Could this ever happen in England?

zaksmum

JC9297 wrote: »

Whether to resuscitate or not is a clinical decision and is not taken lightly. If families were involved in the decision many would not want medical staff to let nature take it's course and would want them to attempt resus whatever the situation.

But the doctor who signed my father's DNR form had that very day assured me he was a fighter and that, in her opinion, he would be fine. The hospital staff later were quoted in the papers as saying they never take such a decision without involvement and consultation with the family.

In my father's case, they even sent us all home saying we were fussing over nothing.

My father died in the early hours of the next morning...completely alone.

PoorCharleyBear

my mother died last month so all this is fresh in my mind.

She was initially in the geriatric ward and the staff were very uninterested to say the least.
She was moved to the stroke ward - 50mtrs around the corner- and what a difference!

The staff were fab and told us the honest prognosis (which we could tell) and we asked for assisted nutrition to be withdrawn as it was making her uncomfortable and only prolonging the inevitable. Drips did not work as her body was breaking down.

The staff asked her children as a group if we were all in agreement and they also asked us separately and said we could change the requested treatment at any point.
Food and drink by mouth only makes people in this position choke and subject to pneumonia...not a nice thing to experience but sometimes decisions in life are very hard.
They gave her as much pain relief as was possible, so we believe she was not in any pain. Nursing staff generally want to help not harm folk.

Rainbowchild

zaksmum wrote: »

I believe that elderly patients are routinely left to starve to death in Britain.

I completly agree after witnessing the care, or lack of it, my mother recieved while in hospital last year. I honestly believe that if I hadn't be able to go at meal times to help her eat then she would have been left to starve.

Uniscots97

Rainbowchild wrote: »

I completly agree after witnessing the care, or lack of it, my mother recieved while in hospital last year. I honestly believe that if I hadn't be able to go at meal times to help her eat then she would have been left to starve.

Completely agree too, for OH's Mum they didn't realise till it was too late. We realised with my Grandpa (who had 2 years in relative good health at home after he got out of the stroke recovery unit) and then with my Grandparents neighbour they didn't realise. In all 3 cases each person was awake and fully aware of what was going on!

Having just been at hospital myself today and seeing how filthy the place is (I refused to use the toilets even though I needed to go) and the staff carrying on their conversation when they have a queue of people waiting then to be told the set of tests I had are clear 'so what did I want to do now'? I find the majority that work there appalling. The ones that do care are slowly beaten down as they end up picking up everyone else's work.

sapphireeye

zaksmum wrote: »

Of course we wouldn't...but my father had smoked heavily all his life and was ALWAYS coughing and spluttering, even as a young man. We told the girl this, but she insisted there was the danger of aspiration.

Surely, at the end of my father's life, a cup of tea for him that wasn't the texture of wallpaper paste wasn't too much to ask?

A Speech Therapist should know the difference between a general cough and a cough which is caused by aspiration and your father wouldn't have been on a puree diet (acknowledged as the safest food consistency going) if it wasn't deemed necessary. Dysphagia (swallowing) is a post graduate course which also requires on the job supervision and most Speech Therapists that work with Dysphagia feel very strongly about making sure their patient's are safe. Speech Therapists are well aware that patients don't like pureed diets and thickened drinks (and so will try and upgrade them as soon as is possible) which makes the job difficult because recommendations are ignored which puts the patient at severe risk of aspiration (food/drink going into the lungs) and if the patient is ill and weak and is unable to clear their lungs then just the smallest amount of food or drink in there could cause a very rapid decline and then possibly death. It's always better to be safe than sorry.

However, if your father was end of life and the Speech Therapists and the medical team were aware of that then I would have expected them to have recommended that he could eat and drink 'with risk' which is where the patient can eat what they like for enjoyment purposes during their last days/weeks as long as they understand that there is a risk of aspiration. However some people don't want to be choking on every meal and wasting their final moments exhausted due to struggling with eating and drinking so it's a case of individual preference.

And as for the meals not arriving, that's unfortunately out of the Speech Therapist's control, that's down to the staff in the kitchens/nurses/HCA's to make sure that the patient has their meal (and the right kind of meal) and is helped with feeding if required.

As to the original question, I think perhaps if someone's body was rejecting food or drink or it was making them uncomfortable or even more ill in their final days then it would have been discussed with the family and a decision made, however as far as I'm aware the aim is always for the patient to be as comfortable as possible.

poet123

The ideal scenario and the actuality are often very different.

zaksmum

sapphireeye wrote: »

A Speech Therapist should know the difference between a general cough and a cough which is caused by aspiration and your father wouldn't have been on a puree diet (acknowledged as the safest food consistency going) if it wasn't deemed necessary. Dysphagia (swallowing) is a post graduate course which also requires on the job supervision and most Speech Therapists that work with Dysphagia feel very strongly about making sure their patient's are safe. Speech Therapists are well aware that patients don't like pureed diets and thickened drinks (and so will try and upgrade them as soon as is possible) which makes the job difficult because recommendations are ignored which puts the patient at severe risk of aspiration (food/drink going into the lungs) and if the patient is ill and weak and is unable to clear their lungs then just the smallest amount of food or drink in there could cause a very rapid decline and then possibly death. It's always better to be safe than sorry.

