Multiple health problems, weakening, multiple falls over last 6 months; dementia, catheter, incontinence. Hospitalized a week ago to remove gall bladder; sepsis, multi antibiotic treatment. Trouble breathing so moved to ICU, now moved out but 24/7 nurse in room to monitor breathing (on oxygen). CHF treatment for fluid retention, sugar level increase, low pulse (25). MIL is in denial, thinks he will get better; dad wants to go home, MIL said she is tiring of caring for all his needs, yet doesn't want in-home nurses (too intrusive) and doesn't want to place him in AL (He has LTC). Dad doesn't have quality of life and basically "just checks out" during waking hours other than to eat.
The surgery and sepsis really weakened him this time although he is not on life support. He's had 4 drs in 1 week as he's been transferred around. I think it is time to have Palliative care speak with the family. Drs. are giving meds for this and that, prescribing arthritis meds, etc. He's already on about 20 meds a day for constipation, sleeping, diuretic, diabetes, BP, liver, daily antibiotic, antidepressents, multi memory enhancing pills... What are your thoughts or experiences? Ultimately it is MIL's decision; but feel like an unbiased consultation from Palliative or Hospice is in order here.
Lessons learned: please know that memory care, AL, etc doesn't mean that they watch over your loved one or administer skilled nursing care. They don't make sure you eat, they don't monitor hygiene, inputs and outputs, etc --for that you need to pay extra for that type of one on one care.
Resident still needs an advocate to visit and monitor and ask questions.
Lastly, DNR doesn't mean all life supports are not given. Dad, even though he had comorbidity conditions, not expected to survive at less than 90 percent, comatose, was still given antibiotics, fluids, vascular meds to sustain blood pressure and oxygen. It was heartbreaking and we had to make decision anyway to remove all supports even with DNR that was very specific. So I learned something new here about what DNRs really mean.
I wish that the dr had insisted on hospice consult immediately. This would have cut dads suffering 24 hrs earlier.
In the end, he had a caring ICU staff but my MIL and family had very difficult time understanding what Dr was really saying.
My only advice is that there are times when the most loving gift we can give is release/permission to let go.
I did this with my SO, "it's ok to go my love, you don't have to fight to stay. I'll be ok, I'll miss you but I'll be ok. I love you, go when you're ready."
Minutes later he was gone ~ peacefully.
I've done this with other loved ones with the same result.
Often people fear for their loved ones and so fight against all odds to stay.
Thinking of you all.
Are your trying to explain things to MIL that she just can't comprehend due to her dementia?
Any other advice to support MIL and FIL -- to help him be as comfortable and peaceful as possible?
But the constant chopping and changing of medical staff sounds disastrous - can you get just one of them to take ownership and start again with a full evaluation?
Now I'm assured that in a case like your FIL I will get fluid and pain killers but nothing else. No feeding, no treatment I will then slip away or rally.
I wish that everyone would make a decision and let it be known. If someone wants treatment at all costs and bringing back over & over. OK but let that be known!
Bless you all in this terrible situation, do keep posting.
Your FIL has really had a rough time; he may just be worn out and may recover or at least stabilize, gradually, especially since he had some major medical issues hit him all at one time. But he won't if he doesn't get proper care and emotional support, unless he has a will of iron.
I would try to talk to his doctors to get their individual opinions before he leaves the hospital, to determine whether palliative or rehabilitative care is appropriate. It doesn't seem likely that he'll be able to come home when your MIL is tired of caregiving.
My experiences are different; had I really recognized when my sister was in a terminal state, I would have brought in hospice earlier. With my father, it was a completely different situation. One pulmonary doctor and an ICU nurse were insistent he would not survive a multiple issue acute health crisis back in 2003. The nagged me to consider final arrangements.
Today my father walks down to the beach to sit and watch the geese, ducks, swimmers and boaters. He'll be 97 this year.
But everyone is different.
I don't suppose one of his sons or daughters has healthcare power of attorney? I assume his wife is close in age to him. Probably not thinking that clearly if she is.