This is concern we have over an elderly member of our family, my father in law. Over the last year and especially the last six months we have all noticed a steady decline in his health. He is in and out of hospital regularly and as multiple medical concerns. To cut a very long story short he is in constant discomfort, on long term medication and now founds it very difficult to cope with everyday things. He lives alone and he has decided that he would like to be placed in a care home.
Being an ex-military man and extremely proud of his independence we were all taken back by his decision but having spent the last week with him we now understand why and fully support him. So he as found a care home that caters solely for ex forces people and we visited it. He was delighted by what he saw, was put at total ease by the extremely helpful nurse who showed us around and it was stressed he would lose none of his independence.
He is now going through the process of filling and submitting his application forms. We were advised at the care home he should get from his doctor a statement for palliative care to speed the process along. Our understanding being that this form of care is to ease discomfort and improve quality of life. This is not how his doctors see it, saying it is end of life care which our father in law is not entitled to, as although he is in constant discomfort and more often than not confused, he did not consider palliative care was appropriate.
Of course looking on the net simply adds to the confusion, so I was wondering if anybody could cast some light on this form of care and who exactly would qualify for it.
Since I'm in the US I am not sure what this form equals here but it sounds like it might be an end of life directive/health care power of attorney or something like that. Here they encourage having those no matter what your age or condition so that when the time comes, the decisions are already made and there is no question about what you want. I don't see why his doctors should be involved. Here it's something the patient signs - doctors have nothing to do with it. Maybe we just need to know more about what the document says.
From what we gather and I am sorry if I am not quite getting this right because we have never been involved in a process like this before but when the forms are sent out from the care home there is one form for his doctor to sign. This form is to list all his medical conditions, prescriptions and doctors recommendations. It is the doctor’s recommendations that basically determine how high up the waiting list for a bed any particular patient will be placed. The greater the need for care (based on his doctors recommendations) the higher up the list and the higher priority that particular patient will get.
Like I say we are none too familiar with this process but we understand that when a doctor recommends palliative care that particular patient will be given priority of others.
It is the grey area that this form of care seems to be in and it doesn’t seem as cut a dry as we first thought. Naturally anybody thinks members of their own family should have priority but it is whether this form of care really is applicable to our father in-law. We believe it is, the doctor doesn’t hold the same opinion.
I have read about palliative care just recently. It is different than hospice. Palliative care, how I understand it, is all towards comfort but not active aggressive treatment of a disease process. It spoke of the benefit from relieving the patient of some anxiety of having the stress of active treatment such as chemotherapy and its accompanying side effects. It takes place long before the person is in the dying process, with only 6 months to live etc. You have to find a physician who understand and believes in this type of care. The article I read actually talked of people who benefited by this type of care and actually got somewhat better. I have probably botched the explanation but I would definately "google" this process. The gentleman, once in his new living situation with other ex-forces folks may have a big psychological boost from exchanging stories with other people who lived the life he did. I think this is a win/win opportunity for all.... especially him. Take care, Sharon
Maybe he/you just needs to talk with his doctor about it. That would be my first thought if the doctor has to check off various things on it. Ask why does he think that way, how long before it gets to palliative care, what he think that entails, etc.
Thank you everybody for your input. Obviously my fathers in laws health and welfare are the priority in this situation and getting the correct care for him is top of the list.
At this point we intend to speak to his GP an the doctors at the hospitals who's medical care he is under to try and assess the best way forward. We feel we have got a degree of understanding and although we cannot predict what is to come in the future, clarity of the situation and the care he requires is something we feel is important.