questions for hospital doctor

[MarieW28]

I've posted once before asking for advice for my Dad who we suspect has vascular dementia. He'd had various blood tests and scans and we were waiting on an appointment with the memory clinic, In the meantime, after advice from some forum members here I contacted Adult Services and had lined up a 6 week assessment/package of support if he agreed to it.

But he got covid, then had a fall and has now been in hospital for a month. He seems to have deteriorated massively while he's been in there - possibly as he wasn't allowed visitors for the first few weeks. The staff say he is very confused and has delirium, he asks for help and doesn't know why, sleeps most of the time. He's had to have blood transfusions, dialysis and physio. A few days ago, the hospital contacted my brother who is on the paperwork as next of kin and asked if he had POA - when he said yes, they arranged a meeting with my brother to discuss next steps. Unfortunately I'm hundreds of miles away but my brother is really keen I lead the questions so I'm going to be on video call. I just really want to make sure I ask the right things though - this is all still quite new to us and I'm sure there are things I won't think of so if anyone can suggest questions they would want to ask, or have asked in similar situations that would be really helpful.

Since then they've also asked my brother's permission to use a feeding tube on Dad as he isn't eating enough. So I was going to ask about that and how long it will be for, whether he's showing any signs of improvement yet etc. And also whether the delirium will improve and he will regain cognitive function. What else should I be asking though? Thanks!

 

[Grannie G]

Hello @MarieW28 Welcome.

I was offered a feeding tube for my husband and declined. He was in the lar=ter stages of dementia and I knew a feeding tube would scare him because he wouldn`t have been able to understand what it was about.

I also felt strongly it would have been against his will. When he was well, he hated medication and doctors. Out GP once remarked how thin his file was.

You and your brother know your dad and I hope know what he would want.

I have to say when I refused the feeding tube, there was a look of relief on the face of the doctor who agreed with me but said they have to ask.

 

[Jaded'n'faded]

To an extent it depends how poorly your dad is and how advanced his dementia is. Delerium does sometimes resolve once a person is back home but not always and often the person doesn't return to their pre-delerium level.

I think you need to have a good talk with your brother about your father's quality of life going forwards and what his wishes would be. If the feeding tube is (very) temporary, it might get him well enough to leave hospital, but what then? Was he living at home? Would he move to a nursing home? Would he be self-funding? All these things need to be discussed.

If the proposed feeding tube is 'PEG feeding' that's a different thing - it tends to be permanent. There is no good outcome with this so please read up on the subject. (Don't do it!)

 

[MarieW28]

Thanks both of you for your replies - as far as I am aware it is a temporary feeding tube as they say he's too weak at the moment. That's one of the questions I want to ask later today. As I said, we haven't got an official dementia diagnosis yet, although the hospital did say they could try and sort that out for us which might be progress? Dad was living at home on his own, and very independent but now he isn't able to get out of bed on his own so there's no way he's going to manage stairs....although moving somewhere more manageable has been a long running argument since he had his stroke.

I had hoped to arrange a care package - and yes it would be self funded - but now I worry he's too far gone for that to be possible and we are looking at a care home. And he was in one temporarily just after his last hospital stay and still blames me for that, even though I had nothing to do with it and didn't even know he'd been discharged from hospital until the care home contacted me. So finding that balance between doing what he wanted and keeping him safe is going to be tough. I guess I just have to wait for the meeting and see what gets said then.