My father is 93 and started gagging on his food in the last few weeks. He had previous problems with acid reflux, hiatal hernia, but was tolerating food very well prior to this time. He also has congestive heart failure but has been doing well. He developed a UTI and the gagging started around the same time as the UTI. He's recovered from the UTI but the gagging continues. I just have a bad feeling about this. If the problem turns out to be cancer I don't see any value in telling him. He has shared with me that he is very afraid of dying. Has anyone else faced this dilemma and how did you handle it?
She gave you the facts about the (possible or probable) diagnosis. That's her responsibility. But the judgement call will be up to you and your sisters.
Is he the kind that would want to know regardless? Or is he one who would find the possible diagnosis and treatment too difficult to face? Perhaps he is too frail at 81 to even decide rationally.
In any case, since you are not at peace about it, you need to settle it in your own mind and heart. Sounds like you might need more discussion with the sisters You know him better than a stranger. Consider, too, that he might not even be able to survive the treatment. Perhaps that's what the doctor was thinking. Cancer treatment can be rough at any age. What a difficult heart wrenching decision for you to make. My heart goes out to you.
1) What makes you think he has cancer?
2) You should have this discussion with his Doctor
Post stroke we had to discontinued one OTC eye vitamin, as she was usually spitting it out anyway and it isn't a "critical" medication. She's now reported having issues with one of her BP meds. For now the plan is monitor BP and whether she takes the med or not - if BP remains relatively stable, let it ride. If it goes up, we'll need to figure out an alternative.
Anyway, swallowing tests can sometimes pin-point the cause. Sometimes it might not, but can determine ways to prepare foods that won't cause gagging and choking. As with others, cancer wouldn't be #1 on my list, but I'm also not a doctor! Leave Dx to them! Whatever is causing the problem, telling him depends a lot on his cognitive ability. If he doesn't have dementia, it's his body, he has every right to know what the test results are and should be consulted as to how he wants to proceed. If he does have dementia, telling him may become an ordeal if he can't remember you told him, so you'd have to put him through that pain over and over. In that case, I wouldn't tell him. Anything else, whether he has dementia or not, you'll have to work with him for whatever intervention is decided on.
"We're all going to die one day, so we should be grateful for everything we already had during our lives and try to find peace, prayer meditation can help to relax. " Also think that death is a release of all our problems in this world"
I think that the place all the good people go when they die is a wonderful and happy place because nobody has come back from there. 💞 Much love and Blessings 🛐
To back it up a bit, tell dr prior to first consult that dad is very afraid of dying so if he wants any tests done - then leave the word cancer out of it for now. If dr thinks it could be cancer or wants to rule it out, they set you up with appt that won't happen for a week or so. THAT period of time starts the whirlwind of thoughts, so no point in being a nervous wreck before the test. You finally get to the appointment for xray, mri, etc and even if you ask what the tech thinks, they won't tell you. So now you play the waiting game again for someone to review test and another appointment with the referring doctor. I would NOT tell him why he is having tests. There's always the chance it's not cancer, so leave it be.
If it turns out to be cancer, you can have the initial conversation with the doctor to find out what a treatment plan would be and how hard it would be on him - or if dr even recommends treatment considering other health issues. That's when you can talk to dad to find out how he wants to proceed. It's no necessary to use the word cancer in the discussion either. You could say, there is a growth near your 'whatever' and doctor thinks some meds (leave out chemo) would help. (Actually some chemo is giving by pill, not )always IV. Or doctor thinks a little radiation would help.
I don't think it would be fair to ignore this fear that he shared since it is obviously bothering him. Does he have some past religious affiliation? Do you have a clergyman that you trust... or even a lay person who might be comfortable discussing death? If he is admitted to the hospital,a chaplain accustomed to helping terminal patients will be available to him. No matter his diagnosis, I hope you will be able to, somehow, address this concern of his also.
Cancer, at 93? Might be a blessing in disguise. I had cancer and am in remission. The tx was beyond horrible and I wouldn't do it again for anything or anyone.
SOMETHING is going to get everyone. For all the times I went in for testing thinking I had cancer, I only really had it the one time. Not that that wasn't enough--I just think that should not be your first go-to.
Mush more likely it's a symptom of dry mouth, gag reflex being too strong--don't look for trouble!
Does Dad have dementia?
