I think I killed my mam

[QuestionableMouse]

I'm really not sure how to even write this, to be honest, let alone have the conversation I need to have with my family.

I think I killed my mam.

She had been really unwell for several years after an extended stay in ICU during COVID. She had heart and kidney failure as well as COPD and was on oxygen at home.

She had a fall in Jan and broke her femur. After several days in the hospital her doctor rang me and explained the fracture wasn't healing and they needed to operate. They didn't feel she was well enough to give consent so asked me for permission to go ahead. I literally had about five minutes, on my own, to make the decision.

She survived the operation but died two days later because her body basically couldn't keep going any more.

I know realistically it wasn't my fault and I didn't actually kill her but I'm really struggling with coming to terms with what happened, not least because I was suffering very badly with anxiety and panic attacks and never made it to the hospital to see her before she died. The last time I saw her, she was laying on her bedroom floor in agony and I feel incredibly guilty about it all.

I am going to speak to someone about grief counselling on Tuesday but I just needed to get it off my chest today. It sounds really stupid but I don't think I realized how much it was weighing on me until last night when a character in the audiobook found out she wasn't actually responsible for her husband's death.

💐💐💐💐 If you made it this far!

Hi, OP, I am a consultant dr.

Not fixing her broken femur would have resulted in a miserable, pain-filled and very short life - it would have been too painful to move her in bed properly. There is a reason why almost everyone gets their broken femur/hip fixed, even if they are otherwise very frail and high risk - not fixing it means that the patient can't move from bed, and is in pain for moving them (which needs to be done to provide nursing care). Having the operation was her best chance of having a reasonable quality of life.

The other thing to say as a healthcare professional is that the doctors wouldn't have offered it if they felt that there was a good alternative. Ultimately the decision to operate is made by doctors - often relatives feel they are being asked to give the go ahead, but actually the decision rests with the doctors.

It would probably be worth getting some counselling, I'm sorry that you have been carrying around this burden for so long.

This.

Sadly we all have an end date and it sounds like your mum was reaching the end of hers, she was already very poorly. She couldn’t have stayed as she was, untreated with an unhealed fracture. You acted on medical advice and I’m sure the doctors did the best they could.

Be kind to yourself and I’m sorry for your loss.

You absolutely did not kill your lovely mam. I hope the grief counselling helps xx

I'm sorry you've been through this and that the medical team caring for your Mum didn't explain things better/check you understood exactly what was happening.
I'm a fairly recently retired Consultant Anaesthetist/ICU Consultant and have dealt with this kind of sitauation many times. Unless you hold a lasting power of attorney for health and social care you cannot legally consent to or refuse consent for treatment on behalf of another person. If a patient is unable to give their own consent then the medical team make the decision they consider to be in the person's best interests. It is good practice to speak to the family to get more information about the patient and to make sure the family understand what is happening and don't have any objections. If there are disagreements it can be necessary to go through more formal processes but usually when things are talked through properly that's rarely necessary. Ultimately medical decisions are made by medical professionals though. If they had not felt surgery was in your Mum's best interests they would not have gone ahead.
It sounds like she was very sick and that surgery was high risk, but that without intervention the risks were even higher than with. Obviously I can't say for certain what they were thinking, but if people, particularly elderly or very frail people become bed bound for a long period after a fracture they are very unlikely to survive. So I'd make an educated guess that the hope was that the surgery would reduce her pain, get her more mobile again and increase the chances of her getting better, even though the outlook was still probably not good.
I'm very sorry for your loss OP but I honestly don't think you caused her death. Ultimately it wasn't really your decision - you agreed with what the medical team wanted to do but you didn't make them do anything they were opposed to - and the decision may well still have been the right one even though things didn't work out the way everyone hoped.

You did the right thing, she couldn't have survived with a broken limb that wasn't healing, infection would have set in and with her state of health she wouldn't have survives and it would have been a horrible cruel way to die. Instead you and the doctors did their best to give her the best chance of survival. Sadly her body after all she had been though wasn't able to cope. I'm sure your mum would be sad to think you felt responsible when you are not at all.

I'm so sorry for your loss @QuestionableMouse . Different circumstances, but your sentence She survived the operation but died two days later because her body basically couldn't keep going any more. really resonated with me, because my Mum's situation was similar. She was in hospital after a fall and her body was also worn out from years of battling illness. She just didn't have any fight left in her.

It was very hard to lose her, but years later, I realized that it was a merciful release, she just couldn't keep battling on and suffering. You absolutely didn't do anything wrong. Your Mam is no longer suffering and is at peace now.

Retired A&E consultant here. Sorry for your loss but you really mustn't blame yourself. If your mum was on her own with no NOK they would have just cracked on with the operation. Your consent was not necessary. The surgical team were being polite involving you in the decision but ultimately they will have acted in your mother's best interests. As a PP mentioned even if there were no prospect of your mother walking again she would still have needed the operation simply for pain relief.

There is no way they would have even given you the option if they didn’t think it was the right decision.