However, if your father was end of life and the Speech Therapists and the medical team were aware of that then I would have expected them to have recommended that he could eat and drink 'with risk' which is where the patient can eat what they like for enjoyment purposes during their last days/weeks as long as they understand that there is a risk of aspiration. However some people don't want to be choking on every meal and wasting their final moments exhausted due to struggling with eating and drinking so it's a case of individual preference.

And as for the meals not arriving, that's unfortunately out of the Speech Therapist's control, that's down to the staff in the kitchens/nurses/HCA's to make sure that the patient has their meal (and the right kind of meal) and is helped with feeding if required.

As to the original question, I think perhaps if someone's body was rejecting food or drink or it was making them uncomfortable or even more ill in their final days then it would have been discussed with the family and a decision made, however as far as I'm aware the aim is always for the patient to be as comfortable as possible.

My father was always prone to eating something then hacking it back up again, giving it another good chew and swallowing it again.

It sounded horrendous - but he was my father and that's just the way he was. The girl who put him on the pureed diet was really thrown the first time she watched him eat, although we explained he'd always done that.

So for the last weeks of his life he not only didn't get the pureed diet, but was offered nothing in it's place. Even his cups of tea made me sick to look at them. You could, quite literally, stand a spoon up in them. I couldn't have drunk them...who could?

He gave up in the end. The nurses said he had hypoxia confusion (confusion caused by lack of oxygen) so he didn't even ask for food anymore. We all just did shifts at his bedside, desperately trying to make sure whatever food was permitted was actually offered.

A few days before he died, he asked if he could have an egg sandwich. The staff reluctantly agreed, and took him off the pureed diet. He really enjoyed it, no sign of any choking. The update to his notes said "Family refusing to agree to pureed diet".

I could go on. My poor, proud,strong, hardworking and dignified father was reduced to a pitiful pathetic shadow of himself. When he asked for help to go to the toilet, nurses said "Just do it in the bed" and he physically couldn't.

I could write a book...but it won't bring my father back.

Kind of makes you dread getting old and frail, doesn't it? Or is that just me?

poet123

zaksmum wrote: »

I could go on. My poor, proud,strong, hardworking and dignified father was reduced to a pitiful pathetic shadow of himself.

I could write a book...but it won't bring my father back.

Kind of makes you dread getting old and frail, doesn't it? Or is that just me?

This resonates with me so much.:(

System

I've seen relatives practically forcing food down dying patients, if their bodies are telling them they don't need it anymore leave them be, its often more for the relatives benefit than the patient's.

People very often believe that their loved one will die if they dont eat or drink anything but actually its the other way round. They dont eat/drink anything because they are dying.

Torry_Quine

sapphireeye wrote: »

A Speech Therapist should know the difference between a general cough and a cough which is caused by aspiration and your father wouldn't have been on a puree diet (acknowledged as the safest food consistency going) if it wasn't deemed necessary. Dysphagia (swallowing) is a post graduate course which also requires on the job supervision and most Speech Therapists that work with Dysphagia feel very strongly about making sure their patient's are safe. Speech Therapists are well aware that patients don't like pureed diets and thickened drinks (and so will try and upgrade them as soon as is possible) which makes the job difficult because recommendations are ignored which puts the patient at severe risk of aspiration (food/drink going into the lungs) and if the patient is ill and weak and is unable to clear their lungs then just the smallest amount of food or drink in there could cause a very rapid decline and then possibly death. It's always better to be safe than sorry.

However, if your father was end of life and the Speech Therapists and the medical team were aware of that then I would have expected them to have recommended that he could eat and drink 'with risk' which is where the patient can eat what they like for enjoyment purposes during their last days/weeks as long as they understand that there is a risk of aspiration. However some people don't want to be choking on every meal and wasting their final moments exhausted due to struggling with eating and drinking so it's a case of individual preference.

And as for the meals not arriving, that's unfortunately out of the Speech Therapist's control, that's down to the staff in the kitchens/nurses/HCA's to make sure that the patient has their meal (and the right kind of meal) and is helped with feeding if required.

As to the original question, I think perhaps if someone's body was rejecting food or drink or it was making them uncomfortable or even more ill in their final days then it would have been discussed with the family and a decision made, however as far as I'm aware the aim is always for the patient to be as comfortable as possible.

Have to agree here. My FIL was in hospital a few years ago now with aspirtation pneumonia as a result of swallowing problems from cancer surgery. When well enough to eat again he was assessed and put on a pureed diet which he constantly complained about saying it was the same food all the time which it wasn't it just all looked alike. Unfortunately he became unable to tolerate that and was told that any food or fluids could potentially be very serious. Since then he has been tube-fed succesfully.