Depending on his memory, he may not remember the diagnosis (even a cancer diagnosis) anyway.
IMO, he has the right to know about any condition he might have.
Would'nt it be better to hear it gently from you, as opposed to a slip of the tongue from someone else.
Sending prayers that it's not cancer!!
I never forgot that.
No matter what you are going through--the bills will keep on coming in relentlessly. That is where the term "life goes on" comes from. The bills.
I am so thankful I have no children. I would never want them to go through what I went through after my folks died. When mom died it nearly destroyed me emotionally, and the financial impact was also horrendous. After one year, I'm still suffering emotionally, but I come to terms with it and re-established my life. The business of death--even with estate planning--was extremely difficult for me. I can't imagine how bad it would have been if I didn't do that. It was awful.
If you have siblings you will find out just how dirty they can get to get a piece of the money pie.
IF he gets a cancer diagnosis that is deemed terminal, get Hospice in ASAP. They are NOT about giving up but living every day to the fullest. The staff are well experienced in how to help those with the fear of dying. Do get them in early and not wait. You do NOT need a doctor's order or permission to have them do a home visit for information.
Best of all peace and golden light to you all.
Gagging or choking can be caused by any number of things.
You do not mention anything in your profile about his medical history.
The choking or gagging could be because he is not swallowing properly, it could be because of acid, it could be inflamed tonsils, ....
Make an appointment with his doctor, if he was seen by a Gastroenterologist make the appointment with that doctor since they would have previous information about his health.
IF your dad has not been diagnosed with any form of Dementia then YES the diagnosis should be shared with him and he should be involved in his care plan. IF he has dementia then there would be no need to share the diagnosis IF you do not plan on treating it and just contact Hospice.
What investigations are being ordered?
What is needed here is a good swallow eval by OT. Contact the doctor.
As for myself, as a nurse, I believe hiding the truth from a patient, from ANY patient, is a terrible mistake.
Please don't be afraid to discuss the "dying" remark with Dad. Ask him for details about why he feels this way. Ask him if it is his heart problems, or his swallow that is of concern. The fact is that with CHF your father has a weakening heart. You know him best and what he wants to hear most, but denying what he is going through may NOT be reassuring.
I would say "Dad, why do you think you are dying? What is worrying you? You have some CHF and that means your heart isn't as good a pump as it was when you were young, so handling fluids in your lungs and in your legs might get to be a problem. You wouldn't expect your heart to be the same as when you were 29 years old, right? What bothers and worries you the most right now? Can you talk to me about it? Is there something we can do? Because we can see the doc about things of concern and talk about them."
Some people are more afraid of death than others. It is a lot for anyone to absorb, right? But he knows where he is in living. Let him talk with you about all this.
I had patients who waited until their family left the room to speak the truth with ME, and that's kind of sad.
We have a client who was diagnosed with inoperable prostate cancer in March. His wife went with him to the consultation. Since then, he has refused to discuss the matter in any way whatsoever with anybody - our call instructions are that he is not aware of how ill he is* and we are not to talk about the disease.
[*Of course he IS aware - he can't very well have missed that his body is wasted and the cancer is erupting through his left groin. What they mean is that he declines to acknowledge it and we must respect his right to do so.]
Easy peasy.
Take him to the doctor.
Her cardiologist told me diuretics can cause dry mouth, which can lead to trouble swallowing.
I agree with calling his doctor, there might be something they can give him to mitigate the symptoms.
Hoping you will have your father tested. And get the advice of a physician.
People who decide to get palliative care or forego treatment are first dealing
with the facts, using medical science instead of relying on our own feelings about another's health. This is not said to hurt your feelings. Of course you are worried for your father. Jumping to conclusions will make it worse for you and him. imo.
And I do not want you to create more worry for yourself. You said: "I just have a bad feeling about this. If the problem turns out to be cancer I don't see any value in telling him." That is not how cancer is diagnosed. And your father has rights.
It is much too soon to be considering these things. I know this because my loved one was told "it may be cancer" and his daughter went around crying wolf for the next 6 years: "My father is dying of cancer". He did not have cancer.
Funkygrandma gave another possibility. Just wait up, more answers will come, and I hope people are kind and understanding to you. Now pull yourself together, wash your face, and take care of business, despite the challenges.
💞🍵💞
Anyways it’s time to call the doctor and get some answers. On to the next step, right? Thanks for listening and God bless you all.