Meet the Other Phone. Flexible and made to last.

Meet the Other Phone.
Flexible and made to last.

Buy now

Please or to access all these features

Elderly parents

Medically optimised!

43 replies

anotherboy1 · 29/03/2025 20:44

My lovely dad who is 93 has been in hospital for the last month. The drs are saying there is nothing medical wrong with him and he needs to be discharged to somewhere. He has hardly eaten for the last ten days and will not drink. He is on a drip to get fluids into him. He is asleep most of the time and I don’t think he is aware I’m even there. Could someone advise me what to say to the hospital please x

OP posts:
anotherboy1 · 30/03/2025 22:45

My dad due to dementia and delirium is not able to express his wishes. I do have a brother but he lives in Hong Kong

OP posts:
BunnyRuddington · 01/04/2025 07:19

anotherboy1 · 30/03/2025 20:47

I did visit my dad every day but due to my mental health I would not be able
to do personal care x

Have you spoken to the Discharge Clerk? I think it’s usually assumed that family will take care in discharge from Hospital. It’s absolutely fine if you aren’t going to provide that care, I’m not sure I could if he has Dementia and Delirium, but you may need to tell the Discharge Clerk that it won’t be you providing that care.

Does your DF have a SW too?

MellowPinkDeer · 01/04/2025 10:54

You could ask for an intermediate care bed , that way for up to 6 weeks he could be cared for out of hospital and see how he gets on in a different environment? Hope you’re ok OP.

KidsDr · 01/04/2025 11:25

Disclaimer: am a paediatrician! But have some previous experience in elderly care and some family experience with dementia and delirium.

This sounds like hypoactive delirium and unfortunately many elderly people do not recover. I like to use the term "brain failure" as a way of conceptualising that a vital organ (the brain) has been pushed into a failure state that may persist even beyond the acute illness, and may be irreversible or not totally reversible. In much the same way that those who are elderly or otherwise in a vulnerable health state can easily tip into other vital organ failure eg heart or kidney, which may also be permanent or even fatal.

There may be a component of cognitive decline / dementia prior to this episode which has been concealed if his daily routines have remained simple and unchanged (and therefore unchallenging) to this point.

So sorry this is happening to your Dad. I agree an honest conversation with the hospital team is needed to move forwards. For example, what is being achieved with the IV fluids? Perhaps they are keeping him hydrated whilst he awaits a discharge destination where it is hoped his delirium will improve and he will drink again? The hospital is generally a very demanding environment for an ailing brain and so his delirium is more likely to get better somewhere else. Staying in hospital to have the IV fluids therefore wouldn't be likely to achieve anything for your father, if you see what I mean?

If this was my Dad I would be very sad as I would be thinking - this is very likely the end of his independent life. I would want to get him out of hospital as quickly as possible but into a situation that is safe and in which he is adequately cared for. I would be weighing up the benefits of home with package of care Vs nursing home (or perhaps other options you could discuss?). A nursing home has the benefit of meeting a very high level of care needs and being the best solution should things stay as bad as they are. Carers at home obviously a return to the familiar environment which would be best if things improve substantially. However, if it doesn't work out he may have to move again to a NH eventually which would be another significant adjustment that could deepen the delirium. I don't think there is any way to predict whether / how much his brain will recover to get him back to something like his previous self.

If he does not return to eating and drinking within a reasonable timeframe then I would view this as a terminal sequence of events and would not want IV fluids / tube feeding to artificially extend the dying process - if it was my Dad. But hopefully that isn't what is happening here and he may make some recovery yet and you'll have some glimpses of your old Dad soon.

Really sorry this is such a horrible place to be. In my family it was my Gran.

Floppyelf · 01/04/2025 11:27

anotherboy1 · 29/03/2025 21:21

He originally hot taken into hospital with a UTI. He has got worse why being there. He is refusing to eat and drinking very little. I wonder how much longer he can go on for

If he himself if refusing to eat, I think he’s made his choice. When my great grandma made that same choice it was her clear way of saying I’m ready to die.

Floppyelf · 01/04/2025 11:29

KidsDr · 01/04/2025 11:25

Disclaimer: am a paediatrician! But have some previous experience in elderly care and some family experience with dementia and delirium.

This sounds like hypoactive delirium and unfortunately many elderly people do not recover. I like to use the term "brain failure" as a way of conceptualising that a vital organ (the brain) has been pushed into a failure state that may persist even beyond the acute illness, and may be irreversible or not totally reversible. In much the same way that those who are elderly or otherwise in a vulnerable health state can easily tip into other vital organ failure eg heart or kidney, which may also be permanent or even fatal.

There may be a component of cognitive decline / dementia prior to this episode which has been concealed if his daily routines have remained simple and unchanged (and therefore unchallenging) to this point.

So sorry this is happening to your Dad. I agree an honest conversation with the hospital team is needed to move forwards. For example, what is being achieved with the IV fluids? Perhaps they are keeping him hydrated whilst he awaits a discharge destination where it is hoped his delirium will improve and he will drink again? The hospital is generally a very demanding environment for an ailing brain and so his delirium is more likely to get better somewhere else. Staying in hospital to have the IV fluids therefore wouldn't be likely to achieve anything for your father, if you see what I mean?

