Doctor told my frail DF (92) that he has just months to live!

I'm reading a lot of stories here that suggest we're to disconnected from death. I'd want to be told, at whatever age - I'd know to stop hoping for a cure and probably to start asking for more pain relief. I'd also get my DNR on record - although I have a kind of one anyway, as an agreement with DH that if I'm in a fatal disease process don't let them break my ribs as well.

I'm sorry for your forthcoming loss OP. I hope you can enjoy some quality time with your Dad and cushion him with love

Of course doctors have to be honest. Imagine the opposite AIBU to think the doctor shouldn't have lied to my parent and said they had years to live when they only had months? Parent died yesterday without saying goodbye to anyone, missing out on a bucket list or time to put their affairs in order? Anyone who has had any form of serious illness that could be life threatening will hear dialogue from early on. Sometimes it takes a few messages of less subtlety to get through to a patient their time is coming to an end.

@iwantmyownicecreamvan

I'm so sorry - it is heartbreaking to read of the loss of both your parents so close together, in those circumstances. 🌺

My father was told about his terminal diagnosis very bluntly indeed. As a pp has said, it took the wind out of his sails and he died 7 months sooner than predicted. I think his wife (my step mother) should have been told and then she could decide when and if to discuss it with my father.

Generally patients are told now and language should be clear with euphemisms. It's been the case for 20+ years. If someone is very poorly and not of clear mind then they may speak to relatives instead.

It must be said however that it has to be done very sensitively (obviously)

Posted too soon

The GP told us to collect statement from the surgery but by the time we got there they had already put it in the post. My DM carers gave her the post but thankfully her sight is too poor to read it and I could just say it was confirmation that the GP had seen her. I’ve got to say seeing that first statement floored me, goodness knows what it would have done to her.

It is important to have this discussion with patients, the only time this wouldn't be appropriate is in those lacking capacity or those who have made it clear that they do not want to know the prognosis. This is taught to anu HCP in palliative care.

People have the right to know, they may need to plan/get things in order, they may have things they would like to do before the die.

Imagine not knowing you were dying and the next thing you have is the district nurses coming in setting up a syringe driver because of your terminal agitation...

I really feel for you OP. My DM is 91, she had a funny turn (TIA?) a month ago, she had just had an horrific experience in hospital and refused to go back. After a video consultation, the first time she has seen a GP in many years, the GP wrote a statement of intent saying that my DM was terminally ill and what would be written on the medical certificate . This has since been renewed, with a different cause of death. My DM does not know if it’s existence as I believe she would give up. She knows her age and that she isn’t in the best of health but to see it in black and white would be too much.

The doctor told my elderly father he was coming to the end of his life. I wasn't party to the discussion but I understand it was done with care and sensitivity. As a result, and due to the pandemic restrictions on visiting, my dad elected not to be admitted to hospital for potentially traumatic intervention that would not greatly extend his life. I think that was a wise decision. He loved life and I don't think he truly believed he would die (ever!), but the doctor being open about how little reserve he had helped him to make a pragmatic decision about his healthcare.

I'm sorry your dad is so poorly, OP. I hope you have more good times together.

Having seen this play out with my father who died in May I feel that if they don't ask they shouldn't be told.

We knew Dad had heart and other problems, he was 91, we phoned the doctor because he kept feeling dizzy thinking she could just tweak his medication a bit, which she did over the phone. Then she asked him to come in, which involved me making the half hour journey to his house and driving through rush hour traffic. She didn't even examine him but just opened the conversation with "You need to make an end of life plan." I watched his face just fall and I felt terrible, it was heartbreaking. She dragged him out when he was feeling ill just to do that! We tried to console him later by saying that all people over a certain age had them, but he knew my mother (87) hadn't been asked so he wasn't convinced. That conversation darkened his last months. It was in February and he died in May after contracting coronavirus.

Both my parents were in the same hospital at the same time with Covid. My mother died in April three days after being admitted. My brother and I agreed we wouldn't tell Dad yet as he was still very ill, but the decision was taken out of our hands as the staff took it upon themselves to tell him immediately - they told me he was very upset, no shit Sherlock, and we weren't allowed to visit him of course.

Also, when he was taken back to hospital at the end with breathing difficulties, they told him outright that they couldn't do anything else for him - why would they do that when he didn't even ask? When I was allowed to see him (because he was dying) he kept telling me they couldn't do any more for him and he just wanted it to end. I honestly thought my heart would break. I feel the end of his life was miserable especially after he lost Mum and I wasn't even allowed to visit him - he was very deaf so phone calls were nigh on impossible.

