When is the right time to look at Priorities of Care ?

[Stresshead]

Hi

I hope you can help.

We have had a visit from the Community Matron to check up on my father who has recently been discharged from hospital. As part of the visit she talked to me about looking at Priorities of Care.

My father is 84 is, lives with me and my husband, has been in hospital 5 times this year with pneumonia and UTI's (sometimes both at the same time) and has bladder cancer although this seems pretty stable. His health is clearly deteriorating, his eating and drinking is poor and has gone from 10 stone 4lb at the beginning of the year to 7 stone 7lb now. His mobility has been affected and now can only walk with me holding his hands. He is also becoming incontinent. Up until August he used to attend luncheon clubs every day and was able to walk to the community transport provided and take himself to the toilet etc. Unfortunately this has stopped now as he isn't fit to go.

The Community Matron has spoken to me today and said that she feels dad is in the later stages of Alzheimers and that the amount of hospital admissions this year shows that his condition is clearly deteriorating. She has asked me to think about whether dad should continue to be admitted to hospital or whether to look at Priorities of Care and opt for palliative care at home.

Has anybody else had to think about this ? If so what made you decide that the time was right to make that decision?

I hope you don't mind me asking for your opinions.

Stresshead x

 

[cragmaid]

Hi, this is scarey when you first start to think about it. It feels almost as if you are giving up, but you are not, you are simply doing a bit of forward planning, so that, when the time comes, you and your's Dad's Health team have an idea of what is the best for him. Nothing decided now is fixed in stone and things can and do get changed if the circumstances warrant it.
I think that the Matron was asking you to stop and think about Dad's decline rationally. She was warning you that his health is failing and now is the time to consider, on his behalf, how much intervention you want or whather you want him to have a calm and peaceful time leading to his death.
I was asked this regarding my late Mum and we opted for an ADNR ( advanced directive of non resuscitation) as there were no surgical interventions which could make Mum well again and CPR can be very brutal when applied in the emergency of a frail person's heart stopping. We also had an ECHP( emergency care health plan) in place that unless severe trauma necessitating stitches or similar was to happen, Mum would not be taken to Hospital and any pain relief was to be managed by the District Nurses/GP as she was in a Residential and not Nursing home.

Mum died, calmly and peacefully and pain free in her own bed at the CH in February of "Frailty of Old Age" and not of the cancer, heart disease, or dementia which plagued her life.
This was the kindest outcome we could home for.

 

[Stresshead]

Thank you Cragmaid. I guess these are all things that I need to think about but don't really want to. She is coming out to see me again next week and bringing the document with her.

I'm glad you took comfort from how your mum spent her last days.

Thanks again x


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[Bod]

I expect this is a conversation that many of us on here will have.
Thank you for raising it, it is a subject that must at least be considered, to the benefit of the sufferer, rather than us, who are left behind.

Bod