My dad is dying - I need help

[LillyHammer]

It has been unofficially confirmed that my dad is dying. Dad has mild dementia but after losing mum 3 only 5 years ago and just coming to terms with that, I am terrified.

I have POA and I want to protect dad for the last few months that I think he has. Can I prohibit the doctor from telling him this awful news?

The doctor is expecting official reports tomorrow and has to tell dad then.

Sweets I don't know want pos means but wishing you
and yours much love too getting through the next difficult few weeks x

It means Power of Attorney

Thank you nice,I don't know my love but still wishing u peace in making the very difficult decisions x

for you at this difficult time.

With POA I think it depends if you have health and welfare or property and financial POA (or both)assuming you're in the UK. If you don't have the Health and Welfare part then you are not allowed to make decisions relating to your Fathers health although the Doctor will listen to you but ultimately they will act in what they perceive to be the patients best interests.

His dementia may make it easier for him to accept/ignore the diagnosis or he may already suspect and be 'glad' to have it confirmed. It is such a personal thing.

I have both POAs and I believe that the kindest thing for my dad is definitely not to tell him. I want to tell him myself and I can embellish the facts so that I believe he won't get too distressed. He is not ready to die, mentally, despite his dementia. He has a happy

The doctor last night told me that because it's my "dad's body" then he has the right to know. I disagree because I know him better than a doctor. Do I have a "right" to let me tell my dad (with doctor present)?

Anyone else been through this?

I'm sorry you are facing this Lily, unfortunately I can't provide much in the way of practical advice.

I'd try appealing to the "do no harm(paraphrased)" section of the hippocratic oath. I can see that the Dr couldn't/wouldn't lie if asked directly by your father but it seems wrong that he'd voluntarily tell him, particularly if it would be to his detriment mentally. Is it the Consultant you're dealing with?

Surely a best interests decision in this case would be not to tell your dad. Sorry you are going through this OP

A Health and Welfare LPA can only be used if your Dad does not have capacity to make decisions - and that has to be decided in the moment, as capacity is often very up and down.

I agree that a doctor may feel he/she has to answer any questions your father has, but doesn't need to volunteer this information.

I know that it is very, very hard, but your father may need to know. A lot of people have to know the truth to come to terms with it.

So sorry.

Tricky one. My Grandma has dementia and doesn't know because the consultant thought it would distress her....I'm uncomfortable with that but it's not my call.

There's a joke one of my consultants uses (I'm an elderly nurse) - 'Mrs Smith, we've got the results of Mr Smith's dementia test, shall we tell him?'
60% say 'No, it'll only upset him'.
'ok Mrs Smith, we've got the results for you too, do you want to know?' 95% say yes!

I understand your misgivings but I do believe it's kinder to tell people. I've seen patients who are dying that don't know and I think it's scarier for them. It doesn't have to be brutal and yes, it might be better coming from you with a doctor present to answer medical questions but I don't think it's right to withhold that information from him.

Very sorry to hear your news. But I don't think POA covers what drs can say to their patient. POA is used so you can make important decisions - usually of a legal nature- which your relative can't because of their state of mind.

I don't think it covers being able to 'gag' a dr who feels they need to speak to their patient.

Is your dad dying due to his mild dementia or because he has another illness?

I'd say you have to think very carefully on this. You know your dad- is he the kind of man who would want to know he was dying and how long he had left? Prognosis are not always accurate anyway- unless he has a terminal illness how do they know he has months left?

You see, you are playing judge and jury; maybe your dad would like this time to speak to people he needs to, to wind up his life...?

I say this as someone who would always want to know- but not everyone is the same.

On the other hand I don't know why a dr would want to tell a patient this unless the patient asked or was having treatment that was painful etc ( chemo) and they were balancing treatment against length of life.

Has your father ever asked about his health and the prognosis?

OP I feel very sorry for you but I think you need to be very honest here with yourself.

Do you really feel it is in your dad's best interest not to be told or do you think it would make it easier for yourself as you can then remain somewhat in denial which is understandable.

Personally I would let the doctors tell him because he may be lucid at times and it may scare him if he has been left in the dark. Also maybe he would like the opportunity to say things to people he cares about and keeping him in the dark would deny him that opportunity.