We weren't there so dont know how the conversation went or how the subject were bought up but doubt it is ever a tick box exercise.

At 92, physically frail and mentally alert I’m not sure anyone needs to be told they don’t have long to live, especially if they haven’t asked the question.
I’m all for being open about death - it happens to us all after all - but I’m not convinced that the policy to tell all patients that they are going to die shortly is the right one.
I know that doctors can’t know how patients will react to being given this information but I struggle to find any benefit in bluntly telling patients like the OPs father who have had a long life and are becoming increasingly frail that the end is near.
To me this just seems like a pointless tick box exercise for the doctor which satisfies some audit trail but has caused unnecessary upset for the patient by telling him something he didn’t really need and more importantly want to know.

If your father is mentally well he has the right to know and it absolutely right for a doctor to tell him the truth. Wouldn't you want to know if it was you?

@SausageCrush

I cannot believe this just came out of the blue. I think if doctor had told him [or me for that matter] that he had a serious disease then I think the next question would be "and how long Have I got"?

I doubt a doctor would say - out of the blue - "you have ... months to live" if there is no critical problem

At 93 DF must have considered the end of his road already. Kidney failure is a good way to die - no pain, in your sleep.

Time to organise some family and fun things to do to take his mind off it, and bear in mind nowadays most of us last a lot longer than doctors predict.

Lots of people are told they have only X left to live and then go on for years. Drs are making a good guess and don't always get it right.

I used to do retirement planning and talked to lots of people (men usually) who said "I've got years ahead so I don't need to know about all the alternatives". My response was always that you might be healthy as a horse but that won't help too much if you trip crossing the road and get hit by a bus. Because none of us have a crystal ball we have to think out what's likely versus what we would like and make our life choices accordingly.

@SausageCrush
I don’t think they should be told, they seem to lose the will to live after that. He could go on for ages! At his age, I’m sure he well aware that each day could be his last in any case, does he need to be told. No I don’t think so. What good can come of it?! I’d be very annoyed and upset.

I don’t know what you could say to turn it around, doctors aren’t always right in any case.
A friend’s 24 year old brother was told he had an inoperable brain tumour and would last a few months. 18 months on he was told it would’ve been operable at the time but sadly it IS now too late.
You just never know.

From my experience: my father told me years before he became ill that if he was dying he would not want to know. When the time came I moved heaven and earth to comply with that wish. The medics said they would not lie if he asked, but would not broach the subject or volunteer the information. That was the best I could achieve.

I do think he knew, but he didn't want it spelled out to him. I think if he had been told he would have given up, and not had the last 2 years of life.

I’m not directly involved in these kinds of discussions, however, I work with palliative patients. As far as I know he should have been asked if he wanted to know (and I imagine he was) as some patients prefer not to be told timescales, they usually would tell people that they’re palliative now as there’s no cure for their illness and it would be a good time to discuss end of life care, for example, sign DNARs, decide on a hospice if needed, sort their will out etc. They would only give timeframes if the patient asked or said they wanted to know and even then it’s quite vague e.g. months, years, not “you have three months to live” as no one can predict that.

Your father has a right to know he’s nearing the end of his life so he can prepare adequately, if he has capacity then he can decide if he wants to know a timescale and if he wants others involved in the discussions and plans (which is usually advisable).

It’s worth also remembering that often when given bad news patients forget large chunks of the information and conversation, in fact a lot of elderly people and people in general do this in normal medical conversations I’ve found, no matter if you explain something repeatedly and very clearly. I’ve had patients swear to colleagues I’ve not explained something to them when I know I went over it about three times and checked they understood.

Try and get him to keep trying Op. Agree with pp, my dad just gave up after he was told that and he had fought so hard

My dgf was told he didn't have long left to live (6months)
After being given this news he completely gave up on life and stopped trying.
I firmly believe that he would have been with us longer had this Doctor not said this to him.
His last four months were sheer hell on Earth. He was scared to be alone, kept calling for an ambulance and he was tormented by fear. He was so anxious he could not eat or drink.
It was cruel.

Before my DF died, he had been to numerous appointments, lots of surgery, a few hospital visits.

I'm sure the consultant didn't mean to be so blunt but he said that he had used every tool in his box and he wouldn't need to see him again.

My poor DF. He was quite surprised at that. I wish the guy had fibbed and said - 'See you in 3 months'. - even if he wouldn't.

It seemed such a small thing for the Dr (Mr) to do. I really feel for you x