Liverpool care pathway

[stella1w]

Posting here for traffic, not debate,
distraught friend just told her mum, demented, at home with 24 hour care has been put on liverpool care pathway. She spoke to the gp about palliative care thinking it would mean a nursing home and was not consulted about lcp. Gp is refused to let her mum have sedatives or water and my friend is v v v upset and feels this is like euthanasia. She doesn,t seem to know what to do or if she has any rights to stop it. It could take four weeks.
I said if she had doubts she should ask for lcp to be postponed until the children had been consulted and undertood and consented.
What can she do?

My mother was not refused fluids or food, nor drugs, I thing it is aplan that is for people who will not survive no matter what, so they reduce the input of drugs etc. That is becuse their bodies can no longer cope. In out cse we did not get that far as mum refused all further treatment. Eventually accepted pain relief and then slipped away.... All is subjective. Hard as hell... we all have to make our choices and arguing about LCPwithout any knowledge is pointless. I would havechosen it if she had not died beforehand...
.

Claig ,for anyone going through the decision of what to do with their failing, dying elderly parents, I really hope they don't stumble on this thread.
I don't believe you've been through this, and I hope you never do.
I deep down wanted my Mum to die, her last month was not a life.
I also desperately wanted her to stay alive and get better, but it wasn't going to happen.
As I've said above, if she hadn't died naturally, the LCP would have been an option if it had been offered.

I haven't been through the LCP, but have had relatives die in hospital.

Cheryl and her dad have been through LCP. They know more about it than most people on here.

I think that is bollocks, we were consulted twice, but only after my mum had reufsed treatment. They do not refuse water. That is a myth. They do offer food but up to patient accept, you actually need to be there rather than reporting what your friend says.... my mum was up for LCP but died last week, she would have been fine on it.... If you are not an 'eye' witness, with first hand experience, perhaps you should not bother continuing with this post.

I think that there's rather a lot of people on here that have had to deal with their dying elderly parents Claig.
It didn't work for Cheryl and her Dad, fair enough.
If it was me, bring it on.

hey know more about it than most people on here

Considering the wealth of knowledge of posters on this thread from both a personal and proffessional viewpoint I very much doubt that.

'If it was me, bring it on.'

To each their own. But there will be a review of it partly due to disturbing cases of fluids being removed when people were compos mentis and to look at the role that financial incentives may play,

It wasn't right for Mrs Greenwood and she is a survivor.

I have listened to the caring healthcare professionals on here, but on balance I am with Cheryl and Dr Tony Cole

'But Dr Tony Cole, chairman of the Medical Ethics Alliance pressure group said: 'If death is accelerated by a single day that will save the NHS nearly £200 ? that is the estimated cost of a patient per day in hospital.
'My position on the LCP is that it is inherently dangerous and unnecessary.'

And I agree with Professor Pullicino

'One of the leading critics, hospital consultant Professor Patrick Pullicino, said: 'Given the fact that the diagnosis of impending death is such a subjective one, putting a financial incentive into the mix is really not a good idea and it could sway the decision-making process.'

If I said what I really want to say to you on this subject, I'd be deleted Claig.
But WTF, you are a heartless cow, who seems to have taken on the case of a stranger to boost your somewhat puzzling views.
How dare you come on here and lecture to people who are going through the worst thing possible, on theory alone.
Fucking live it and then decide.

I'm a nurse in a private care home and we only ever start the LCP when the client is showing signs of approaching death - usually for the last couple of days of their life. It is an invaluable tool for us to use to ensure the peaceful and painfree last few hours/days for the client. I have never seen it misused or even used prematurely. If people are capable of drinking then they are given drinks although most are unconscious by this stage due to natural deterioration of their condition.

I don't know what is going on in NHS hospitals, but we always use it appropriately and I would expect hospices do too.

I am not heartless, but yoiu are rude.
I agree with Dr Tony Cole and professor Pullicino. That's not theory alone. I listen to people's experiences and read newspaper articles and make my judgements.

We have seen scandals in our public life, and one day we may discover that some lay behind the poor treatment of our elderly, the dehydration in hospitals and the lack of punishment for the people who were charged with their care.

LaVolcan is right about people making a fuss. That is how change happens. Newspapers and families are making a fuss and it won't disappear. That is why there is now an inquiry into it.

You can insult people who disagree with you and who care for teh rights of people who are put on these schemes without consultation, but you are fighting a losing battle. The wheels are in motion, it is out in public and an inquiry will be held. The newspapers will not remain silent and nor will the public, whatever insults and vitriol is hurled at them.

A man in his twenties phoning 999 to get a drink of water due to severe dehydration due to lack of care by hospital staff is a national scandal. These things have been going on for years and some papers have reported them.

They won't last forever, the facade will be broken down, the truth will out and the dirty underbelly of what happened and why will eventually be revealed. In the meantime, vulnerable people will continue to suffer, but one day we will end it.

