Active management of chest infection post aspiration pneumonia

Discussion in 'End of life care' started by doodle1, Jan 26, 2019.

  1. doodle1

    doodle1 Registered User

    May 11, 2012
    241
    When do the doctors say enough is enough? Three weeks ago MuM aged 941/2 had a seizure followed by aspiration pneumonia. She was admitted to hospital and recovered enough to be sent home,having had IV antibiotics,with only oral antibiotics. She was very bright the first two days afterwards ( for mums stage that is 7b/c). Three days after the end of those antibiotics the chest infection returned and she is now on her third set of antibiotics and it's not clearing. I am very loathe to have her re admitted to hospital for all the obvious reasons . She is very weak and as her gp said is not picking up as quickly as she would like. I should say mum has very very advanced Alz. I have no wish to prolong any distress but equally no wish to shorten her life if she might pick up. I am in bits. I am also an only with no other relatives except my husband and daughters and so the responsibility is mine.
    Any thoughts gratefully received .she has had a very good life.
     
  2. canary

    canary Registered User

    Feb 25, 2014
    9,880
    Female
    South coast
    This is a very hard decision. I would suggest that you go and and have a very frank and open discussion with her GP. The problem is that many doctors (especially ones in hospital) feel that they have to try and preserve life at all costs, but like you I feel this may not always be appropriate.

    When mum got to the advanced stage I talked to her GP and said that I didnt want mum going into hospital as it caused so much distress. We agreed that if she fell and broke a bone then she should go to hospital as it caused pain and that if she got an infection then oral antibiotics would be prescribed, but if they did not work then mum should not be taken to hospital for IV antibiotics.

    In the event mum fell and broke her hip, so she had it repaired under a GA, but this propelled her into final stages and she passed away a month later in her care home, with family around and looked after by the carers who she knew.
     
  3. AliceA

    AliceA Registered User

    May 27, 2016
    2,239
    It is a tough one for you, if she picks up it would only be to the state before the infection at best.
    At one time decisions were just made but everyone seems concerned about being sued to it is back to the family to decide without always enough information to say yea or nay to anything.
    You may have to ask the doctor for an honest opinion. Warmest wishes x
     
  4. doodle1

    doodle1 Registered User

    May 11, 2012
    241
    Thank you both mum has picked up a little and the home are telling me she is a bit better. But the moment she comes off the antibiotics ,I suspect it will be a downward oath again. Maybe I will chat to her gp re more oral antibiotics rather than a re admission yo hospital, x
     
  5. Herewego

    Herewego Registered User

    Mar 9, 2017
    93
    I would look at whether you believe your mom has any quality of life or is she just existing? If so, providing medical intervention is prolonging her life when if nature was left to run its course then the inevitable would happen.

    Why are decisions being made to prolong her life? Is it the right thing for your mom? If it is possible to think about what your mom would want - does that help?

    We are coming to this stage too and it is difficult to say the least - I certainly don't have the answer - I know if it was me (and I have made my wishes plainly clear to my children) they are to do nothing to prolong my life once the quality of life is gone. Making this decision for another however is extremely hard, especially if everyone is not on the same page.

    You can only do what you think is right at the time and be at peace with your decision - no one can make it for you and all any of us can do is what we think is right at the time.
     
  6. Lawson58

    Lawson58 Registered User

    I agree with the idea of having a very serious heart to heart with your mum's GP. Unfortunately, decisions made at a time of great crisis aren't always the best ones but whatever you decide, it has to have the best interests of your mum as the priority. It can be so painful to stop medication knowing that such a decision might not prolong the life of your mum but I wonder if your mum could have the choice, what would it be?

    It seems to me that when people reach such a great age, they often are content to let go, feeling that they have had enough and are too worn out to want to keep on living when there seems so little point to it.

    I do hope that you can find peace as you go through such a tough time and I know that you will make the decision that you are content to live with.
     
  7. Witzend

    Witzend Registered User

    Aug 29, 2007
    4,293
    SW London
    In this sort of situation I once asked the GP what he'd do if it were his own, much loved relative.
    He said he'd want palliative care only.
    So it may be helpful,to ask this.

    I think some (or maybe many) medics are afraid of advising palliative care only, when it seems that it really would be kinder to,let nature take its course, because some relatives can become very angry/indignant or even horrified, if everything possible is not done to keep someone alive, no matter how pitiful the state they're in.
    They are maybe afraid of being accused of callousness and just wanting people to die in order to save the NHS money/beds.
     
  8. doodle1

    doodle1 Registered User

    May 11, 2012
    241
    Thank you all for your responses . I am all over the place. Mum has bounced back atm from her infection it seems. We need to wait another week to see if this remains so. To compound this on Saturday she sustained a cut and bruise to her face in the home that they are saying is an unexplained incident but it has been. Notified to the safeguarding team at the CQ C.
    There is no rational explanation for this incident . Mum loves the home and until now has been fantastically cared for. But this is the third incident in three weeks. The other two could have been put down to rough handling.but this one.....
    Her cough is still there and I am not sure if it is a revisit of the pneumonia or early/ mid stage heart failure.
    .so it's tricky all round ..
     

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