So bloody exhausted waiting for someone to die 2

[StiffyByngsDogBartholomew]

https://www.mumsnet.com/talk/elderly_parents/4866628-so-bloody-exhausted-waiting-for-someone-to-die?page=1
Carrying on from our original discussion

I am so sorry @SeriouslyAgain and hope that this is the beginning of better times for you and being able to remember your mum as she was before this all happened. Wishing you strength fir this last leg of the journey xx

@SeriouslyAgain I've only been on the thread for a short time but am so sorry for your loss and hope you have time and support to rest and heal yourself after this journey- which will have been yours as much as your mum's.

@TheMessThatYouLeftWhenYouWentAway
This thread really is the circle of life! I was new to it only in November. Both the worst thread to have to be on, and the absolute best of MN!

One more thank you for yet more wise, kind words. Thinking of you all out there.
My first lesson of sadmin is that if someone dies at a weekend and there is no out of hours gp to certify, you have to phone 111. The poor little buggers answering the phone sound like they're about 12 and absolutely terrified😂. They were actually pretty good and the on-call doc arrives (albeit about 6 hours after the 111 call1! ) in a snazzy chauffeur-driven car.

Oh gosh Seriously that sounds like a first hurdle. Hopefully the cause of death is quite straightforward and easily certified. Our very no nonsense GP said there were certain things she'd put down as cause of death that would be unquestioned and others (that were in some ways also true) that she'd leave out just to keep it simple.

@SeriouslyAgain sorry for your loss. The end is somehow still a shock and a sad event even when you know it is coming and know that your mum had already been ebbing away for years.

Had she seen her GP in the last 28 days or will it be referred to the coroner? My dad's death was referred to the coroner last year despite him having see an on call GP and having daily visits from an Intensive Care at Home Team as he hadn't seen HIS GP. In his case it probably only delayed things by 24-48 hours as he obviously wasn't fit and well.

@SeriouslyAgain I'm so sorry for your loss, none of this is easy is it. Sending you a huge hug

So sorry for your loss @SeriouslyAgain - and to @Choux - but also thank you for sharing your journey and the hurdles and lessons you’ve learned.

DM died before 111 was a thing and I’m sure the GP who certified wisely left things out to keep it simple. It is helpful to me to remember again what poor DF went through back then when he was caring for terminally ill DM in her last few months.

Warmest love to @SeriouslyAgain and to @Choux . It's so hard, I know.

Thanks @FiniteSagacity and @popularinthe80s but the loss of my dad is not as recent as @SeriouslyAgain s loss.

And I am now in a different phase of caring as mum is in a care home so much less dad to day stress although I am gearing up for Round 2 as mum is deteriorating which is a worry. She is starting to be in pain but her dementia means she can't explain where the pain or what it feels like. So last week she spent a night on a bed in a corridor of A&E (with a carer from her care home bless them) while she had bloods and an x Ray to see if they could find anything. She was sent back with no diagnosis and given liquid antibiotics and painkillers as getting her to take tablets is now impossible.

The care home and GPs are really good with looking after her as per 'the rules'. But am sure if I pretended she was a dog and explained her health to a vet, the vet would advise that it might soon be kinder to put her to sleep.

The care home and GPs are really good with looking after her as per 'the rules'. But am sure if I pretended she was a dog and explained her health to a vet, the vet would advise that it might soon be kinder to put her to sleep. Doctor has just agreed to amend Dad’s details to “not for hospital” based on his most recently expressed views. You can’t, obviously, have them put to sleep, but there are things that can be done to ensure treatment is appropriate.

Gosh Mere, that’s a change isn’t it as your dad previously expressed that he wanted to carry on as long as possible. I hope whatever the future holds for your dad, he remains comfortable and pain free.

I’ve had a really good think about this, and realise this was before his repeated hospitalisations about 5 years ago, and his previous views were based on an ICU 30 years ago. He still wants to carry on as long as possible, but he’s been quite clear he doesn’t want to go into the local hospital, and, to be fair, the hospital experience when you’re old and frail, with poor hearing and declining cognition, is very different than for a young fit person with an illness or fracture.

He gave us all a worry at the weekend but today he’s back to normal, to the extent we had a coherent discussion about Gaza, even if it did trail off to Mumps in Oldham He can still teach me things!

Ah, ok, it’s a precautionary thing, bit like mum agreeing to a DNR recently. Something in place to ensure wishes are followed in the event of an emergency. Sounds like he’s “buggering on” for the moment.

It is scary how quickly our elderly relatives health can fall off a cliff. Bit like the reverse of toddlers who can be worryingly lethargic, cranky and running a very high temperature one minute and then up and running around their exhausted parents a short time later.

