When the antibiotics aren't working

[Stickthatupyourdojo]

Hi all, apologies but I'm posting this on behalf of my mum and her siblings about my grandad.

He's 92 and been in hospital for nearly 2 weeks with sepsis from endocarditis. He's on 4 hourly IV having been bumped up from daily but the latest bloods show no real improvement and it seems to be resistant. We know he's on flucloxacillin purely as it was written on the drip and the latest update is the (last?) option is valve replacement and a wash out of the infection. Grandad/dad doesn't want this operation.

My family is struggling to pin down a doctor during visiting hours to get a proper update on likely course of action. Nurses advise need to ask the doctor. Grandad too confused to relay information. Mum and family know this Tuesday it will have been two weeks of antibiotics and they're due to end then. They have no idea what happens next. Grandad speaks about coming home in the next couple of days in one breath and then saying he's had a good innings but it's his time in the next. Obviously none of us want to ask him directly difficult questions. He has a good colour but isn't eating that much and is sleepy.

Has anyone had an elderly loved one in a similar situation who can advise what the next steps are likely to be? We've assumed the only other option to surgery is palliative care, but will he get to come home? Will they extend the antibiotics just in case they do work?

Any advice gratefully received.

[Peekaboobo]

If that were my loved one I'd be taking them home and withdrawing all treatment. If you speak to the staff they should be able to facilitate this for you with transport and a hospital bed and carers coming in if necessary.

I know you said the Drs are hard to pin down but really, you need to speak to them. And as difficult as it might be - you need to have a conversation with your grandad to find out what he wants. Although realistically his only options are to be in hospital or to be at home. I know what I'd choose.

[jamsandwich1]

I think in this situation you need to speak with the doctors.
In working hours ask the nurse in charge that you need to schedule a meeting with the doctors looking after him so that you understand what is going on.
A family meeting will be possible to arrange.

This sounds very complex and you need to have a proper discussion not getting second hand information here and there. I don’t think any of us could properly advise in this situation.

[Stickthatupyourdojo]

Thank you both, I'll relay that to my mum. Most days they are taking it turns to go in although at weekends we can manage to go together. I feel it's only my mum who is quite active in speaking to the doctors (she's down as his contact) and asking questions, the other two are lovely and just as involved in visiting and helping him but very passive in that they wait to be told the 'latest' either by mum or if they happen to catch the doctor. You're right in that we should all start to find out options to discuss with grandad to ensure his wishes are met and he understands as best as he can.