I see I didn't make it clear but his dementia diagnosis is not what is causing this. He was managing fine - with a little help.

He now has a secondary disease - I had diagnosed by internet browsing and the doctor yesterday took me aside and mentioned that it could be that and that it wasn't good news.

This disease at this stage probably has 3 months maximum taking in to account dad's physical frailty. I would rather he had a couple of weeks at the end when he knew he was going rather than 3 months to think about this. I want him to be happy for as long as possible.

I really don't think it's your call. I know this is very hard but it's a conversation best had between your dad and his dr. Is it cancer or something else? The dr will presumably reach a point where they are explaining to your dad that treatment will not cure him. From my understanding of these situations drs make a judgement; some patients do not want to know at all, others do and ask questions.

You have to try and step back from protecting your dad from the truth. How do you know he would be happier not knowing? You might be happier with him not knowing but that is a belief- it's not for certain.

He is not a child; he's an adult and may wish to say his goodbyes or have some kind of quality time with friends and family if that is possible in his final weeks. I don't think it's your role to decide whether he can or can't. I'm really sorry you are dealing with this.

OP, sorry for this news. It must be very difficult for you.

IME, doctors give information in a step by step fashion and are led by the patient in how explicit they are re the prognosis. Some people want the full details, some don't and don't ask. I don't think any doctor would say, 'Sorry, Mr Smith, but you only have a couple of moths left'.

It might be more, 'Mr Smith, we have you test results now. Unfortunately
We have found cancerous cells in your biopsy....' Then discuss treatment options....answer questions about prognosis only if directly asked. Also the information might be offered in more than one conversation and support offered.

Obviously it all depends on the individual circumstances. I think it would be reasonable for you to discuss your concerns with the doctors but ultimately the doctor should be led by the patient.

I wish you well.x

I'm so sorry Lilly - this really is a hard time for you. My dad died in 2011 and had been in and out of hospital for a number of years. He became quite obsessed with his health and, although he didn't have dementia he was, at almost 88, quite forgetful, prone to anxiety and emotionally unsteady.

During his last stay in hospital he was told that his x ray showed suspicious shadows on his lungs and a consultant would come and see him the next day. The [very arrogant and pompous] consultant duly arrived and ordered me, my sister and my mum out of the room. We pleaded that my mum at least be allowed to stay and he reluctantly agreed. Dsis and I stood outside with our ears pressed to the door. The consultant was very blunt - told my dad he had lung cancer which had spread to other organs and that he was very sorry but there was nothing at all he could do. I was furious with the consultant when he deigned to speak to me and dsis. I thought he should have asked us if we thought dad was emotionally strong enough to deal with such news and if he had asked us I would have said no way should dad be told. The consultant's view was that dad was his patient and he would therefore only deal with him. We didn't have POA but I'm not sure that would have made any difference.

HOWEVER, with hindsight, it was probably best that dad was told. He actually became very stoical - once he knew his time was up he just wanted to go. He even dictated his obituary to me and was very keen to get it right (although mum promptly changed half of it before it went in the local paper!) We were all set to take him home and look after him for the few weeks/months we were told he had left. However, dad was adamant that he wanted as much medication as he could possibly have. I relayed this several times to the wonderful doctor on dad's ward who said that they had to get the balance right and too much medication could hasten his end. However, one morning the same doctor said he had had a long conversation with dad through the night and that dad had made it absolutely clear he didn't want to extend his life at the expense of being in any pain or unable to sleep. By the next day dad was barely conscious and he died in the middle of the night a couple of days later, with me by his side. I am eternally grateful to that doctor for taking the time to talk to dad and doing what he could to help him.

With hindsight it was better that he knew. He took charge in the end and didn't try to fight against the inevitable. I do understand your qualms though - I'm not sure I could cope with the knowledge that I was about to die. But I'm not sure anyone should keep that knowledge from someone. I remember reading recently that Paul McCartney didn't tell Linda that she was about to die because he didn't think she could cope with it and I thought that was terrible.

But you know your dad and we don't. I certainly wouldn't let a bunch of strangers tell you what you should or shouldn't do in this situation.

Thank you all for your advice. Lots to think about for me.