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non treatment in hospital - Carers UK Forum

non treatment in hospital

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hi havnt been on here lately,my mum whos 88 with dementia was admitted to hospital 10 days ago for dehydration from a chest infection,she was checked and told later that day could go home a nurse who overheard conversation said she should stay another day and they would sort a care package out,next day they decided to sort constipation out then day after she slept all day,doctor said he didnt exspect her to wake up to my suprise few hours later was sat up in bed eating food ,next day she was sick i suspect noro virus as the lady in next bed had same symptons,then on weekend i caught it ,yesterday i was told a care package was being set up and she would be home next couple of days they were giving her anti biotics for small lung infection,today i spoke to doc and to my suprise he told me they would not give her any more anti biotics if she gets anything else that would be it because of her age ,can they do this?
Sounds like they're talking along the lines of DNR - Do Not Resuccitate. I'm not sure what the law is, but I think that the doctors can decide on their own bat that no more 'therapeutic' care be given (which might just be not resuccitating her if she has a heart attack etc - ie, they won't give her CPR - and/or it might mean not giving her antibiotics to fight off an infection.) Although I think the docs can make that decision they MUST back it up with medical evidence etc -basically they are 'leaving someone to die' and that has to be justified in some respect.

I'm not sure if either you, as a relative, have a right to challenge that DNR, or even if she does!

If this is a question of DNR/withdrawal of therapeutic care, then although obviously I can understand why you would be upset (!), BUT, please, please do consider just what would be the alternative? Yes, your mum may 'bounce back' (it happens!) but it may also be that her quality of life post hospital would be very grim indeed.

Death comes to us all - modern medicine can keep people alive in circumstances that we, if it happens to us, might prefer not to experience. Do remember that 'in olden days' (ie, before antibiotics), pneumonia was usually regarded as 'The Old Man's Friend' ......

Others here may have a lot more expertise in knowing just what doctors do and don't have the right to 'dictate' in terms of therapeutic or life-extending treatment.

Wishing you well at a worrying time, and I do hope the 'right decision' is made about your mum, whoever gets to make it, and whatever that 'best' may be.
many thanks for reply,i have already been told by doctor they wont resuccitate her because it would be cruel
Webby

When mum went into her final decline we told the district nurse we were keeping her at home to die as that was mum’s most ardent wish. When we were presented with a DNR to sign, we couldn’t quite bring ourselves to as it felt like signing a death sentence.

The doc was brill with us. He explained very gently that resuis is a brutal process; it has to be to re-start a stopped heart. It’s not at all the gentle brace up and down shown on telly. Even young strong adults often have their ribs broken by the process.
The doc also said that by the time a person reaches their 80’s their bones are very weak, even hale and hearty looking octogenarians have weak bones, frail ones are like glass.

He said the decision lay with us and without a DNR if, by chance an ambulance was called, they’d have to resus by law.
Perhaps home deaths are different to hospital ones.
Dad and me talked long and hard about it, and by the time the doc came the next we had signed it. In our case the DNR wasn’t for the doc it was to give to the ambulance personnel. I still can’t fathom the logic of that as mum was having a home death.
We felt awful, but knew it was for the best.as she died very peacefully in her own bed.

It’s a shock when you first hear those words DNR; I know I was. But I think with very old patients they do know best. In fact it would be torture to resus a really elderly person. Obviously for younger people a few broken ribs are a price worth paying for life. But for an octogenarian approaching their time it would be beyond a crime to do so.

My thoughts are with you Webby

Take care of yourself

Sajahar xx
Sajahar, a wise and compassionate post.

In a way, it might be nice if the medics could come up with a new acronym along the lines of LNTIC - Letting Nature Take Its Course......

One of the sayings I hold very dear is this - apparently it is an Arabic proverb:

'Until my hour comes, no man can slay me.
But when my hour comes, no man can save me.'

I find that a comforting thought.
Yes, I've seen another version of that saying, and I like to think it's true.

When my mum was very ill, the GP completed a form, I believe it was called the Critical Care Form, which was a single sheet of A4, with a summary of all mum's ailments (some I'd suspected but no one had ever actually told me), it also said the GP had talked to mum about DNR, and she had signed the relevant form.

This CCF summary was then copied to the nursing home, and the ambulance service, so that in the event of any emergency, everyone knew what the situation was. Such a good idea, although it would have been even more helpful years earlier!!!

So I'd suggest to anyone with a frail elderly parent that they ask the GP if he/she feels it appropriate to complete a CCF?
Webby,

I understand what you're going through. My mother passed away a couple of weeks ago, she was 88 and had all sorts of health problems, including some dementia (though it was hard to gauge how bad it had become).

My father is nearly 86 and is in a care home. When he went into the home he had moderate dementia but was still fairly switched on, mentally. Now, two and a half years later, he has become much more frail, can barely walk, has developed incontinence and his dementia has progressed onto the next stage. He sometimes thinks I'm his sister and regularly asks how his own parents are (who died many years ago), but can't/won't process the news of my mother's death. He is confused and sometimes talks to imaginary people. Just over a year ago he went into hospital with a urinary tract infection, then developed pneumonia. He barely pulled through it. He now has another chest infection and they've put him on antibiotics. I have mixed feelings about whether that was the right choice for him, because his future looks very bleak so maybe the medics aren't doing him any favours, keeping him alive to then experience the final, hideous stages of dementia. In his position I'd not want anything to prolong my life, just painkillers when needed.

I doubt that anything I say here will help you, but just wanted you to know you are not alone in wondering what is for the best in this type of situation. It's just so hard contemplating the death of a parent, even when they've had a long life and they are struggling with various phsysical/mental infirmities, it's just so hard to face the fact that their time is coming to an end.