Mum HAS a no hospital treatment directive where it is something like pneumonia and she would need to be an inpatient. But twice in the last three months she has had a night in A&E having tests.

First she had a fall and hit her head so needed a CT scan and monitoring as she couldn't say what happened or if it hurt. That was19 hours in A&E. And then last week a night to see if she had a fracture and what strength pain relief she had.

They now think her current pain in back and hip could be arthritis or osteoporosis related. My fear is it will progress and they won't dose her up on enough pain relief and she will be uncomfortable or in actual pain. And I need to be her advocate from 200 miles away.

If your mind is going and your body is going then it's not a great life even if she is being well looked after.

@MereDintofPandiculation I think our DFs would get along well as DF loves railway history and also a tangential conversation ☕

I think I was the only person not lost for words when the carer agency asked if there was a DNR in place. But obviously I had to choose my words carefully in the moment.

I have greatly appreciated the experiences shared here that mean I know that a conversation needs to be had with DF about how he feels about these things and to get them down. DF is so frail that CPR would be physically and mentally very traumatic.

Unfortunately, I think DF’s recent trips to hospital have been thrilling. The first to A+E, while not pleasant seemed to be an Adrenalin thrill (not for those taking him for the out of hours marathon/nightmare it turned out to be). The second to a clinic appointment was like a day out. A stressful, rushed, prodded and poked (and thirsty and starving) day out but probably wouldn’t put him off. Which may be a turnaround from his 2023 adamant position that any trip to any hospital and he’d die in there so paramedics were patching him up at home.

Today DF sounds so confused and blatantly didn’t want to talk about what I called him about (more medical appointments), so today’s tangent was long spoons and knickerbocker glory glasses.

It's so difficult. There's always a balance to be struck. The key person in my view is always the GP. I've known care home GPs who were thoughtful and excellent (and capable of pushing back against me and my sister combined, which I'm afraid is no mean feat) and I've also known a few who did seem to apply a rather routine approach to their care home residents.

Yes, it was made clear to me that the "no hospital" directive wouldn't extend to things like fractures.

But today's A&E is no place for the elderly, is it? (Let's face it, it's no place for the sick).

I had the opposite. 4 year old playing happily with the toys in GP's waiting room, only there because I felt I should show someone his rash. Told to take him to hospital, straight to children's ward. Still happy when I got there, within an hour he was limp in my arms. 4 weeks recovery. Whereas my dad this week has been more like a toddler.

@FiniteSagacity I know those tangential conversations well! Sometimes the end of a sentence is miles away from its beginning.

@PermanentTemporary We're very lucky that the nursing home GP is the same practice that my father was with, and that I'm still with. They've been really good at discussing him with me.

Mum's GP said to me quite unequivocally that she was willing to manage any future broken hip in the community, without transfer or surgery. So it's not an unequivocal 'yes' to admission. But it would depend on the circumstances.

HiPlease check your EPAs and LPAs are registered because I am having all sorts of 💩 going on.

Yes, to be fair, the GP discussing "no hospital" with me was talking about open fractures with bits of bone sticking out, so the implication was other fractures could be dealt with by the care home.

What does 'manage it in the community' mean? Surely an unoperated broken hip would be painful and the lack of mobility would quickly lead to bedsores, circulation issues or other problems?

Or does it mean they dose the patient up with morphine so they are never awake and pass away from dehydration in a few days?

Getting old is not for the faint hearted!

@choux I think in the circumstances at the time, it would have been the latter, givrn that my mum wa right in the middle of one of her many 'come at once, she's in her last hours' calls (16 months ago ) - though even though she did come vack from that, sges never stood up or even sat up very well again. But surgery is always a bit of a toss-up and it is possible to decide against and to just go for bed-bound living with the assumption that the person will only have a short time left. My aunt did eventually have surgery for a broken pelvis - I think because she'd been gardening when she fell and in many ways appeared to be functioning quite well before the break, also they thought she would go quickly and she is just as tough as my mum and kept living. The surgery wasn't presented as a failure but she got gangrene and took something fairly awful like 8 weeks to die (apparently she showed no sign of being uncomfortable). My own view is that her apparently good functioning was propped up to an extraordinary extent by her selfless partner and her own phenomenal will. Tbf without the surgery it might have dragged on even longer.

@Choux By the time you get to the “no hospital” decision I would imagine you are already looking at immobility, fighting daily to avoid bedsores, and who knows what other problems.

@PermanentTemporary’s posts shows that the decision may not be obvious, and hospital has its own dangers.