Mumsnet hasn't checked the qualifications of anyone posting here. If you have medical concerns, please seek medical attention; if you think your problem could be acute, do so immediately. Even qualified doctors can't diagnose over the internet, so do bear that in mind when seeking or giving advice.
Mumsnet hasn't checked the qualifications of anyone posting here. If you have medical concerns, please seek medical attention; if you think your problem could be acute, do so immediately. Even qualified doctors can't diagnose over the internet, so do bear that in mind when seeking or giving advice.
Dementia & Alzheimer's
Palliative Care
minmooch · 08/12/2021 12:59
My dad has been in a care home since 2018 with vascular dementia. He caught Covid in February and has been bedbound since then and has not left his bed even to sit in a chair.
He needs care for everything. He cannot sit unaided, walk, wash, toilet, feed himself. He has bladder cancer and has had skin cancer.
He no longer knows me or any of his family probably for the last couple of years.
He spends most days asleep. Speaks very little but will occasionally say something that makes sense like What day is it. Usually most sentences don't make any sense.
He has deteriorated rather quickly over the last few weeks. Now no longer moves any of his limbs, nor even moves his head. SALT have been in and assessed him for thickened drinks and not quite purée food. He still eats a little but only with assistance.
He is being moved to palliative care but is not considered end of life yet.
I have asked for a review of all his meds to determine what he really needs.
My brother and I have POA for both health and finance. We had many open discussions with Dad about his care. We know what his wishes are.
He currently has a chest infection. Dr wants to put him on antibiotics. I just can't see where this is in his best interests? He is not going to get better. He is only going to get worse. It may get rid of this chest infection but what then? He is likely to face more infections or get pneumonia as is usual in end stage dementia.
It just seems wrong. I want to say no to antibiotics because I know what my Dad would want. Gp wants to give. He would not want to exist like this or have medicines that only elongate this existence.
Anyone got any advice?
freshcarnation · 08/12/2021 16:37
I agree with you. If it were my mum I would want the same for her.
SparklingLime · 08/12/2021 17:02
Have you got a DNR in place? Has he recorded his wishes in any way?
PermanentTemporary · 08/12/2021 18:46
Absolutely agree with you. Antibiotics for a UTI are more of a grey area in my view as the symptoms can be so bad. Usually they use antibiotics for chest to prevent breathlessness and chest pain. But I would ask your GP what the rationale is for managing distress that hasn't happened yet. I'd call then quickly though as they get prescribed so automatically that you can miss the moment.
minmooch · 08/12/2021 20:15
@PermanentTemporary well we missed the moment on this one. Dad is already on day 2.5 of a 5 day course. I managed to get a call back from his GP tonight who didn't know that my brother and I had POA for both health and finances. She said the care home did not let her know. This is exceptionally frustrating as we have had both POA since before my Dad even went into the care home. She agreed that before any other medical intervention it will be discussed with my brother or I. Dad is being referred to palliative care and the team will be in touch for further discussions. I talked to her at length and expressed my views and what I feel my Dad would or would not want. I think she said that if Dad doesn't respond to these antibiotics then there wouldn't be much else they could do anyway as we have all agreed no hospitals, no intubation, no IV antibiotics and a DNR is already in place.
She agreed after 10 months in bed Dad is never going to get back to where he was before he got COVID and that his decline has sped up over the last few weeks.
I hope for my Dad that his suffering with dementia is over soon. It's just an existence, not a life and he would be horrified if he knew where/how he is.
SparklingLime · 08/12/2021 21:18
Oh, @minmooch, it’s such a hard time to go through. Especially when communication breaks down between professionals. I hope it’s peaceful now and all goes smoothly. 
PermanentTemporary · 08/12/2021 21:34
Oh minmooch. We missed it as well and it is SO frustrating. But you can only move on - it is always a judgement call and it might make him.more comfortable without prolonging things.
PermanentTemporary · 08/12/2021 21:51
Tbh it's not that easy a get out for the GP - if they're making a best interests decision on behalf of someone without mental capacity, they should consult with the people who know him, whether they have POA or not.
To comment on this thread you need to create a Mumsnet account.