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Elderly parents

Father in hospital with pneumonia

10 replies

LaBelleSauvage123 · 28/06/2022 22:57

My 87 year old father is in hospital with ventilator-acquired pneumonia following a fall which compromised his airway. He is on strong antibiotics and regular suction but isn’t strong enough or mobile enough to clear the secretions by coughing and moving about. Doctors have said that he risks getting further infections and my siblings and I need to think about whether these should be treated or not. The issue is that he is very confused - the doctors have described this as delirium, but he has been moved today from ICU to a dementia ward. He was showing slight signs of cognitive decline before his fall but nothing like this - he recognises us, but is hallucinating and most of what he says doesn’t make sense.
He appears to have no idea of the seriousness of his illness ( and in fact at the moment all his SATs are stable and his heart is strong). I have a strong feeling that the best thing for him would be to go home with nursing care - in familiar surroundings the delirium might recede and then we could have a better idea of his wishes as far as ongoing treatment is concerned. But I don’t know if this is even possible.

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exexpat · 29/06/2022 00:37

Sorry to hear about your father. Mine was hospitalised many times with pneumonia and other issues over several years before he died, and hospital-induced delirium was increasingly an issue with him. It is very common - if you look down the elderly parents board there is a recent thread on this topic.

There were times when he had pneumonia when he was talking total gibberish (babbling away, seemed to think he was communicating but was not using real words), and other times when he sounded normal but was clearly delusional. Mostly it only cleared up when he left hospital, but obviously he had to be medically fit for discharge before that could happen. By the end I think he was also suffering from the early stages of vascular dementia, and anything else going wrong with him just magnified the effects of that.

You may find that when your father is physically well enough to be discharged his mental state will improve again, but it is probably more important to concentrate on his physical recovery for now.

Do you have health and welfare power of attorney for him, and have you ever talked about his wishes? What is his general state of health and quality of life before he went into hospital?

In my father's case, I ended up wishing that he had been allowed to succumb to one of his many health issues months before his eventual death, as his last six months or so were awful for him and for the rest of the family, but he had multiple health problems, had been disabled for nearly 20 years, and his quality of life was rapidly declining before that. Your father may be in a much better general state and so could still enjoy life for a while longer if properly treated.

PermanentTemporary · 29/06/2022 07:31

Ask your consultant to be specific about treatments. And ask about getting him home. What are the barriers to that right now, today? Can his money fund 24 hour care at home and would he need just one person, 2 or whatever? Are there hospital at home care teams that are NHS funded?

Get in touch with the occupational therapist. They are the ones who know the details of how discharge could work.

LaBelleSauvage123 · 29/06/2022 18:39

Thank you both. We do have POA for health and welfare. Whatever happens, we have to get him out of there. He pulled out his tubes in the night ( as we warned them he would) so has had no food or water since then. He’s lying there in a dirty pad. The nurses don’t seem to know anything about his medical condition. His confusion was much worse today and he didn’t recognise me or my sister until we’d been there for an hour or so. We spoke to a nurse practitioner about our concerns and he has made a referral to the Care of the Elderly team and says that a full medical review will be done tomorrow. So I intend to get there at 10 and stay until I have some idea of what’s going on.

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LIZS · 29/06/2022 18:50

Infections can trigger delirium, for example a uti is very common in the elderly and particularly if catheterised or dehydrated. The drugs used to ventilate him can also take a while to leave the system or it could be triggered by the trauma of a fall. Fingers crossed time and rehab helps.

LaBelleSauvage123 · 29/06/2022 19:42

I’m just not sure how much rehab he’s going to get in the ward he’s in. They are struggling to even provide basic care.

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LaBelleSauvage123 · 29/06/2022 19:44

He has enough money to fund care at home but I don’t think they’ll discharge him

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LadyGardenersQuestionTime · 29/06/2022 19:50

Hospital-acquired delirium is pretty common - the Care of the Elderly team (or Frailty team or whoever) will be much better placed to advise and make decisions. But nursing care in his own home may be unrealistic - he may need a nursing home.

LaBelleSauvage123 · 29/06/2022 20:05

I think that would be better than this to be honest

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LaBelleSauvage123 · 30/06/2022 22:40

Today has been an utter nightmare. I got to the ward at 10am and waiting for a ward round that never materialised ( well other patients were seen but not dad). My dads chest sounded awful so I asked the nurse about suction - she appeared totally bemused by the question ( he was being suctioned every 4 hours in ICU). Later that morning the same nurse asked if I was staying and said if I was she would give dad IV fluids as I could make sure he didn’t pull the tube out! After 3 hours and dad dozing I asked the nurse to keep an eye on him so I could pop out for a drink and a wee. I returned after 30 mins to find alarms going off and everyone rushing to my dads part of the ward. He’d fallen out of bed trying to get up. No one was watching him. He has cut his head and completely closed up one eye and is now even more confused and agitated than ever. A registrar then appeared and talked to me about the plan for the next few days. They found a nurse from another ward to sit with him 1:1 and are looking to provide one long term, but with no promises. They seem determined to keep him on the dementia ward until he’s ‘medically stable’ - but they can’t treat him properly because his delirium makes him resist or pull tubes out. So surely he’ll never become medically stable? It’s an utter nightmare. I’m not blaming individual staff - it’s the system that’s broken. I went to PALS to make a complaint and the woman there said the same thing. We can’t physically be there all the time but it seems the only way to keep him safe and make sure he’s being treated.

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PritiPatelsMaker · 02/07/2022 09:25

Doctors have said that he risks getting further infections and my siblings and I need to think about whether these should be treated or not.

I'm so sorry that you're going through this @LaBelleSauvage123

Have you and your Siblings made a decision on this yet? Do you think that asking for a meeting with his Consultant would help?

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