Hello all,
Does anyone else have any experience of anticipatory/just in case medications being prescribed but not actually present for end of life care?
My grandfathers doctor was never brilliant, he had to regularly be essentially forced by management of the home to come out when needed and often point blank refused. As annoyed as we were by this we did accept that it is unfortunate but it is extremely common for doctors to be like this with care homes and once over a certain age it is very difficult. The care home told us multiple times that his doctor wasn't the only one like it - infact they didn't have any doctor on their books for the residents that was different. We also have first hand experience as he used to be our doctor and a medical condition that I had had for 10+ years without any success of solving from him was solved within 3 weeks of moving. He also told me that my allergy to pollen was down to my weight and losing a few pounds would help it.
The unfortunate thing was that Grandad knew him/trusted him and he was a 'familiar face' so when he had capacity he refused point blank to change doctors and we respected his views.
The anticipatory medication was prescribed for my grandad on Monday morning as he hadn't really recovered from 3 days worth of haloperidol that the doctor had given him after he'd become aggressive. The haloperidol really hastened the end and clearly wasn't suitable. The staff were horrified at the change. (The care home told me they just wanted further mental health support put into place but the doctor overruled and prescribed the haloperidol that just turned him into a zombie and stopped him eating/drinking/being able to communicate even slightly and more) We were assured it was put into place and that it would be ready when things progressed.
Admittedly things progressed quicker than we thought they would as I was called 11pm Monday night because his skin had mottled and he was cold to the touch and was panting like breathing. When I arrived half an hour later he was really obviously distressed and in agony though unconscious. He had been given oramorph but they told me that his anticipatory medication wasn't available. I asked for Rapid Response to be called as he clearly wasn't comfortable and was crying in his sleep/unconcious state and grimacing and they said that they couldn't do anything as it wasn't there - but did authorise a dose of oramorph every hour to keep him comfortable. Thankfully after the rest of the hour had passed (after the first dose) - and a further half hour ish (after the second dose) he finally calmed somewhat and remained 'asleep' until he passed at 3.40am. (much more suddenly than we all expected).
We are in two minds as to whether or not to make a complaint about this as it was horrific to witness (especially as it was clear from the mottled skin/breathing/fingertips going blue) that the man was dying and heartbreaking to think of what he was thinking/feeling at that time too given he was literally crying. We don't want it to happen to anyone else!
However my sister in law is a GP approx 60 miles away from where we live and she said that sadly it isn't unheard of for it to happen like that and given that it was so quick after being deemed end of life care it was always likely that the medication wouldn't be there (but there was a good few working hours of the doctor/pharmacy day left and it was emergency meds!) She agrees that it was wrong and horrendous for him to die like that - but says she isn't surprised that it did.
Has this happened to anyone else? Is it more common than we'd like to think?
Thank you
Does anyone else have any experience of anticipatory/just in case medications being prescribed but not actually present for end of life care?
My grandfathers doctor was never brilliant, he had to regularly be essentially forced by management of the home to come out when needed and often point blank refused. As annoyed as we were by this we did accept that it is unfortunate but it is extremely common for doctors to be like this with care homes and once over a certain age it is very difficult. The care home told us multiple times that his doctor wasn't the only one like it - infact they didn't have any doctor on their books for the residents that was different. We also have first hand experience as he used to be our doctor and a medical condition that I had had for 10+ years without any success of solving from him was solved within 3 weeks of moving. He also told me that my allergy to pollen was down to my weight and losing a few pounds would help it.
The unfortunate thing was that Grandad knew him/trusted him and he was a 'familiar face' so when he had capacity he refused point blank to change doctors and we respected his views.
The anticipatory medication was prescribed for my grandad on Monday morning as he hadn't really recovered from 3 days worth of haloperidol that the doctor had given him after he'd become aggressive. The haloperidol really hastened the end and clearly wasn't suitable. The staff were horrified at the change. (The care home told me they just wanted further mental health support put into place but the doctor overruled and prescribed the haloperidol that just turned him into a zombie and stopped him eating/drinking/being able to communicate even slightly and more) We were assured it was put into place and that it would be ready when things progressed.
Admittedly things progressed quicker than we thought they would as I was called 11pm Monday night because his skin had mottled and he was cold to the touch and was panting like breathing. When I arrived half an hour later he was really obviously distressed and in agony though unconscious. He had been given oramorph but they told me that his anticipatory medication wasn't available. I asked for Rapid Response to be called as he clearly wasn't comfortable and was crying in his sleep/unconcious state and grimacing and they said that they couldn't do anything as it wasn't there - but did authorise a dose of oramorph every hour to keep him comfortable. Thankfully after the rest of the hour had passed (after the first dose) - and a further half hour ish (after the second dose) he finally calmed somewhat and remained 'asleep' until he passed at 3.40am. (much more suddenly than we all expected).
We are in two minds as to whether or not to make a complaint about this as it was horrific to witness (especially as it was clear from the mottled skin/breathing/fingertips going blue) that the man was dying and heartbreaking to think of what he was thinking/feeling at that time too given he was literally crying. We don't want it to happen to anyone else!
However my sister in law is a GP approx 60 miles away from where we live and she said that sadly it isn't unheard of for it to happen like that and given that it was so quick after being deemed end of life care it was always likely that the medication wouldn't be there (but there was a good few working hours of the doctor/pharmacy day left and it was emergency meds!) She agrees that it was wrong and horrendous for him to die like that - but says she isn't surprised that it did.
Has this happened to anyone else? Is it more common than we'd like to think?
Thank you