To think something is not quite right about my elderly aunt's way of looking after her brother

He was on palliative care at home. Taking him to a hospital to die slowly there would have been cruel. She did the right thing, and he got to die at home, peacefully, as he wanted.

I think she did the right thing.

I recently watched my grandfather die in hospital. His care was utterly shocking. I knew the NHS was struggling, but I didn’t know how bad it was, or how little some of the doctors and nurses cared. I had to beg them to give him medicine for pain (he had cancer), they’d say he hadn’t asked for it (he had dementia) and I also had to ask them why he was wet on a daily basis. This was just a tiny bit of the awful care he received.
They refused to give him palliative or end of life care, until 24 hours before he passed. It was cruel. Disgusting. Undignified. And has left me traumatised.

I wish we could have taken him home and let him die there. He’d fallen and broken his hip though, so they wouldn’t let us.

I would be grateful that your uncle died where he was comfortable, with his sister.

I’m sorry for your loss OP you are grieving, but gently his organs were dying and he was in palliative care at home. It’s ok he died there, better comfortable at home with loved ones than a shared ward.

Your aunt did what she thought he wanted. Be kind to her and yourself.

68! Elderly?! It def is not

The strike situation is different, but not all strokes are easy to spot

Let it go, she did what most of us would prefer truth be told. I wouldn't want a few more days or weeks hooked up to machines, frightened, he was obviously terminal.

While I agree that she should have called an ambulance as soon as she thought he was having a stroke, it probably wouldn't have made much difference given how long it would have taken an ambulance to reach him. My mother was recently deemed to be at high risk of stroke and her husband was told to get her into his car and to hospital rather than call ambulance ambulance because it wouldn't get there quickly enough. I guess your aunt wouldn't have been in a position to do this?

Also please don't underestimate the pressure that would have been on your aunt in trying to provide care 24/7, especially when it got to the palliative stage. It's incredibly stressful and difficult. It sounds like your aunt was doing her best and following medical support and guidance.

Please don't make her feel guilty for doing everything she reasonably could according to your late uncle's wishes.

He was receiving palliative care and given months to live. Why would you put him through all that to drag a few extra months of illness out of him? She was right to let him die in his own home imo.

She followed his wishes. He didn’t want to go in to hospital. What would have been the point of calling an ambulance and “keeping” him alive?! He had a palliative diagnosis anyway.

I don’t see the point of you going on like this OP. What are you hoping to achieve?!

A couple of weeks ago doctors said his organs were slowly deteriorating. They estimated he had 4 months left to live and said he should receive palliative care at home.

Her sister (another aunty of mine) was saying they should phone the paramedics but she said "what are they even going to do?" and "they will just take him to hospital and he doesn't like it" and "it's better he stays home, he is happier here". And then he got worse and worse and basically died.

AIBU to think the whole thing is nuts, she should have called for medical help and maybe he might have lived!?

He was dying and doctors were aware he was likely to do so at home. This is quite a normal situation.

Assuming he could express his wishes, paramedics wouldn’t necessarily have taken him to hospital especially if he didn’t want that. A lot of people prefer to die at home.

He was already receiving palliative care and was dying. It’s medical care that is available, not miracle cures. YABU.

We all have different ways of approaching these kinds of situations, OP. I’d let it go. A family member on my DH side decided to take charge of another person’s care as they approached the end of their life. In my opinion, their priorities and choices were utterly bizarre and resulted in the person dying alone in hospital instead of at home with the people who loved them. But that’s just my opinion. Nothing illegal happened and I wasn’t there (Covid). Someone has to make the decisions and not everyone will believe them to be the correct ones.

As long as he wasn't it pain then yabu. He would have been dragged to hospital and not had the death he wanted. Relatives often want excess medical intervention that isn't in the best interest if the person who is dying.

I think people have unrealistic ideas of what palliative care in hospitals actually looks like. It's not dignified or peaceful in any way.

I agree with this poster and others saying similar. It's hard to let someone go and not want everything done so as to prolong life, but it's often not the best thing for the person who is dying. I am so sorry for your loss, but your Aunt did your Uncle a final kindness in respecting his wishes.

I agree with what your aunt did. He was palliative- he was going to die. It’s not like it was reversible. If he’s gone into hospital what would have been gained? Another few days or weeks but being in a hospital ward (or a&e trolley) surrounded by strangers. No thanks, I think it’s much kinder to die in your own bed, with people you love around you, in a place you know. Quality over
quantity.

Her judgement sounds off re the stroke.

I agree with other posters that these days we seem to focus on prolonging life no matter what the quality of life. I think your aunt did her best according to her own moral values.

In the olden days ( and pre Shipman ) some (?) gp’s would give adequate meds so that the person would slip away peacefully at home ,it’s only in recent decades that we have entered this phase of trying to keep elderly people alive infinitum without regards to their wishes of where they want to be cared for.someone who is end of life will die and it’s quality of end of life not quantity that’s important.

Agree with PP. What could the paramedics or Doctors do? They'd bring him in, he speaks little English you said so presumably couldn't necessarily understand everything that was going on. He'd have life prolonged surrounded by strange sounds, in a medical environment with strangers by his bedside, and for what? Best case, to be discharged to die a few weeks later. Worst case he passes anyway in the hospital potentially alone.
Terminal illnesses are horrible and it sounds like your aunty did her best to make him comfortable in his last hours

She made a call based on prioritising her understanding of his wishes over prolonging his life at all costs.

It sounds like they were in touch with the NHS and the OP doesn’t mention her uncle being in pain, so I’d assume they were in the system. There isn’t much in the way of palliative care other than pain control and home help with hygiene if you are lucky / need it.

If he had gone to hospital they would probably have extended his life a few days or weeks but not the quality of life. My elderly mother had a stroke and went to hospital and they sent her home after 10 hours in A n E. The carers called an ambulance when she had another one but she had signed a DNR and we refused to let them take her to hospital. Instead she died 6 days later at home quietly with her family around her with no medical interventions. The palliative care team were wonderful. I think we are forgetting how to let people go.

I’d imagine she was right and he’d have preferred to die peacefully at home. At end of life who wants to be carted around in an ambulance and dumped into an unfamiliar hospital ward.

You are right that a stroke should receive immediate attention, but given some family friends just left it several days (with no excuses such as little English or belief in conspiracy theories) I don’t think I’d hold that against her either.

I think the two things you need to realise are - it’s really tough being a carer and at the end of life life is about quality not quantity - I think it’s safe to say your uncle was happier to die at home rather than linger on for two weeks in Hospt.

Palliative care is surprisingly limited. My MIL recently passed away on palliative care and the amount of input she received was minimal - oxygen and sedation was all she was given at the end.