any nurses out there - advice please

[vampire-teddy]

my father is in a nursing home.  he has dementia.  he has not wanted to eat much for some time and now refuses to eat or drink anything.  at present he is in hospital after a fall two nights ago during which his head went through a wall and he had a minor brain bleed.  he weighs 53 kgs at 5 foot 8 and is 86 years old.  he is completely emaciated.  he is currently on a drip at the hospital but when he goes back to the nursing home on monday he won't be anymore.  I am wondering how long he will survive if he doesn't eat and or drink anything.  he already has bad kidneys and a very low heart rate.  i am prepared for the evitable.  he is on a non resus order and is not to be force fed or sustained in any way.  i know he would hate it and the he wants to go as he has said so when he was still able.  he is no longer coherant and has to be heavily sedated or he gets agitated and tries to get out of bed (he can no longer support himself).  he also lashes out to anyone who tries to help him.  he was a wonderful gentle man who has been a great dad and i hate seeing him like this.

I know i should be asking the doctors and i am trying but tracking them down in the public hospital system is nigh on impossible.  if any nurses out there have any idea i would appreciate it.  i know nothing is exact but wonder how much longer he could be suffering.  

[izabsmiling]

((((Teddy)))) 

I have nursed the elderly  in the past (not a proper nurse some may say as I didn't hand out pills) .It  sounds  to me as though your Father and his body may know where they are at xxxxxxxx

the medical staff need to be communicating with you .I'd suggest asking a nurse if there could be a family meeting arranged with the Dr so that you all informed and involved and supported ..as you should be in the care of your Father.

[lost*over*time]

I've worked in the hospitality area of a residential care facility until pretty recently, as well as in the management of 2 home delivered meals services for aged predominately.

The stimulation of a person's appetite starts with aroma....something as simple as having the aroma of a cooked meal will stimulate the production of saliva, and aid appetite. 

Ofcourse, speak with the nursing staff, but the cook or hospitality manager may also have some great advice as far as appetite and sustanence.

A person can last a long time without food, but will not without fluids.

It's incredibly heartbreaking to watch someone that you love go through this....my thoughts and best wishes for love and strength are with you, your dad, your partner and your families xx

[cherry*135]

Sorry to hear this vampire.

I am not a nurse either. When my Aunt (n her 90's) with dementia (living in a secure home) had a fall and broke her hip, the operation went well, no problems physically. After the operation, in hospital, she would not drink or eat... just spat out anything that was put in her mouth

With her having late stages of dementia there was no way to explain and for her to understand must eat/drink to get well.

My cousin who is a nurse said to me farily early on they don't expect her to recover because of the dementia. She wasn't well enough to return to the retirement home and spent the last month of her life in a rehab hospital.

[kwozie1]

my OH lasted about a week without any food or water but he was also on heavy dosages of morphine....it is not nice to watch someone you love fade away like this.

Thinking of you at this sad time

[kyliecrv]

From memory my OH last 3 maybe 4 days with zero food or water (no drip etc). He was at home so no medical intervention besides a morphine pack, was pretty brutal.

[freddie*rooster]

I agree with Iza, you need to ask questions and get some positive advice as to what the nursing staff will do for you, it sounds to me like the food refusal is part of the disease, and not his intention to refuse food in order to die. Teddy, don't live with regret that you didn't persue this with the Doctor, you need to ask lots of questions and demand to know what they intend to do to help your Dad.♥

[kengillard]

can the staff at the hospital discharge a patient in his condition legally?   I don't think so.  I'd be talking to the social worker at the hospital.

[vampire-teddy]

unfortunately they cannot keep him in because there is nothing they can do for him and will need the bed.  the nursing home may send him on to pallative care.  the not eating thing has been going on for a long time well before any dementia show up but is now a complete refusal. we have tried everything for well over a year as far as the eating is concerned to no avail so i am sure that there is nothing that can be done on that level.  today he was complaining of a bad headache probably because of the fall and brain bleed but we do not know what the situaton is regarding that now (despite asking).  I am not leaving the hospital tomorrow until i see the doctor and know what is going to happen.  i think they will put him on morphine because you can't touch him without him being in pain now.  he no longer recognises my mother and won't let her touch him either.  i tend to agree with iza that his body knows where it is at.    luckily my mother is still quite active though not 100% but she has a large network of friends through her church and is very well looked after by us and lots of people keep an eye on her.  

thank you for all the well wishes and thoughts, they are very much appreciated.  we will see what tomorrow brings and just hope the outcome is the right one for him whatever that may be.

[twinkles**stars]

Never an easy time....healing thoughts sent

[izabsmiling]

Hi Vampire Teddy 

I've tried to find the right words in a private message and other posts to you and not felt they sounded as I would If I could speak to you in person. I will try again and hope that it comes out right .

I suggest that you may be best to call the ward where your Father is and ask to speak to the Nurse in Charge .Tell her/him of your concerns about your Father ,the future plans for his care, the state he was in today and lack of information being shared with your family.Sometimes it is the person on the phone who gets the attention/ear of the right person and doesn't so often get put off .Perhaps also ask that if there is a possibility that your Dad may be put in Palliative Care in the very near future if it is possible that the  Palliative Care Team be involved prior to the planned tranfer back to the Nursing Home on Monday .It may be more comfortable for him and all of you if Palliative care is required that the transfer on Monday be to Palliative care unit rather than  to the Nursing home ?

Thinking of you all xx