My mum is 87 and in a home.
On Thursday she had her dinner and sicked it up in the evening. They checked her oxygen levels which were down so they shipped her off to hospital.
The doctor has said that she won't be able to eat again and would need to be nourished by a nasal tube.
Is there an illness that would take you from eating mashed up food in Thursday to not being able to in 2 days?
If she does need the tube , are they in full time? That would be pretty horrible if it is.
If it's put in just for feeding is that a proper medical procedure? I'm assuming her intake would need to be properly monitored. No doubt all of this would be beyond the abilities of the absolute superstars that currently look after her. This would mean moving to a care home with a higher level of care.
My brother had a phone call from a doctor this morning and he had the impression that he was touching on the topic of letting mum go. They said she is living off her body fat at the moment.
She is awake , would they simply let her starve to death?
It's her husband's funeral on Wednesday and when we asked if she would be able to make it ,the doctor said anything is possible.
On one hand they seem to want to
let her go and on the other she can go out for the day.
I'm going in tomorrow but it's quite difficult to pin someone down about the prognosis and when they do they speak medical stuff that we don't understand.
The nasal tube is just plug and play, not really an operation but just a bit nasty procedure. It can easily removed as patients condition improves. Source: me, I spent a month on and off feeding tubes nasally and on IV last year.
This must be really difficult for you zippy, mothers are unique and totally special, seeing them trying to cope with difficult situations and becoming increasingly dependent on others as the years take their toll is really hard.
I have no expertise on the subject but perhaps a couple of observations might help:
Is there an illness that would take you from eating mashed up food in Thursday to not being able to in 2 days?
My very first thought was that she has had a stroke. The swallowing process is highly complex and I know that after my father had a stroke he had long-term difficulty with swallowing. Perhaps your mother has had a stroke which has paralysed muscles required for swallowing?
If she does need the tube , are they in full time? That would be pretty horrible if it is.
It does indeed sound horrible but although I really don't know I suspect that it is probably not as unpleasant as it appears to be.
They said she is living off her body fat at the moment.
She is awake , would they simply let her starve to death?
If she is old and frail I can't imagine that she will starve to death as a younger and healthier person would. When my elderly and very frail father gave up and stopped eating the end didn't take very long to come. It was predicted that pneumonia would be the cause of death because the immune system becomes so weak in a frail and elderly person, which is what happened.
And btw it was a perfect way for my father to depart imo, he was at home in bed comfortable, relaxed, and happy, with my mother by his side
It's her husband's funeral on Wednesday and when we asked if she would be able to make it ,the doctor said anything is possible.
So could that explain the sudden deterioration, ie, the death of her husband? Maybe attending her husband's funeral will add to her medical issues but it might still be worth doing for her emotional and psychological needs? Also I don't know but if they were very close is it really in her best interests for her to try to carry on without him?
It is a really crap place to be Zippy and I am sure that you will do whatever you think is best for your mum, but sadly we still all feel guilt afterwards. I wish you the best of luck.
My brother had a phone call from a doctor this morning and he had the impression that he was touching on the topic of letting mum go.
That sound like an oblique way of trying to find out if your mum has expressed a wish to die. They won't let her starve unless you or she decides that's enough and in some ways injecting a meal will ensure that a ward staff member will supervise it and a full meal will be administered. Some elderly patients end up starving because of mobility problems where a plate of food is left out of reach or the co-ordination to use cutlery is no longer there.
You are due to have the worst conversation with a parent there is, I am remembering mine 25 years ago as I write. Find out what your mother wants to do and then ensure it happens be prepared to have someone attend at mealtimes. I suspect that after Wednesday things may well resolve themselves but up until then have a big man-hug and bonne chance. (My mum was 58 when she said enough after 15 years of treatment).
When my Dad died my Mum essentially gave up and prepared to join him. It took about 9 months of gradual, then sudden, deterioration.
It's possible that you'll be asked about a DNR (Do not resucitate) form when taking her out of the home. In my experience that was a good way to introduce the topic of reducing medical intervention.
I think you need to speak to a doctor and find out the cause/issues etc.
Hopefully you've got a health LPOA in place. If that's the case then my attitude would be and has been:
As long a she's capable of making decisions, she makes them. Beyond that you respect wishes already expressed.
If the issue looks temporary and there's a chance of a pleasant non-suffering future then hang in there. From what you've said that is is your concern and what's promted your thread.
If your mother is suffering and the future is going to get progressively bleaker then you and your Brother need to pin down the doctors for an ernest chat - whilst waving the LPAO under their noses and saying you'll take responsibility for any decision that's legal, in the best interest of your mother and will limit her suffering.
It struck me that for the doctors it's something of a legal and ethical minefield and you have to make your mother's and your own wishes very clear. I'd like to say more but this is a public forum.
Sorry to hear this Zippykona, i've been through similar circumstances.
A couple of people have mentioned DNR - it's worth 5 minutes looking up what it means as it is often misunderstood.
Without knowing your mother’s full medical history it is impossible to make a diagnosis.
I’m sorry that you’re going through this so soon after losing your father.
If what I’m about to say comes across as unfeeling, I apologise, I’m just trying to clarify.
However it is not uncommon for older people to stop being able to eat as they age and become frailer. Sometimes it has an acute cause, like a stroke, which may improve with time, others it does not.
One of the problems with a feeding tube is that once they’re put in, it then becomes hard to make the decision to stop it if they don’t improve.
It sounds like there is a high risk that she would not swallow her food properly if fed in the normal way, and this would mean that she would likely get a nasty lung infection with a high risk of dying.
The question comes down to, does she have a quality of life that is worth trying to get her back to through medical treatment, or is it better to let her go?
The interesting thing about these decisions is that most medically trained people would stop interventions for themselves or their loved ones quite significantly before lay people would.
However what’s most important about these decisions is that the person making them arrives at them in a way that they feel comfortable with. Often people have to see for themselves that something isn’t working in order to believe that it isn’t likely to work.
Once again, I’m sorry that you’re having to make these decisions at an already difficult time.
Happy to answer any questions you might have, and feel free to PM me if it would help to chat on the phone?