Doctor told my frail DF (92) that he has just months to live!

[SausageCrush]

Is this usual?
My Df has a variety of health issues, but is still mentally sharp. The news is not a surprise, but i am rather shocked that he was told.
Since the doctor told him on Friday he has been feeling very low.
He obviously knows he is very old and ill, but usually has a very bright outlook and wants to keep going for as long as possible.

In what context was he told? Did he ask, or is he ill at the moment? Seems a bit odd of the GP to say otherwise.

It surely he’d want to know? My grandad is 93 and completely with it mentally, if he only had that time frame then he should have the right to know this?

Do you suspect the information to be correct and in context? As in 'you have x cancer and I would suggest you have around x months to live'? If it was just guessing because he's old then no its not really appropriate to guess IMO. If its based on a relevant diagnosis then (you say he's ' sharp') then I'm not sure why it would be hidden from him?

Yes this is usual, your father has a right to know and it means he can participate in his care planning and treatment options.Best practice would be if a family member was present, when your father was given this upsetting news.

Did you witness the conversation? What was the context?

I tend to find (in my work) that these are very nuance and delicate. But as your day, your dad is sharp and completely with it, so he’s the right person to have the conversation with.

Imagine how your dad would have felt if the GP had assumed he shouldn’t be privy to his own health information and had defaulted to speaking to the next of kin instead? That would be inexcusable given your dad has capacity and is able to actively participate in his own care!

*these conversations are very nuanced and delicate.

Yes, these days this is normal. In the past doctors were more evasive but now it is considered best to be honest.

I’d have hated my DF being told that. The doctor took me on one side in about May and said he wouldn’t last until Christmas. He died in July. When my DF asked me if it was the end, I told him it wasn’t. Luckily his memory went suddenly in the last week so he had no idea what was coming. It does seem to be the practice now to tell people that they’re going to die soon. My XP was told and was distraught. It would have been kinder to have said nothing. I’ve seen programmes like 24 hours in A&E where the doctor tells them. I think it’s cruel. I’m so sorry that your DF has been given this news.

Do they really tell people now, in the absence of a life-limiting illness? I don’t know that I’d want to be told that, if I hadn’t actually asked.

Inthebleak

Since GP’s are not psychic I don’t think they can tell anyone how long they’ve got left if they’re fit and well with no medical conditions. Your guess would be as good as theirs

I assume OP’s DF has been told this in light of a diagnosis or multiple diagnoses and increasing frailty.

He has the right to know. It can help people and their families find peace and plan their future care and get the support they may need. It can also help with fees through fast track if people are usually self funding.
Knowing how long you have doesn't mean people cant keep going as long as they can but can help them accept that they may experience changes.
Sorry he has received this news.

Before my DF died, he had been to numerous appointments, lots of surgery, a few hospital visits.

I'm sure the consultant didn't mean to be so blunt but he said that he had used every tool in his box and he wouldn't need to see him again.

My poor DF. He was quite surprised at that. I wish the guy had fibbed and said - 'See you in 3 months'. - even if he wouldn't.

It seemed such a small thing for the Dr (Mr) to do. I really feel for you x

My dgf was told he didn't have long left to live (6months)
After being given this news he completely gave up on life and stopped trying.
I firmly believe that he would have been with us longer had this Doctor not said this to him.
His last four months were sheer hell on Earth. He was scared to be alone, kept calling for an ambulance and he was tormented by fear. He was so anxious he could not eat or drink.
It was cruel.

Thank you for getting back to me.
Yes, he was given the news following a blood test result about his kidney function.
He already has all of his finances, wishes, care, etc sorted out (not that the doctor would know all that.)
It just seems to have deflated Df and has made me sad to see him like this.

Try and get him to keep trying Op. Agree with pp, my dad just gave up after he was told that and he had fought so hard

I’m not directly involved in these kinds of discussions, however, I work with palliative patients. As far as I know he should have been asked if he wanted to know (and I imagine he was) as some patients prefer not to be told timescales, they usually would tell people that they’re palliative now as there’s no cure for their illness and it would be a good time to discuss end of life care, for example, sign DNARs, decide on a hospice if needed, sort their will out etc. They would only give timeframes if the patient asked or said they wanted to know and even then it’s quite vague e.g. months, years, not “you have three months to live” as no one can predict that.

Your father has a right to know he’s nearing the end of his life so he can prepare adequately, if he has capacity then he can decide if he wants to know a timescale and if he wants others involved in the discussions and plans (which is usually advisable).

