now are especially depressing for elders in rehab centers and nursing homes.

Please ask for his depression to be evaluated and treated when you meet tomorrow.
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Fundamentally I believe that making the choice to discontinue treatments is not something that should be denied him just because he has dementia, but if the staff are clumsy with the needle would a port be an option, and would your father be willing to try that? There must be an underlying reason for the anemia, is that being addressed, are there other treatment options?
I'd like to share a Teepa Snow video that I found very helpful
https://www.youtube.com/watch?v=mNJxq4J5kYY
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Shane1124 May 2020
I’m not sure a port can be used for blood transfusions due to several factors: one is that transfusions need to be given with a large gauge needle & two the port could get a clot which is why transfusing through that line is not generally done. Chemo yes. I could be wrong though as I haven’t done clinical nursing in 5 years.
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