They would have asked your mum if they could and persuaded her to go through with it.

They can’t force it obviously but asking was literally their way of saying it is the best option.

You did absolutely the right thing and in no way responsible for her death.

You didnt kill her. She was very ill and she is now resting in peace, free from pain.if she could, she would probably thank youxxx

Oh bless you 🥰
she needed the operation
you gave her the the chance by consenting to the op that she may have healed - she clearly wasn’t going to heal without it -
surgeons don’t recommend surgery unless there is a clear need
please don’t be hard on yourself - you did nothing wrong and clearly love her very much xx

It really does appear that everything was stacked against your mum OP and you gave consent in the hope that she would make a full recovery, not to end her life prematurely.
Take comfort in the memories you shared over the years 💐💐

This is really brave of you to confront head on, OP.

I want to point out, though, she was a frail woman who’d had a serious injury. Your choice wasn’t between health or death. It was between two really risky options and the outlook for not operating on her would have been even worse.

You don’t need to torture yourself with this. Don’t let this worry stop you processing her loss and your grief.

It’s ok to miss her, and to wish she had died in different circumstances. But That was never in your control. 💐

Stop torturing yourself. You did not kill her. You need to give yourself a break. I do understand. I had similar with my dad and you just drive yourself mad with "what ifs".
Be kind to yourself. It does get better.

Please do listen to the medics who have posted on here.

This. Thinking of you dear OP. We can only do what we think is best at the time - and you did. She would understand entirely. Take care and yes, grief counselling is a great idea if you can get some. Sending a big hug x

They wouldn’t have done the operation if they didn’t think she would survive it. You all did your best with the information available to you. You were having a very difficult time yourself and if she couldn’t give consent and was on pain meds she might not have even known whether you were there.

I’ve had a lot of grief in my life and it brings me comfort to think of death as a kind and benevolent figure that saves us from something worse. I imagine him carefully tending to his plants, feeding his ghostly cats and then popping out when someone’s time has come to hold their hand while he guides them to painlessness and peace. Sounds a bit weird written down

You made a choice that really wasn't any choice at all.

There was no good outcome. You opted to give her a chance. If you'd not, she'd have died shortly afterwards and you'd have the same guilt the other way round.

Be kinder to yourself. I think grief counselling is a good idea as I suspect your guilt here is tied up to not being able to see her.

If you had refused the surgery there was a high chance she would have died. As more expert posters have said, a broken femur is a very serious injury even without all the other complications your DM had.

There was no way anyone could predict which option would give the best result.

I am glad you are getting some grief counselling.

It sounds as though your thoughts are stuck, partly because of your last memory of your mum. You did not kill her. Your consent did not hasten her end, she died because she was frail and unwell and the broken femur was a step too far for her body. Don't take on self-blame, you don't need it, the grief is enough.

When you feel able, go and look at some pictures of your mum during better times. It might help to drive out those last memories and replace them with nicer ones. You did what you could. I hope the counselling helps.

So sorry for your loss, this is a common feeling tbh. My nana had to gp into hospital after getting pneumonia after a cold and because she had copd from being a smoker for most of her life, its was bad. She begged my mum not to take her to hospital. Begged to go home. She died a few days after being admitted, and my mum still has nightmares about not following her wishes, but she was trying to save her life, didnt know it would be fatal at that point. It's a huge emotional and mental toll to care for elderly parents so please don't think you killed her, you did your absolute best and took the right path, she couldn't have lived with a fractured femur. You gave her a chance.

I'm going to come at this from a medico-legal point of view in the hope that, taking the emotion out of it, it might help you. It was the doctor's decision to operate, OP, not yours. Even if you had a health and welfare LPA which would have given you the legal right to make treatment decisions when your Mum did not have capacity to make them for herself, you could not have compelled the doctor to give treatment or perform surgery they did not feel was appropriate medically. So, it's no one's fault, but the doctor made the decision, not you. xx

Sorry for your loss. No you didn't kill your mum. You made a very difficult decision which you know deep down was the best decision for your mum. X

My love, she was almost definitely going to die with the surgery because of everything her body had been through, but would DEFINITITELY have died without it.

You made the ONLY decision you could have, and you made it from love and care.

If you'd not been there, and the doctors hadn't been able to get hold of anyone, they would have acted in 'best interests', and done the surgery anyway (I say this as a senior consultant).

Given everything you've said, she likely wouldn't even have known you were there even if you had made it in. You were there all the times that mattered.

This grief has clearly been a long time coming, and what you've got planned sounds like a good idea. You aren't responsible for any of this.

You didnt kill her, you gave her the best chance for recovery, you made the decision with love. Grief can make every emotion magnified. My dad died of a heart attack and the hospital said it happened because a cold he was fighting at the time carried infection to his heart. I had come back from uni that week and passed my raging cold onto him and i blamed myself for years. Try to be gentle with yourself

You were following doctor's advice. What if you'd said no and she'd died anyway? You can't blame yourself for making the only decision you reasonably could at the time. That's only what any of us can do.