If this was my Dad I would be very sad as I would be thinking - this is very likely the end of his independent life. I would want to get him out of hospital as quickly as possible but into a situation that is safe and in which he is adequately cared for. I would be weighing up the benefits of home with package of care Vs nursing home (or perhaps other options you could discuss?). A nursing home has the benefit of meeting a very high level of care needs and being the best solution should things stay as bad as they are. Carers at home obviously a return to the familiar environment which would be best if things improve substantially. However, if it doesn't work out he may have to move again to a NH eventually which would be another significant adjustment that could deepen the delirium. I don't think there is any way to predict whether / how much his brain will recover to get him back to something like his previous self.

If he does not return to eating and drinking within a reasonable timeframe then I would view this as a terminal sequence of events and would not want IV fluids / tube feeding to artificially extend the dying process - if it was my Dad. But hopefully that isn't what is happening here and he may make some recovery yet and you'll have some glimpses of your old Dad soon.

Really sorry this is such a horrible place to be. In my family it was my Gran.

Edited

I read your post after posting mine. Our experiences are two different ones. Since you have the medical experience, I hope @anotherboy1 gives more weight to yours.

anotherboy1 · 01/04/2025 11:32

@KidsDr thank you for your reply. I was thinking along the same lines. I’m going into the hospital now so will give an update later on this evening x

OP posts:
KidsDr · 01/04/2025 12:14

@Floppyelf

No I don't think your experience is less valid. Ceasing to eat and drink is frequently part of the dying process and it's right to interpret it in that way if the context fits. I think far too often totally inappropriate and uncomfortable things happen to maintain nutrition/hydration in people who essentially have terminal brain failure. I think sometimes we struggle to view the brain as a vital organ that can fail in the same way as a heart or kidneys, and in the same way, when it gets to the end propping it's functions up artificially is both unkind and futile.

That said, there is sometimes recovery in delirium. I wanted to express my hope that OP's Dad could yet improve but think it would be realistic to keep the possibility that he makes no further recovery in mind as well.

KidsDr · 01/04/2025 12:24

@anotherboy1

Again so sorry you are going through this. I wanted to add I think sometimes / often doctors use euphemisms and coded language and that they are not even aware they are doing so.

For example "nothing medically wrong". The word "medical" there is probably used to mean "receptive to treatment provided by the medical team". Just as "surgical" means something that is managed by the surgical team (even if it doesn't involve surgery, ironically enough). There is no dictionary of doctor speak it's just hospital culture to speak in this way.

But it's actually very invalidating and confusing to hear "nothing medically wrong" when of course, you have observed that there is something dreadfully wrong with your father.

It is poor communication and (we) doctors must work really hard not to speak in our own secret language. Direct questions "will my father recover from this?" "Is my father dying?" "is there anything further that medical treatment in hospital can achieve for my father?" Etc might help to open up the dialogue a bit more. Doctors do want to speak openly and be understood and will probably be grateful if you help them to do this(!)

Once again, sorry you are going through this awful time.

SockFluffInTheBath · 03/04/2025 06:52

@anotherboy1 how is your DF?

olympicsrock · 03/04/2025 07:18

Oh dear this sounds very distressing . It does sound like hypoactive delerium.
What they mean by medically optimised is that there is no infection / drug interaction/ constipation etc that they can treat to get him better. Only time will tell how much of a recovery he will make and his new base line may be much lower than before.
He obviously has significant care needs even if they are not medical . At his age if he is not able to engage with therapy and is not eating and drinking , you should be prepared for the suggestion that he will need a nursing home
placement and is in the last period of his life.

I would be tempted to feel that he has had a good innings living independently into his 90s and that prolonging the end is not a good thing. This comes from
my experience in medicine - I’m sorry if it sounds blunt. Sending good wishes - this is tough to see as a daughter x

redphonecase · 03/04/2025 07:37

Make it clear you can't provide any care and don't vary from that. He'll need residential or nursing care and isn't fit for discharge if still on IV fluids.

anotherboy1 · 03/04/2025 09:09

@SockFluffInTheBaththank you for asking and for everyone’s lovely replies. My dad is still very poorly. I thought I would try and get him to eat. He had a tiny bit vomited and was very distressed afterwards it is so awful

OP posts:
SockFluffInTheBath · 04/04/2025 09:11

That’s difficult @anotherboy1 I'm sorry you’re having to see this. Have they said anything more about his prognosis?

anotherboy1 · 06/04/2025 17:32

I’ve been in to see my dad and even though I’m scared to say there does seem to be some improvement. He ate a small piece of chicken I brought in and also chatted a little on FaceTime to my brother.

OP posts:
anotherboy1 · 24/05/2025 21:36

Just to let you know my dad passed away in a care home which he had been in for a week. I know I am lucky that I have had him for 92 years in my life and his passing was peaceful

OP posts:
doodahdayy · 24/05/2025 21:49

@anotherboy1so sorry for your loss. Glad your lovely dad had a peaceful passing x

Kevinbaconsrealwife · 24/05/2025 21:53

Bless your heart, I’m so sorry for your loss xx

New posts on this thread. Refresh page
Swipe left for the next trending thread