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.

No Mirabai, I did not lie to her about my mother in fact she was the one who told me about my mother's diagnosis, I lied to her about her own impending death.

She had a rapidly growing lung tumour which was similar to mesothelioma in that you could see the increase in size daily, ie scans taken at the end of the week to those at the beginning of the week showed visible growth to naked eye. At the point she asked me I knew that she had a short time but the prep for Christmas was her favourite time of the year, which meant we were able to spend an afternoon planning for a Christmas that I knew full well she would not live to see.

We had a full and frank discussion about the time my mother had left and were able to plan accordingly, and follow my mother's wishes about what should happen at her funeral.

Dont be ridiculous.
At what point do you think people should have actual facts hidden from them?
Death is part of life- patients are involved in how they wish this to happen- have a look at the RESPECT form

Yes 100% would like to know. And if I'm old I probably would know anyways.
I'm a nurse and find that people already know it's more everyone around them doesn't want to talk about it.
It's about future planning.

I'm already making advanced decisions about what I treatment I would decline in the future. I don't want to suffer and have unnecessary interventions. I'm on 35 so I know health care/treatments will change in the future. But when my husband started having seizures and diagnosed with epilepsy we both have had frank conversations on what we would want!

My elderly grandma is dying, she knows, she's got her injectable medications in the house etc her health is deteriorating quickly. We all know it's happening! But trying to keep her as comfortable as we can. With less stress as she has things in place for every eventuality. If she wants to remain at home...she can!
If she feels as though she needs to go to hospital or hospice...she can!
My dad's side of the family just don't talk about it. My mother's side do!
The less stressed about death etc is my mother's side of the family!

@Mirabai I should also add that at the point we spoke about Christmas, my sister was aware that her own diagnosis was terminal and had taken the decision not to have further treatment.

I think this is very personal, so a blanket approach isn't going to suit everyone. Personally, I don't think being honest that a patient is terminal/is unlikely to survive another episode is callous. I think it is absolutely necessary to ensure the patient understands the potential outcome, lives the remainder of their life as they wish, gets their affairs in order and has the information they need to decide whether they want further medical intervention now or in the future.

You mention the possibility of a patient dying at home rather than being "comfortable" in a hospital, as if it's a bad thing. This is absolutely what a patient should decide. The reality is, hospitals here aren't comfortable, you won't be cared for or receive adequate pain medication (if any at all), you won't get any peace and I would much rather die at home. If your experience of hospitals has been positive, that is great and will influece your decision, as it should. But I think everyone should know the likely outcome of health issues and the likely treatment you will receive from GPs, community nurses and hospitals, to help you decide what you are likely to do if the worst case scenario does arise.

@VexedofVirginiaWater
Thank you for replying, I totally agree re age, I am of a similar age to you, & was thinking that if I was 30, 40 or even 50 years old, I would have probably protested strongly that I'd want to be told if I was terminally ill. Death would hopefully be so far away! Things change. I never understood that as my body ages, I'd still remain in my teens at heart! Our personalities don't change. I suppose I would still rather know, BUT, as you say, the book needs editing.. I'd like to be told that I could have drugs to help me, say, not be in pain, that my life was still valued.. not that I 'probably wouldn't survive' the next episode. In that case, I'd want to go to the neaest vets & ask to be put down like a dog. They are kind. I cuddled my late dogs when they set off on their last journey, they weren't alone or depressed.

I understand your grief at not being able to visit your Dad & fearing that he thought he was forgotten. My late mum was in a nursing home too at that time, & someone - I suppose the Govt - decreed that even though all the residents had been mixing, they'll all have to be locked in their rooms. My mum was the most sociable of people & due to Alzheimer's, just could NOT understand why she'd been shut up alone. It was barbaric. She screamed & clawed at the door. I'm sure that hastened her end, which was a blessing when it came.

Hugs to you. I hope your sad memories will fade in time. xx

A lot of that is about attitude though isn’t it?

Just because you’re told you’re going to die/have a limited chance of surviving the next episode, doesn’t mean you have to go home and wait to die. That doesn’t mean that a positive attitude is going to save someone with a terminal illness, but there is significant evidence that actually, a positive attitude does have a huge impact on recovery and even how end of life is played out.

I have a heart condition as well and I’ve been told more than once that I am going to die. I’ve survived two cardiac arrests so far, as well as sepsis, but my condition is catching up with me and next week I have to go for an assessment to see if I am able to be listed for transplant.

If I do there’s a chance I will die waiting for a heart.

If they find a heart there’s a 10% I will die on the table, and after that there’s a chance I could die from post op complications.

There’s no point dressing that up. And there’s no point me sitting at home waiting to die either. What exactly does that achieve? I’m alive now and I will live that life to its full. And if I’m meant to die then that’s what is meant to be.

We’re all going to die. Every single one of us. But I would say that actually, knowing is preferable because we have an insight into how that is going t happen.

You could walk out of your house and get hit by a bus tomorrow. No maybe you wouldn’t want to know, but you should still be prepared for that to happen.

Nobody should be waiting to be told they’re going to die to get their affairs in order. Everyone should have done that already.

Everyone should have a will, appointed guardians for their children, and IMO have a power of attorney registered which can come into force if you are suddenly incapacitated.

