Callous doctors?

[cornflakecrunchie]

Why do they tell (especially older people) nowadays that they're going to die? Would you want to know? I certainly wouldn't. I can't understand why they aren't 'treated' with some placebo.. the power of the human mind would otherwise see them off faster, or maybe that's what's wanted these days?
The (two) people that I know of are just sitting at home now, wondering if the next symptom means The End.

If I was told I had something terminal I would kill myself. At least then I wouldn't have to wake up every morning wondering if today was The Day. I would have control.

Many years ago I worked with someone who was told he would not recover. He went and threw himself off the hospital roof after the appointment.

Very much depends on the individual but the doctors have no way of knowing that.

DH was given a devastating diagnosis, and the medics were excellent at explaining when there were treatment options, and then when those options were exhausted there were no further treatments available and he would now die.

In terms of why the news is delivered so clearly (or bluntly), when you get bad news you really do miss out key information, so the fewer words and flowery language the better.

Delivering bad news is truly an art, and as you were in the room with your loved one you know best the tone and timing of delivery, but false hope and denial are cruel and unfair ways to treat adults - people deserve the utmost honesty when it comes to their health.

I'd also very gently say that your anger is a completely understandable reaction, but it's worth unpicking if it was the message or the messenger that's causing it.

The (two) people that I know of are just sitting at home now, wondering if the next symptom means The End. That's not the fault of the doctor who relayed to them relevant medical information and diagnosis. In this, they're like the anxious overworriers we sometimes see on MN who have correctly identified that there is a potential medical issue, either by themselves or by the doctor acting properly and reasonably in having something potentially worrying investigated further, and are spiralling into a catastrophic event that they must have some terrible cancer or awful life-changing condition.

Patients should be informed of anything that the doctor has noticed and requested, all results, and all diagnoses.

@Wishimaywishimight
Thank you for your comment, I'm so sorry about your dear Dad, this is exactly what I mean.. what possible purpose was there for telling him? Laying there thinking of nothing else, & the effect on family left behind..
@OAPapparently exactly, that would be really helpful re medical records.

People often want to know and get stressed and upset when they feel people aren't being honest about how long they have. It denies everyone a chance for a proper goodbye too.

Yes. It's scary.
But it's imo better to know. You need to face the truth of your situation not hide from it or have it hidden from you by someone who has made the decision for you that you can't handle it.

I filled in what's called a respect form a couple of years ago after I was given the news I have heart failure and stage 3 kidney disease. On top of the copd I already have. And other things.

I am not considered terminally ill because I don't have a guaranteed expiry date. But every day could be my last. I could live another ten years or I could die in ten seconds and never press post on this.

This is why I have "what if" conversations with loved ones.
Had it with my mum after my dad died. (Not right after). Hypothetically, if you were/had X, would you want to know?
She would not.

So I know her wishes and can communicate that to doctors. Well, if I'm still here. If not my sister can. My husband otoh is firmly in the give me the facts camp.

@Timeforabiscuit
Thank you, that was nicely put, I lost my DH a long time ago, too, (young) so hugs to you..
It's not so much the initial 'it's terminal', though, it's following appts, & the 'you probably won't survive another episode' when they are in terror & pain having been blue-lighted to hospital..how does that help or put them at ease? I'm not saying keep medical information back per se, but that seems needlessly callous. Both patients aren't my family, so I'm seeing their struggles from a distance, but it does make you feel helpless.
If I was in their situation, I'd just think 'f the lot of you' & crawl away & die.

Everyone has the right to know they have a terminal illness. They need to make a will, say goodbye to people and places, and make peace with their life.

Not everyone is afraid of dying OP.

There is no 'one size fits all'. Some people want to know and some absolutely do not.

Another 'great idea' from someone who hasn't considered the consequences, moral issues or real life ramifications at all.

No, OP, it's not callous for doctors to be honest with their patients.

I’d be furious if I found out that people hadn’t told me information about my own mortality. For a start I’d want the ability to make any plans/ say goodbyes/ sort my affairs out and have a major declutter.

@Goody2ShoesAndTheFilthyBeast
I haven't heard of the respect form. I had POA (financial & medical) for my late mum. Thank goodness, because still several things weren't run by me..
@Mirabai They have made wills & are saying goodbyes. You're missing my point.

