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Share information, support and advice on all aspects of caring.
Hi sorry I haven't been able to introduce myself first but I am in need of some urgent advice.

My 91 year old mother is currently in Hospital being treated for Pneumonia. They believe it was caused by food going down the wrong way and into her lungs. As a result of this she has been nil by mouth so she can rest her throat muscles in an attempt to make them stronger.

She has not had her daily tablets since she has been in hospital because of the nil by mouth.

I am really worried that not eating, drinking or taking her daily tablets will cause even more problems and cause her to get weaker. She is not on anything to give her nutrition.

She hasn't eaten in a few days and got to go without anything until Monday at least.

I really feel that this isn't the correct way to go about things but none of the nurses or doctors are taking my concerns seriously.

(Her daily tablets are important because they treat her heart condition)
Ask to see the person in charge of the ward. I am just a lay person, but would have expected her to be on a drip at very least. Is she having any medication at all, like antibiotics to fight the infection.
I'm also extremely concerned at your mother's situation. Could you confirm if she's having any intravenous liquids or medication.

Heart medication is important - my husband takes a variety of pills and when he was regularly sailing his doctor would prescribe an anti-seasickness patch (usually only available on private prescription) because of the danger of not being able to keep down his daily medication if he was ill onboard.

I hate to mention it, but if your mother is really receiving no medication or hydration (something that is vitally important for the elderly) what came into the back of mind was the notorious "Liverpool Care Pathway" (so I hope you can confirm that she's receiving something).
Hi Vanessa,
I agree with previous replies, if your mum is being treated for pneumonia she should have a drip/ line etc through which fluids, antibiotics etc can be given.

If she is nil by mouth, her important heart medication needs to be administered intravenously. If you don't get results via the medic in charge of the ward, I would contact your Mum's cardiologist urgently.

I agree it's vital to talk to someone in charge of her care, who will ultimately be a consultant, though I doubt you'll see them, but at least the 'next doctor down'....or failing that the ward sister etc. You do need to know what the treatment plan is for your mum, and what is going on, and why.

If she is on a drip, then that will be giving her the fluids she needs, and it could well be giving her the nutrition she needs. Do bear in mind that as a very elderly lady, plus that she's simply lying in a hospital bed right now, her actual need for nutrition will be very low. She'll be like a car engine just 'ticking over' at standstill. Moreover, if she is carrying any 'weight' at all (fat reserves!), her body will be able to draw on them, even if the liquid food going straight into her veins (where all our food ends up eventually anyway!) is very low level (it will be mostly sugar I would think).

As for her heart medication, again, do remember that this can be given non-orally for her - it can be injected into her (when you're not there), or applied perhaps as a patch that 'soaks in' through the skin over several hours.

BUT, this should be made clear to you on her treatment plan.

I'm afraid I, to, echo the possibility that your mum has been placed in palliative care now, and her actual condition will not be treated 'therapeutically' (ie, with the aim of getting her better and out of hospital) but simply to make her 'comfortable' (ie, not in pain etc) while 'Nature takes its course' (the Liverpool pathway that is supposed to let critically ill patients simply 'fade away'). (If there is no sign of drips going into her, this might be an indication this is happening....).

Do you know if a DNR (Do Not Resucitate) has been applied to her? My understanding (which may be wrong!) is that a doctor (a senior one I believe, eg a consultant) can, off their own bat, authorise a DNR, irrespective of what the family might want and possibly even of the patient's wishes (if they are in a state to express them)(I'm not sure about that at all, but I do know that the concept of a DNR is to avoid any drastic treatment - such as CPR - which could be highly traumatic for the patient, and very possibly cause further injuries - eg, broken ribs while applying heart massage - that would only result in death shortly afterwards anyway, or a severe deteroriation in the quality of life). In a way, a DNR is, again, a means to 'let nature take its course'.

Although I would very much hope not, there is also the possibility that your mum's care in hospital is NOT what it should be! A friend of mine's mother was in hospital for a heart condition, but she was also severely diabetic (Type I), but because it was a cardio ward, several times my friend visited to discover that her insulin had NOT been given, that she had been allowed to go hypo etc, because she was being given the wrong kind of food at the wrong time. This was clearly just incompetence by the hospital, nothing to do with any 'deliberate treatment plan'. SO, I say this because it could be that your mum's heart meds have simply been 'forgotten' or whatever, so definitely worth checking and finding out whether what is going on is 'deliberate' or 'incompetant'!

Finally, I'm going to raise the very ,very difficult subject of how you would feel if the hospital has, indeed, placed a DNR on your mum, and is letting her follow a palliative-only path.

Your mother is now a very elderly lady - yes, she might, possibly, live for years year, but you do need to ask yourself how good her quality of life will be for those years. I say this because, very sadly, my MIL is now 93 - her body is very strong for her age, but her mind has now almost completely gone. She has advanced dementia, has to live in a care home, and really, the only 'final mercy' for her will be for her to 'slip away'. I would not wish her fate on anyway.

Sometimes, you see, life ceases to be a blessing, and becomes a burden. Please do think long and hard about which it is for your mum, and which it is likely to be.

(By completely contrast, of course, she might make a very good recovery, and have years of 'good life' still left for both her and yourself to enjoy.)

Hopign the hospital matter gets understood and resolved if necessary, kind regards at a worrying time, Jenny
Thanks to everyone for your help and advise. After talking to Dr yesterday, mam is now being allowed sips of water which has calmed her down. She is on intravenous antibiotics and vitamins. I have ongoing concerns with her nursing as everytime the nurses attend to her they leave the buzzer on the wall and not on her bed so, as she is bed bound, (she is also blind and profoundly deaf), she has no way of alerting them.
I have also gone back to find her lying down flat which the Dr stated should not happen due to her breathing problem. When I mention it to nurses they are very put out and on the defensive. Although she is now being treated she is getting the very basic of care that a much younger, normally healthy person would find difficult. I am off to hospital today to see Dr again and voice my concerns.
I am sorry to hear this Vanessa. My 31 year old severely disabled son is in a similar position. He has been in Intensive care for 28 weeks yesterday and is completely unable to operate the button to call for help. He is supposed to have one to one support but they keep taking his nurse off him to go and help with other patients. He relies on help to suction him in order to cough because he has a tracheostomy and cannot talk. He has woken through the night feeling like he is choking and needing suctioning and no one is there to do it. We have complained until we are blue in the face but we get the same rote reply every time. There are people in here worse than him, we never leave him alone there is always someone within calling distance (considering he can't talk). I hope you manage to get things sorted for your mum.