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Elderly parents

Can an Attorney ask a care home staff to not provide nutritional shakes/fluids for an end of life patient?

33 replies

zippyswife · 30/10/2024 16:25

MIL is in a care home. She is on a gold framework end of life care plan put in place by her GP. She has been in hospital, come out, not regained movement in her legs and is bed ridden and incontinent. She has advanced vascular Dementia and often very confused and distressed, living an internal nightmare of having ‘lost her child’. She is unable to swallow food or take medication orally. We have been told that she has hours/days and this is the dying stage. My husband has power of attorney for health.

MIL before dementia was a very strong and proud woman. She would be appalled at her current situation and would want to be removed from it as quickly as possible. Having seen her family suffer dementia, she was clear and blunt on her wishes if in similar situation.

She is in a nursing care home, and has a ‘Respect Form’ that she should not be returned to hospital, receiving care in the home. The home and staff, however well intended, are regularly giving her liquid based nutritional shakes/additive, soup and porridge. She needs assistance to take in any fluids, sometime the shakes etc are delivered with persistence that she would not want, but is not able to communicate.

The use of the nutritional drinks is prolonging her physical ‘end of Life’ and causing her mental distress in a way she would never have ever wanted. The most dignified and respectful thing she would want is to be left for nature to take its course, whilst of course bieng hydrated (with water/juice) and loved.

Do others have experience of this. Can husband acting as attorney decline nutritional drinks and additives on her behalf?

OP posts:
TizerorFizz · 31/10/2024 11:32

@Oblomov24 I think I must write my own wishes! I don’t want any crap end of life care. I want out before I get so bad I’m not making coherent decisions. We don’t take personal views into account early enough. DM had a great life but hospital was a nightmare in her last year. It’s mostly a horrible end to a life.

rickyrickygrimes · 31/10/2024 14:36

Hi OP

What's the link between her GP and the care home? MILs GP practice is directly associated with the nursing home, so any diagnosis / prescriptions / other medical issues are (in theory at least) passed directly to the nursing home staff by the GP. Is your DH expected to be the link?

What is the 'gold framework end of life care plan put in place by her GP'? Is it a written document (and does your DH have a copy?) with clear steps / actions that the carers are expected to follow - and does it specify that she is not to be offered the nutritional shakes etc? I imagine that unless they have it clearly in writing from the GP they will continue to offer and to encourage her to take some as they will be covering their own backs.

Lovelysummerdays · 31/10/2024 14:51

CookieMonster28 · 30/10/2024 16:47

Sorry to hear about your MIL.

Has she had her swallow assessed by a Speech and Language Therapist?

If she's imminently end of life it's unusual that care staff would be giving her nutrition...but keeping her mouth moist and hydrated for comfort. If it's any reassurance with dementia and approaching end of life it's very unlikely she will be experiencing feelings of hunger or thirst.

Its definitely worth your husband discussing with GP and care home manager. I'm not 100% sure if he can request they stop.

I worked in a care home ( just as a housekeeper) and even at end of life the carers were trying to get fluids in and recording amounts. I think no one wants to be responsible for hastening death so fluids/ nutritional shakes are given unless contra indicated medically. It might be a kindness but I remember several they killed/ attempted to kill my gran press stories about Liverpool care pathway.

ComingBackHome · 31/10/2024 14:54

@TizerorFizz i think we should ALL make our own wishes clear. And way before it looks like it might be needed too.
(Same than with a PoA or a will for that matter)

BetterInColour · 31/10/2024 14:55

I agree with you OP, also people can say 'yes' to this whilst not knowing the implications of this which is that eating and drinking actively in their last hours interferes with death and also they can choke or aspirate very very easily which is so distressing.

I hope you get this sorted as this is not appropriate care for a confused patient who is 'hours' away. This is a hard time being at a remove as well, be kind to yourselves.

AnnaMagnani · 31/10/2024 16:10

So sorry for your DH and his mum.

The care home are correct in that they should offer.

However your DH would also be correct to respond 'you asked once, she said no' if they keep asking over and over if she wants a drink.

rickyrickygrimes · 31/10/2024 18:09

@zippyswife

I think no one wants to be responsible for hastening death so fluids/ nutritional shakes are given unless contra indicated medically.

This is why any instructions from the GP need to be in writing and expressly shared with the care home. Has this happened?

GETTINGLIKEMYMOTHER · 01/11/2024 23:18

Having seen residents (with fairly advanced dementia) at my DM’s care home being badgered and pestered to eat and drink when they clearly didn’t want to - crying or whimpering and repeatedly turning their heads away - I must say I’d be very forceful in such circs. To me it’s almost a form of abuse - but at the same time I do know that it was done with the best of intentions - however misguided.
I had already made it clear that there was to be no ‘striving to keep alive’ of my DM who was over 90 with advanced dementia.
OP, I would have a very firm word with the staff, and say you know it would certainly be against your mother’s own wishes to have her already limited life prolonged in this way.

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