Have you ever worked in healthcare?

I’m so sorry you’ve all been upset like this. I would want maximum information, but there are ways of communicating it; you can convey bad news in a sympathetic way, which doesn’t seem to have happened here. Some doctors really don’t have much of a bedside manner, sadly.

@Icanttakethisanymore Have I come up with a 'great idea'? I must have missed that.. & you have absolutely NO idea of my life or the problems I've faced. More than most, & still come through smiling. Could you do the same? Silly me, of COURSE you're going to say you have, with bells on!

I totally agree with you, @MrsTigerface - thank you.

I’ve got no idea what you are talking about.

@Icanttakethisanymore Ditto, so we're both happy!

Sorry this is so long, but I am still grieving over these deaths which were over 4 years ago.

I know exactly what you mean and had a similar experience with my Dad 4-5 years ago. Firstly, my mum called the GP saying his symptoms had got worse. He was given an appointment at the back end of the afternoon which I had to take them for. She didn't even examine him (which he was expecting) but just immediately said "Good afternoon Mr ... we need to discuss an end of life plan." He knew he didn't have long, because he wasn't stupid, and he had put everything in place like wills etc, but it made him think it was going to be tomorrow.

I get why people have to have end of life plans, I really do - but I think we should all have one - from our twenties say. Make an end of life plan which can be amended over the years, but made BEFORE you are old and infirm. He virtually gave up after this, wouldn't get out of bed, kept telling my Mum to leave him alone because he was dying. We didn't know what to do.

Then the pandemic arrived and he had a hospital stay where he caught Covid and brought it home to Mum - I was talking to them through a window, saw how ill they were, called the same GP who was worse than useless, so I moved in to look after them. They both ended up in hospital (after several ambulance call-outs) where of course I couldn't visit. (Also I had caught covid from them of course and I had never felt so ill.)

Three days after being admitted Mum died - Mum, who wasn't even asked for an EOL plan. The hospital phoned early to let me know and I asked them not to tell Dad until I could phone him and tell him - but they already had. They must have raced to his hospital bed to tell him. They told me he was very upset. I said - no shit, his wife of 65 years dies and he wasn't allowed to see her and is ill himself with no visitors - of course he's upset.

Then, this man at death's door recovers from covid but is still ill, so goes into a nursing home for 6 weeks, but 2 weeks later is back in hospital where he is told (he didn't ask, just was told) that there was nothing more they could do for him. I was allowed to visit for a while as he was end of life. Apparently he asked the doctor if he could just give him something, but of course they couldn't. He just kept saying, I just want it to be over. It was utterly heartbreaking, and if I could have given him some pills to end it, you know, I think I would have.

What was the point of telling him at this stage? He knew he hadn't long. Why rush to tell him his wife had died when he was alone and ill? I am sure there are good clinical reasons for everything, but from his and my point of view, it just seems needlessly cruel.

Um... because it's inhumane to lie... and as for giving placebo... 🙄

"Older people" are just as capable of dealing with uncomfortable reality as any other group. They don't need to be infantilised or lied to.

Telling someone that their diagnosis is terminal is an art form and not a science and you have to respect the person that you are informing. My mother had secondaries in her liver and asked how long so that she could get her affairs in order. However, she told my sister she did not know... and when the ward sister came into her room to check that she had understood, she explained that she did not want the memory of her telling my sister to be one of my sister's last memories of her. When I talked to her she wanted to know the basics but not the detail, so telling her it was one of the quicker forms was helpful.

With my sister, I had to lie when she asked if she would make it to Christmas, I knew she wouldn't so I told her what she needed to hear at the time.

Doctors have to be transparent about a diagnosis and then gauge what patients can take or want to know. I realise that it must have been difficult to hear this message but on this occasion, it is not about you but the patient in front of them. You will also see that a lot of cancer patients hate the term "fighting cancer" because that is not how they see it... one size does not fit all for this but you have to start with a baseline of sharing the information and take it from there.

You are only expressing your thoughts OP. Of course people should be told what their prognosis is,however upsetting that is.

Absolutely this. I would be furious if I wasn't told the truth.