Is it nearing the end?

[BB49]

I posted recently about my FIL, 88, who had been recovering in a rehab hospital from a fall. The discharge team advised with his lack of mobility and general condition he would be unsafe to go back home with carers. He didn’t really engage with any of the physio at the hospital. He moved last week to a lovely residential home where he is on a care wing.

His condition concerns me though. We have been told that he is refusing to get out of bed other than to be helped to get washed etc, he is always tired and wants to sleep, very frail, lots of wasting and muscle loss due to not moving and eating and drinking very little. The nurses need to keep coming in to remind him to drink as he won’t do it of his own accord. He was like this in the hospital as well so it has been several weeks really with no change apart from he looks worse and is even weaker. His breathing is laboured and he just looks awful.

He has a wheelchair, so could be transferred to it to be wheeled around and talk to people and involve himself in activities but I just can’t see it happening. He’s not able/not wanting to sit in his chair either.

The nurses are saying that as he’s no strength in his legs now he may need a hoist.

So he’s in this lovely home, not interacting with anything and just spending his days in bed in his room with no one to talk to really! We turned the TV on for him yesterday so at least he could get some mental stimulation from that. He does have capacity, just terrible short term memory loss.

I don’t know what I’m asking really - just how long this could last for as it seems like no life.

It sounds like he has given up. After my DM reached this point (not wanting to get out of bed or engage with physio, losing interest in food and drink, not wanting any social interaction, sleeping a lot) she died within a few weeks, but I have no idea what is typical. I knew she really had had enough a long time before and did not want to be alive any more.

Can you arrange to have a talk with a manager or someone senior at the home? They will certainly have seen this before.

@SoloSofa24 sorry to hear of your mum. Yes it definitely feels like he has given up both mentally and physically. He’s only been in the home for a week so i suppose they need to get to know him, but that’s good idea about speaking to the senior care manager.

I think when people get to the stage where they cannot see any prospect of returning to their homes or any kind of independent life, they can (on some level, whether conscious or subconscious) just decide it is not worth fighting any more.

With my DM it was after a failed operation for bladder cancer, and the realisation that she would be stuck with a catheter for life and would need to stay in a care home. She had already lost most of what had made life worth living for her, and that was the final straw - she did not say so in so many words, but it was clear what was going on.

Does your FiL have the cognitive capacity to talk about his wishes? And do you have PoA for health, or any kind of advance directive/ReSpect form for him?

We do have PoA for health and he does seem to have capacity, but only seems to express that he’s tired and wants to remain in bed, he’s happy enough doing that and being looked after in the home I think, but is not doing anything like trying to interact socially to make his life more enjoyable. I need to check on the Respect forms.

Generally people give up eating and drinking because they are dying. This could cary on for several weeks. My mum had a stroke in the care home, was admitted to hospital and lived 5 weeks without eating. Eventually I asked for the fluid drip to be stopped. It sounds like he is comfortable, not in any pain and will go in his own time.

It is really hard to watch and I feel for you.

Thank you, I’m sorry about your mum, that must have been very hard. He’ll eat when given food but only very small amounts. I guess we can only see if things improve.