My experience ( for what it's worth ) my mum was told she had months to live,she had been living with cancer for sometime ,we knew she was dying but several times after being told she had months to live she would have pretty bad infections leaving her confused and very unwell ,on one occasion,after she had already survived longer than expected she was put on he LCP as the hospital believed she had days to live ( the cancer was finally winning ) however she continued and drink and eat with help,she had some drugs withdrawn but within the space of 1 week she went from being too ill to be moved to a hospice to being too well and off the LCP,she died 6 months later but my experience was that the LCP was used appropriately,she was not denied the basics and was taken off the plan when it became clear she was not giving up!

I've read most of this thread with interest as my uncle was on the pathway at the end of his life and its likely a near reactive will have to consider this soon.

I can only say, logically, that counting up the experiences of the people here I can see a vast majority getting comfort out of this/similar experiences rather than pain. It seems that hyperbole is clouding certain people's judgement.

There is not a conspiracy that health professionals buy into (I cannot believe that, it is ridiculous) they want the best for their patient, each is an individual and they treat them as such, every persons genuine experience on here speaks to that.

I am very sorry for everyone's loss.

IME hiddenhome, the care home staff where my mum died were exactly like you.
Loving and caring, and though mum refused to eat,they made sure she kept up with liquids.
And can I just say, it was people like you that made me realise that my mum was in a good place, and took away my guilt.
I couldn't look after her, but the staff in her care home did.
We only hear the bad publicity, but there are so many ordinary women and men looking after our elderly in homes who never get the praise they deserve, and IME you are pretty amazing.

This thread is bringing back all my grief over my DM. She died only a few months ago and the HCPs were wonderful with her. But I am now beginning to doubt that we did the right thing. She wanted to die and refused all treatment. We had to agree all this with her doctors because it was what she wanted. We were weeping as we did this.

To argue against the LCP on the basis of hearsay and newspaper reports is appalling and heartless. It is not the idea of the LCP that is at fault but sometimes individual doctors and nurses who are not implementing it properly.

Can't say any more as am too upset.

Gurl, You did the right thing with the information you had.
As did I, my Mum was suffering as was yours.
It was her time and she is at peace now, as is your mum.
Please don't let people like Claig upset you, I've reported her, her ridiculous theories have no place on here.

I welcome an enquiry into the LCP if only to clear up misconceptions and ensure confidence in the medical care of our dear ones.

My dMum died last year from lung cancer. She had many hospital stays, some were positive experiences, some terrible. Her final admission was in an emergency, she was there for a few days of distressing illness before she said herself she had had enough of all the treatments\investigations and wanted help. 'No more' is how she expressed it and we called for the oncall dr.

The dr gently and respectfully made sure we were all in agreement - LCP wasn't actually mentioned but we knew what was happening.

DMum was taken to a peaceful sideroom, all active treatment was stopped and we were encouraged to stay with her, beds were brought etc. As she deteriorated she stopped eating but still had sips of tea and water, she was sedated but could still talk a bit. The minister was brought on her request, cups of tea etc etc but no invasive care. As she struggled to breath a morphine pump was put in and a catheter, she slipped in and out of consciousness, until eventually she slipped away peacefully.

I can't fault the care she and we received. It was awful to experience, at times very distressing. When Dad had a moment of panic that she might recover given the chance, they turned on the sats monitor to show how much she was struggling and it gave him peace to know there was no hope at all.

Gosh, didn't mean to blurt that out. I've kept it in, but this thread has touched a nerve...

Our experience of course doesn't mean that all hospital staff are so respectful and caring...

Gurl an unMumsnetty (((((Hug)))) for you because it's hard seeing a loved one die. I have no doubt you did absolutely the right thing and made the best decisions you all could at the time based on what was happening.
I am 2 years in from my auntie's death and now I can see we made the right decisions for her when she could not. It's taken time to get to this point though

Let's see what MNHQ says. I have just quoted from the Mail and Telegraph. They are not ridiculous theories. You lead a sheltered life. You've obviously never read Melanie Phillips and other columnists.

maybe
A brilliant post, and I hope it gives reassurance to all on here that have felt guilt and doubt about the most painful decisions they'll ever have to make.

Nobody should be having fluids removed on the LCP, that's not what it's about at all. I agree that bringing in a financial incentive is dangerous.....the LCP isn't dangerous and doesn't hasten death if used appropriately and properly. The cases being highlighted by claig from the media are cases where it has not been used appropriately or properly.

The dehydration issue is a separate topic and is horrific. Thankfully when my gran was very ill there was a fluid chart and she was kept well hydrated. Her fluid and calorie intake were calculated according to her weight and she was helped to get that fluid in. Keeping people hydrated and fed is not rocket science and its disgusting that it should be an issue in this day and age. Even those with poor swallow reflexes can have drinks with an added thickener.

Thanks Lady