Elderly Dad in ICU - needs to eat, but won't - says he's going to die soon - how do I help him?

[weetabixforeva]

Elderly Dad was given a traceostomy to aid breathing following a major op a few weeks ago. He now just has a breathing mask over the trache and the plan is to reduce the size of the trache tube, and maybe take the whole thing out in a few days.

He's being fed though a tube in his nose, but medics say he now needs to start eating food again, but he's really reluctant - just closes his eyes and says that he's going to die very soon. Staff say this isn't so and to encourage him to eat. Dad has a speaking valve in sometimes; at other times he writes.

I/they have tried to give him jelly, yoghurt, soup, water, pop but he only take a spoonful of any of them - seems he's just given up. I'm so worried about him. Any ideas?

I'm so sorry you and he are going through this. Your father sounds naturally depressed after a scary illness and hospital does not exactly lift the spirits.

Might be an odd question, but what does he love? What when he is well and at home makes his life worth living? These may be daft suggestions as obviously I don't know him or the precise rules of the ward he's on. Does he have grandchildren? A soft, warm sleepy baby to cuddle might lift his spirits or some nattery toddlers with home made cards. In small doses perhaps?

Spring flowers? Smells he loves? Actually good smells can get the tastebuds going. Could you bring a DVD in with films he likes? Lively colours in cards and gifts?

Is there a therapist on staff at the hospital? Ward staff tend to be focussed on the physical illness, they may not have thought that he needed some emotional support.

I do hope you find some help.

Bumping

A few year ago my grandad was in hospital and he would not eat. My mum used to sit with him all day, and all day long push grapes into his mouth. He did recover enough to leave the hospital. Thinking of you.

Hi weetabix im so sorry to hear about your Dad. I work in ICU, and it seems from what you are saying he is making progress, trache mask, speaking valve etc all in preparation for removal of trache.
how long has he been in ITU?
Do they have a resident clinical psychologist? They should do, most have.

Its very common to experience feelings like this in ITU, or some level of ITU psychosis from lack of sleep, loss of time, and the inability to know night from day, also the amount of drugs we give patients doesnt help.
It can be easily reversed and he may need to be seen by the clincal psych.
If he is tube fed then i woudnt worry too much at this stage, let him feel normal again first, although eating is a part of this. You are doing all the right things, bring in things he likes to eat cooked at home (hospital food is shite).

Hth please feel free to ask anything

He's very fond of his grandchildren, all adults now, and he's made a bit of an effort when they've visited - a few smiles. One of them has children (Dad's great grandchildren) but children not allowed in IC, and anyway would be quite a scary place for a child, I think, especially as Great Grandad looks strange with all his tubes and wires. We put together a photo album for him, but he refused to look at it.

A few friends have sent cards, which I've showed him and read to him which also raised a smile.

I think maybe these smiles he gives sometimes are worthy of more acknowledgement than I've been giving them. Afterall why should he be happy and cheery after all he's been through, and is still going through.

Thanks Wyrd for helping me think that through.

And thanks for the force feeding of grapes idea purple. It made me

Thanks mosschops

Dad's been in ICU for a month. I'll ask about the psychologist.

He says he can't sleep, but always seems to be dosing. I took him some earplugs in but he said they made no difference. I don't want to mention it to the staff as I'm concerned they'll dope him up again. He seemed to be having sooooooooooo much medication at one time.

Do you think I could take a radio in? There are some programmes on Radio 4 he used to enjoy. Would this be allowed do you think?

Absolutely, we always encourage relatives to bring in radio/mp3/dvd etc, its a long day when youre in a hospital bed on your own.
If hes been there a month then he probably is suffering some degree of icu problems, youd be amazed the effect of not knowing whether its night or day can have on the human body, also constant noise, and effects of drugs like midazolam and propofol which keep you sedated but its not real sleep IYKWIM.

staff should be doing all they can to help with regard to normalising, we have tvs and a dvd library at work, we stick up cards/photos/letters, provide eye masks and ear plugs and even let some patients have a drop of whiskey if thats what theyre used to at nightime.

I really hate wards that have set rules that are not flexible for patients, we are all individuals and should be treated as such. Ive been a victim of that myself and its very frustrating as a patient

Many thanks mosschops for the advice and empathy - much appreciated.

I hope he was a bit better today when you went in .
just take it slow, and expect him to do the same, even when he is medically better it may take some time to get over his icu admission.

Wishing you all lots of un-MN hugs and love xx

Thanks so much mosschops.

Dad was a little brighter, some of the time, today. I took a radio in for him - tuned it to Radio 4 whilst I was in the car park - but when I got it onto ICU it wouldn't tune in to any station. I know the mobile phone reception is rubbish within the hospital, but not sure what the problem was with the radio. Very disappointing

I know it's not really the same as listening live, but could you record his favourite radio 4 shows at home then take them n the next day?

Radio 4 do some podcasts I think

Hello. Re the food, try taking in small portions so it's not intimidating of foods he loves. A lot of older people lose their appetite in hospital and that's what we suggest I work with older people
I agree try to find things he likes to do...podcasts are a great idea. It's going to be small steps forward but it sounds like you're a great support :)

Yes great idea about recording podcasts for him, plus if you can put them on an ipod for him at least he can listen in peace instead of listening to the machines, nurses gossip and other relatives.

After suggesting radio 4 podcasts I've been listening to some of the old desert island discs. They're great.