Death is part of life.

Because the alternative is lying. We have to be transparent, it’s drummed into us as healthcare professionals. It’s about having honest conversations.

The alternative is we don’t, then we have furious families threatening to sue us or put in complaints because we’ve lied or given false hope.

Also, full resuscitation is horrific and can do a lot of damage.

To give a counter view... when my elderly granddad, with advanced dementia, was in hospital, my grandma became very distressed. It took some coaxing, but finally came out that she was scared that my granddad must be for full resuscitation as no one had discussed it with her. And she knew it would have been strongly against both his previous wishes and his best interests. But she didn't dare bring it up with the staff in case she looked cruel and heartless. I went to the sister in charge, got things clarified, and great relief all round. But my grandma would have been saved a lot of distress if only the doctors had been more "callous" and "blunt" with her.

That’s horrific. How dare you make a decision for someone else on the basis of what you think they like. Just so you could spend a nice day with her. She may have preferred to do something else entirely. Unforgivable.

That's personal to you. I'd want to be told then I could have the choice of whether to continue possible painful or side effects inducing treatment when it's not going to cure me. Or spend as much of my money as I could enjoying my last month's etc.

Also, full resuscitation is horrific and can do a lot of damage. this. I had several fractured ribs and a bout of pneumonia to show for mine. The consultant who was on call that night came to see me a few days later and said that I was fortunate, that people can end up with broken ribs, punctured lungs etc. And as brutal as that all sounds, the alternative is death, which for someone who is elderly and frail and perhaps has limited capacity to be able to realise why they’re suddenly so broken and in such pain, is almost certainly preferable.

What do you think you achieve by calling someone horrific and unforgivable for a decision which can’t be unmade and was undertaken in terrible circumstances?

Whether you agree with this poster or not you can have some compassion and also some recognition that perhaps you don’t know everything about these people, their relationships, and what mattered to them.

What an awful post! Don't you think the poster has enough to deal with, ie, grief without you piling on top of it?!

Also, full resuscitation is horrific and can do a lot of damage.

My Dad had been though one and got left with broken ribs - it was a planned procedure years earlier where they stopped heart and restarted so it beat in time and they'd clearly hit major problems. He still wanted it - made his wishes clear to family afterwards and was always clear to medics.

However it's communication again - a well okay we'll clearly bare his wishes in mind but ultimately it's a medical decision would have said the same but felt less dismissive - what we got was more than once oh well it's not up to you and clearly a huff at us following Dad stated wishes and not agreeing with DNR order they wanted and Dad upset and worried they'd asked him yet again.

I think we all understood why they had the conversation but not why we weren't listened to.

In contrast IL hadn't discussed it at all and when they asked MIL she said oh yes - and FIL was upset afterwards when he made a full recovery and was worried it's on his records though he's not actually against it just wants it discussed with him - so he's reassured they'll talk to him about it again.

My late dad was told there was nothing else they can do - it devastated him, and us. I agree with you OP - medics should speak to family members and make a plan based on what is best for a particular patient.

Every time I think of my poor dad being upset on top of everything else, it breaks my heart.

I'm in my 60s with no immediate family. I would need to know so that I could finish getting my affairs in order.

Or maybe you'd call your kids who'd come running and sit with you to the end in your own home instead of being bumbled into an ambulance and dying in a corridor?

Absolutely not "callous" at all. In fact, the words I'd use are "honest, professional and responsible". Of course patients should be informed - it can help them to use the time to put their affairs in order. We're all going to die - we need to be ready for it.

What makes you think that it’s ethical to tell blatant lies and gaslight dying people? Absolutely ridiculous idea OP - even for MN this is batshit.

I very much doubt that the poster’s sister who was lied to by her didn’t know.

If the doctors had relayed this information to the family, then they would have had to tell it to the sister - unless she had explicitly asked not to be kept informed.

My SIL died of a brain tumour some years back, and there was a point where her family knew re the prognosis but she was in hospital and undergoing surgery at the time. As soon as she came round the dr’s told her what the prognosis was.

It’s understandable that a family member might choose to not tell a relative that they’re going to die/that they will live to see Christmas, I’d imagine that that was done as much for the PP’s benefit, i.e. wanting it to be true, as anything else.

But a doctor telling the family and then lying to the patient is absolutely unforgivable. But that’s on them not on the sister.

But lack of compassion - how and when it's said Vs telling them the truth are different. It should be absolutely done with the up most compassion but people have a right to say goodbyes, to tidy up anything they wanted to leave until the end, . I'm sorry it doesn't always happen that way - that people are left scared etc. but that doesn't mean telling them per se was wrong

I agree with you op. When we are diagnosed with something serious we should be asked "do you want to know if it becomes terminal or not". I wouldn't want to know myself.

I'd want to know!

I could better prepare and so could my family. You go to seek medical help then yes you should absolutely be told the truth

Your placebo idea is beyond ridiculous

I had a massive heart attack a few months ago. I was very lucky indeed to survive it. I was told that initially and, at all my appointments since, it has been made clear that another could be fatal. Every single doctor and other healthcare professionals have been factual whilst being kind and compassionate. I would much rather have honest and open conversations about what is happening in my body than be fibbed off or lied to.