I need to rant

[Sphynx]

Please don’t read if you are likely to be upset by criticism of NHS.

My beautiful mother has been in her care home for about 4 years. She has deteriorated lately and today the manager said he thinks she is possibly at end of life. The thing is, she has a UTI and if that could be treated I think she would be ok. Our difficulty is that she will not take medication (tried everything) so the only way to get antibiotics in her is through an IV and last time we decided enough was enough and took her to A&E we had a 9 hour wait with mum needing the loo repeatedly and myself and my sister not able to manage to help her well. Someone (some sort of community nurse) came to assess her today at the request of the care home. He said she has an infection but not bad enough to need emergency ambulance so it would be a 4 hour wait for transport and then a however long wait at A&E. I think that would have finished her off so we put her to bed.

I just can’t believe how many barriers there seem to be for something as simple as IV rehydration and antibiotics. Her GP is useless. Tried to get her moved but the GP in catchment won’t take patients from her care home because of some historic argument. I feel like we just go round and round in circles watching Mum get worse because no one will help.

 

[mhw]

Depending on what her palliative care/eol plan is they may not prescribed any iv drugs at the end as its basically prolonging the inevitable and actually causing more pain and suffering.
I know that's not what some people want to hear sorry, but if the body is shutting down and the patient refuses oral meds and or fluids etc the doctors have that difficult decision to make.

 

[canary]

Has your mum stopped eating and drinking?
My father in law reached this stage when he had very advanced dementia and got a UTI. He was taken into hospital, given IV antibiotics and was rehydrated, but he did not start eating and drinking again and passed away.

A similar thing happened to mum. She was taken into hospital because she stopped eating and drinking, but no infection was found, so she was rehydrated and sent back to her care home. She didn't start eating and drinking again, though. I talked to the GP and we decided to just let nature take its course.

I agree that the NHS is in a state, but once they stop eating and drinking they are already dying. There comes a time when you have to consider - will this intervention extend their life, or just prolong their death?

 

[Sphynx]

She was eating and drinking before she got the infection. She has stopped eating & drinking because she feels ill. She had started eating and drinking again when she felt better after the antibiotics and rehydration last time. I am sort of at peace with her dying, but I want her to be comfortable and peaceful if possible.

 

[Duggies-girl]

She was eating and drinking before she got the infection. She has stopped eating & drinking because she feels ill. She had started eating and drinking again when she felt better after the antibiotics and rehydration last time. I am sort of at peace with her dying, but I want her to be comfortable and peaceful if possible.

My 88 year old dad with dementia was already on palliative care for terminal cancer when he caught pneumonia and was admitted to hospital. He was put on oxygen and given iv antibiotics and blood transfusions and he recovered to go home. I was happy with the treatment dad got as it was appropriate for him at the time.

The hospital stay was not pleasant but I won't go into that right now because it is not relevant to your mums condition.

Dad may have been in better general health than your mum but he was treated all the same. I just want to point out that palliative care does not mean 'no treatment' it means any treatment can be given to make the patient more comfortable but life prolonging treatment that may cause harm should not be given. Dad recovered and lived another year at home quite happily. If your mum is at end of life then this won't happen but she can still receive treatment that makes her more comfortable.

You know your mum best and I hope that you get what is best for her.