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15 Jan
2:31pm, 15 Jan 2024
16,236 posts
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jda
2 weeks and 2 days after my FiL was admitted to hospital, my wife was finally able to have a chat with a consultant about him. The consultant was quite apologetic about the lack of communication, there hasn't been any attempt to gain informed consent for any treatment so far including the operation last week. It does now seem that a clear decision has been made to keep him in for a full 6 weeks with the external elbow brace, which is a relief, as in her first phone call this morning the doctor who had just examined him was threatening to discharge him in a few days! The official reason is that he can't look after the wounds satisfactorily, but he is of course completely incapable of looking after himself, it's doubtful that he can even stand up unaided.
We'll see whether promises of better communication are upheld. Surely it's not normal that they just do stuff to a dementia patient without any reference to the attorney (that they knew about from early on)? Maybe there was no reasonable alternative to the lengthy hospital stay but it would be good to have had that conversation and perhaps talk about the longer-term prognosis.
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15 Jan
2:35pm, 15 Jan 2024
66,143 posts
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LindsD
It does all sound pretty sub-standard, jda.
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15 Jan
4:25pm, 15 Jan 2024
49,147 posts
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HappyG(rrr)
That does sound bad jda. I would have thought that a Health PoA (as distinct from financial) being in place would mean that they were *obliged* to consult about medical and welfare decisions? Hope things improve for FiL and your family.
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15 Jan
4:43pm, 15 Jan 2024
6,852 posts
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Little Miss Happy
jda - one can only assume/hope that they have assessed his capacity around each decision and found him to possess it.
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15 Jan
4:49pm, 15 Jan 2024
16,238 posts
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jda
Well there is perhaps a bit of a question of whether FiL actually has capacity, no formal need to consult if not. However the Denial of Liberty thing (which we've never had any real notification or clarification about, it was just me chatting with a nurse when she mentioned it, and I'm not even an attorney for him) seems to imply a judgement of loss of capacity and they do seem to understand he's struggling to understand things. Their main justification for not letting him out is after all that he's pulling at his bandages and can't be trusted to care for his injuries. He is a rather convincing liar though, at a superficial level.
We were there at mealtime yesterday, and I'm not really convinced that "I'm not hungry now, maybe I'll eat it later" is actually an honest assessment of his own appetite rather than an act of denial when faced with a sealed packet of sandwiches that he has no clue how to open with one (left) hand. Some well-intentioned person had also left him a whole apple - but with no knife, not much in the way of teeth, what was he supposed to do with it? Lick it to death? He did eat a bowl of soup, so maybe he's ok. It's just hard to be sure. And at least while he's there, he is basically safe and being looked after.
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15 Jan
4:54pm, 15 Jan 2024
49,149 posts
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HappyG(rrr)
Not eating properly is such a worry. And seems such a basic healthcare necessity, doesn't it?
My MiL who was in a wheelchair and had little speech or mobility, would absolutely devour plates of sushi and other yummy snacks when we brought them to the nursing home. Which made us worry that she wasn't eating properly either because she didn't like it or because she couldn't. This was supposed to be a nice, caring place, and the staff were very pleasant when we spoke to them and the setting was lovely. But you just wondered how much attention the residents got when we weren't there. Perhaps because the staff were just over stretched, but who knows? It's a tough job too, and underpaid too, of course.
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15 Jan
5:01pm, 15 Jan 2024
16,239 posts
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jda
(x-posted) Yes LMH he can certainly give the impression of understanding. It's difficult to say whether he truly understands something when he forgets it 5 minutes later. But if the doctors only talk to him, there is no chance for my wife to explain things to him when we visit. Eg yesterday he told us he thought they might be taking the brace off today and would we be coming to take him home? Which is partly the reason for the frantic phone calling today! We were pretty sure it was nonsense but it was still quite stressful.
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15 Jan
5:20pm, 15 Jan 2024
6,854 posts
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Little Miss Happy
I've been stuck in a hospital bed with one useable arm and no way of accessing the food they'd brought me. Fortunately I was able to speak up and pint out the problem. Unfortunately it's a lack of staff. Some places have volunteers who go in and help at mealtimes but there are never enough people/time. The domestics who leave the food often don't think/it's not their job.
jda - DOLS is a formal process that would have had to be followed within a certain time frame if he had persisted in trying to leave and not be judged to have capacity to make that decision (you are allowed to discharge yourself against medical advice if you have capacity). There isn't any excuse for the lack of communication if you believe he doesn't have capacity and you/your wife has LPOA but the doctors will often parachute in for two minutes, say their piece, ask if the patient understands/is happy and take it at face value if they get the answer they want/expect. It's probably a good idea for your wife to inform the ward manager of her concerns about FiL's lack of capacity and communication issues and ask to be involved in any future decision making.
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15 Jan
6:46pm, 15 Jan 2024
12,099 posts
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leaguefreak
Are his meals coming on a regular coloured tray? Some hospitals at least have systems where they have specific trays (mum had red trays) to indicate she needed help eating so they didn't just leave it there. May be worth broaching with the staff. Even if he eats independently usually he may not be able to just now.
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16 Jan
10:50am, 16 Jan 2024
7,251 posts
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ThorntonRunner
Mum(99) has had a tough few weeks. She's had a cough/cold that developed into a chest infection and, four courses of antibiotics on, she's still not really right. She had a chest x-ray last week and is now awaiting a ct scan. There's something there which could be either the infection, longstanding damage from having TB 70 years ago, or something more sinister.
She's VERY tired and has raised the possibility of going into a care home (she also says she's had enough - 99 years is plenty long enough and she's ready to go - not said in a morbid or depressed way - just matter of fact, and I can understand where she's coming from). My sister visited a care home a day or so ago but was concerned about the lack of interaction between residents. Mum is mentally alert and sociable. She lives in a retirement village that has a social centre with coffee bar and she has a network of friends there.
Sister is coming round to us tomorrow and we'll talk about what we might be able to do to address the concerns that mum has about staying where she is. We already do some of her washing - we could take it all on. We could go round and have lunch at hers a couple of times a week so on those days she doesn't have to cook herself. My nephew already sleeps there just so there's someone in the house at night (reassurance), we can look at personal alarms so we are automatically contacted in case of issues during the day. I've just applied to register her finance POA with her bank so I can help monitor and manage that side of things (dad had always done that, so she's found it a bit of a chore since he died two years ago).
Hopefully as the weather improves and the days get longer she'll recover some of the spark that she's lost over winter.
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The Sandwich Generation - Aged Ps and children to care for?
Jun 2023
