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I v fluid for advanced alz

Discussion in 'Middle - later stages of dementia' started by Jotag, Aug 23, 2015.

  1. Jotag

    Jotag Registered User

    Aug 19, 2015
    14
    Hi

    I have already posted something similar but no response really . My dad is in hospital with advanced Alzheimer's, extremely low weight sleeping most of the day/night eating and drinking very little. The doctor has taken blood from dad to see if he is dehydrated ?? Telling me that if he is he will be given a iv fluid drip ?? Surly this can't be comfort care, doctor advised they will only give dad enough fluid to bring his levels back up ?

    Anyone with experience

    J x
     
  2. Kevinl

    Kevinl Registered User

    Aug 24, 2013
    4,665
    Salford
    I've no experience of this but if they're testing for dehydration and if he has it they'll rehydrate with an IV drip, seems reasonable enough. If it's difficult for him to drink you say he's "drinking very little" IV is probably the best option.
    I don't really see what the question is could you say what you think they should or shouldn't be doing?
    K
     
  3. garnuft

    garnuft Registered User

    Sep 7, 2012
    6,589
    I have some experience of this.
    My Mam had stopped eating and virtually stopped drinking too, we had a meeting with the consultant at the hospital and I specifically asked him if he thought IV fluids would be beneficial to Mam.

    His answer was that we would then have to make another decision about withdrawing them.
     
  4. Beate

    Beate Registered User

    May 21, 2014
    11,490
    Female
    London
    Do you have health & welfare power of attorney? Even if not, doctors should consult the family and take their wishes into account. But the thing is, as long as your dad still drinks, even little amounts, he probably wants to, and the hospital can't just deny him fluids. If on the other hand he flatly refused any food or drink, he should have that choice and not be forced on drips. Has the SALT team been to see him at all?
     
  5. Jotag

    Jotag Registered User

    Aug 19, 2015
    14
    Hi

    No I don't have poa over dad, but staff are aware iv looked after him for the last four years and have visited him each day for the last 14 weeks hes been in hospital . Dad will try to drink ( when spoon feed thicken liquids ) the problem is he swollenung isn't good and most of the fluid falls out also has a dropped lip so even less stays in his mouth .

    Doctor has asked my thoughts ( but only when I asked why they had taken blood) I clearly said I don't want any iv fluid as this will just prolong my dads suffering. Doctor advised that it would be comfort care ? I just feel they are only doing it cause of there duty if care ie can't be seen to let someone die of dehydration ?

    Jx
     
  6. garnuft

    garnuft Registered User

    Sep 7, 2012
    6,589
    Oh Jotag, your dear Dad.x

    If it were me I would ask for him to be kept comfortable and pain free,

    I would ask 'is he at the end of his life?' and seek reassurance that they will do all they can to keep him comfortable and pain free.

    A private room and pain killers would be my priority.

    Strength to you, my friend, in these harsh times. x
     
  7. Jotag

    Jotag Registered User

    Aug 19, 2015
    14
    They tell me they don't know how long he has?? Last guess was months , but looking at him today I doubt that very much, I feel the staff are to worried to give a details , luckily he has a private room and is already on a morphine patch. We'll see what tomorrow brings another meeting with the doc

    J x
     
  8. garnuft

    garnuft Registered User

    Sep 7, 2012
    6,589
    Best wishes for tomorrow's meeting.

    Try to go for plain talking...sometimes Doctors are reluctant to broach the subject, understandably, as different families have different approaches.

    It will help the Doctor to know your approach and what your Dad's approach would have been.

    I hope you and your Dad have a peaceful night, I know you won't be able to stop thinking and being afraid, but I share my shoulders to help you bear the burden (sadly it's only through the ether) and hope it helps you to battle on for a little longer. x
     
  9. Jotag

    Jotag Registered User

    Aug 19, 2015
    14
    Thanks

    I will try the plain talking again tomorrow did try on Friday and didn't get my anywhere, all the doctor kept saying was he needs fluid to keep him comfortable .. I sometimes think it doesn't help that I'm doing this alone and only 31 ( dad has early onset now 59) so there's a bunch of doctors and various other people .. Then there's me with very little knowledge - all I know is my dad is suffering each and every day now

    Thanks for the support

    J x
     
  10. Beate

    Beate Registered User

    May 21, 2014
    11,490
    Female
    London
    If he has trouble swallowing, he really should already have been seen by the SALT (speech and language therapy) team. Has this happened?

    I am afraid I agree with the doctor's comfort care argument. It's cruel to take fluids away from people if they still want to drink. Not giving fluids does not hasten death. This article, even though it's from the Daily Mail, sets out the NICE guidelines quite clearly:

    http://www.dailymail.co.uk/news/art...g-watchdog-fears-banned-care-pathway-use.html

    "Now guidance from NHS watchdog Nice – the first of its kind – expressly tells staff to ‘support’ dying patients to drink, or get them to suck sponges soaked in water if they are very frail.
    It specifically points out that dehydration is ‘unlikely to hasten death’ and fluids will not ‘prolong’ the dying process, but in fact ease a patient's suffering.
    Staff are told to make patients and their families fully aware of this fact in case they are hoping that by avoiding drink, the end will come more quickly."
     
  11. garnuft

    garnuft Registered User

    Sep 7, 2012
    6,589
  12. Jotag

    Jotag Registered User

    Aug 19, 2015
    14
    Hi
    Yes he's been seen by the salt team all they have advised it thickened fluids but this was at least 4/5 weeks ago

    Thanks I'll ready over this now so difficult to know what to do or say

    Jo
     

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