It’s worth also remembering that often when given bad news patients forget large chunks of the information and conversation, in fact a lot of elderly people and people in general do this in normal medical conversations I’ve found, no matter if you explain something repeatedly and very clearly. I’ve had patients swear to colleagues I’ve not explained something to them when I know I went over it about three times and checked they understood.

From my experience: my father told me years before he became ill that if he was dying he would not want to know. When the time came I moved heaven and earth to comply with that wish. The medics said they would not lie if he asked, but would not broach the subject or volunteer the information. That was the best I could achieve.

I do think he knew, but he didn't want it spelled out to him. I think if he had been told he would have given up, and not had the last 2 years of life.

@SausageCrush
I don’t think they should be told, they seem to lose the will to live after that. He could go on for ages! At his age, I’m sure he well aware that each day could be his last in any case, does he need to be told. No I don’t think so. What good can come of it?! I’d be very annoyed and upset.

I don’t know what you could say to turn it around, doctors aren’t always right in any case.
A friend’s 24 year old brother was told he had an inoperable brain tumour and would last a few months. 18 months on he was told it would’ve been operable at the time but sadly it IS now too late.
You just never know.

Lots of people are told they have only X left to live and then go on for years. Drs are making a good guess and don't always get it right.

I used to do retirement planning and talked to lots of people (men usually) who said "I've got years ahead so I don't need to know about all the alternatives". My response was always that you might be healthy as a horse but that won't help too much if you trip crossing the road and get hit by a bus. Because none of us have a crystal ball we have to think out what's likely versus what we would like and make our life choices accordingly.

At 93 DF must have considered the end of his road already. Kidney failure is a good way to die - no pain, in your sleep.

Time to organise some family and fun things to do to take his mind off it, and bear in mind nowadays most of us last a lot longer than doctors predict.

@SausageCrush

I cannot believe this just came out of the blue. I think if doctor had told him [or me for that matter] that he had a serious disease then I think the next question would be "and how long Have I got"?

I doubt a doctor would say - out of the blue - "you have ... months to live" if there is no critical problem

If your father is mentally well he has the right to know and it absolutely right for a doctor to tell him the truth. Wouldn't you want to know if it was you?

At 92, physically frail and mentally alert I’m not sure anyone needs to be told they don’t have long to live, especially if they haven’t asked the question.
I’m all for being open about death - it happens to us all after all - but I’m not convinced that the policy to tell all patients that they are going to die shortly is the right one.
I know that doctors can’t know how patients will react to being given this information but I struggle to find any benefit in bluntly telling patients like the OPs father who have had a long life and are becoming increasingly frail that the end is near.
To me this just seems like a pointless tick box exercise for the doctor which satisfies some audit trail but has caused unnecessary upset for the patient by telling him something he didn’t really need and more importantly want to know.

We weren't there so dont know how the conversation went or how the subject were bought up but doubt it is ever a tick box exercise.

Having seen this play out with my father who died in May I feel that if they don't ask they shouldn't be told.

We knew Dad had heart and other problems, he was 91, we phoned the doctor because he kept feeling dizzy thinking she could just tweak his medication a bit, which she did over the phone. Then she asked him to come in, which involved me making the half hour journey to his house and driving through rush hour traffic. She didn't even examine him but just opened the conversation with "You need to make an end of life plan." I watched his face just fall and I felt terrible, it was heartbreaking. She dragged him out when he was feeling ill just to do that! We tried to console him later by saying that all people over a certain age had them, but he knew my mother (87) hadn't been asked so he wasn't convinced. That conversation darkened his last months. It was in February and he died in May after contracting coronavirus.

Both my parents were in the same hospital at the same time with Covid. My mother died in April three days after being admitted. My brother and I agreed we wouldn't tell Dad yet as he was still very ill, but the decision was taken out of our hands as the staff took it upon themselves to tell him immediately - they told me he was very upset, no shit Sherlock, and we weren't allowed to visit him of course.

Also, when he was taken back to hospital at the end with breathing difficulties, they told him outright that they couldn't do anything else for him - why would they do that when he didn't even ask? When I was allowed to see him (because he was dying) he kept telling me they couldn't do any more for him and he just wanted it to end. I honestly thought my heart would break. I feel the end of his life was miserable especially after he lost Mum and I wasn't even allowed to visit him - he was very deaf so phone calls were nigh on impossible.