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Old 02-04-2012, 05:58 PM   #1
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need information regarding what to do

hello everyone.

I'm new to this board, hit this thread while stalkin here and there. Ma FIL has been diagnosed wid dementia a year ago and in one year he declined dramatically. he reduced weight, lost whole memory and speakin power. Now he is on food pipe and hospitalized.
last time when we took him to hospital, he'v had left eating and opening mouth and swallowin as well... he was on food pipe and ensure when due to sudden vommits, he was caught by aspiration pneumonia... and till today he has been admitted in hospital ( in ICU and now in ward)... he's been given oxygen through tracheostomy.

I donno what to expect next???... docs said that he had stroke during his last air travel
are these all symptoms of last stage of dementia? he isnt eating on his own. he doesnt response, only open eyes when he feels pain and even then not responsive... complete memory loss, he doesnt recognize us...

 
Old 02-04-2012, 10:17 PM   #2
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Re: need information regarding what to do

My mom is in pallitife care, we opted out of the feeding tube and any other heroic measures, This must be hard on your family and no doubt some hard desscions must be made. my heart goes out to you. It sounds like you have done everything possible to extend your loved ones time, perhaps now is the time to let go. Your mil is failing and there is no fix. We have choosen to make my mom as comfortable as possible, no pain, no anguish. I am forever greatful that when her time comes She will pass in peace, I hope that you can find a way to ease your mils troubles and may he find peace.

hugs judy

 
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Old 02-04-2012, 11:59 PM   #3
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Re: need information regarding what to do

rikkahn... sometimes the dementia is far along when you finally get a diagnosis. By the time you notice the symptoms they are already many years into the dementia. It is not unusual for a dementia patient to take a sudden and dramatic tun for the worst. My Mom lost her ability to speak over just a short few weeks. She has lost from 135 to 98 pounds... most of that in the last year. She does still eat if she is fed.

I like Jags have my Mom on palliative care. There will be no feeding tubes, no intensive care, no IVs, and no artificial means of breathing. These are her wishes and agreed to by the family. I did the same thing for my Dad.

If they are feeding your FIL through a feeding tub, have an IV for hydration, and he is on a breathing machine... he could remain like that for an extended period of time. Aspiration pneumonia is an inflammation/infection of the lungs caused when something (usually food) is aspirated (sucked) into the lungs. It is common when a feeding tube is used. It does respond to antibiotics but there is a chance of abscesses in the lung because of the foreign substances. And the changes of the aspiration pneumonia returning is high with the feeding tube. With the addition of the stoke to all his other problem, is there a possibility that he will recover?

I am sorry you have all this to deal with and glad you are here....

Love, deb

 
Old 02-05-2012, 11:12 AM   #4
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Re: need information regarding what to do

Hi Rikk,

I don't know why your FIL has declined so fast. But I do know that in the last stage of dementia, the person can no longer eat and will get choked a lot. Your FIL is at this stage and will need hospice soon. Is he in hospice yet? He is in the ward now so you can talk to the doctor about hospice. This will allow him to suffer less.

I don't know if your FIL had given the family the health directive? Did he say he wants no tube feeding or no artificial means?
It is hard if he has no such thing written.

My FIL is in severe stage of Alzheimer's and he is in a nursing home for memory impaired. He has stopped walking/talking/thinking/eating in the active mode/sense. He can still do these things "part-time" or occaisionally with lots of help. He cannot walk on his own without lots of help. He is in wheelchair full-time. He can only use the walker with lots of help (like learning to walk) to go from his bed to the bathroom or to the activity room in the morning. He is on pureed food now and can only have soft desserts. He did have aspirational pneumonia in 2010. He gets choked even on water unless he drinks it slowly.
He is not in hospice yet but in 6 months or 1 year, he will soon decline further. My FIL has this health directive saying he wants nothing artificial. This home will not give him tube feeding if it comes to the point.

There is no point for feeding pipe because he will die soon enough and he will suffer the infections from the pipe/tubes. If the family does not want him to suffer, they should let him go and put him in hospice for comfort care.

Sorry that your FIL is in bad shape.

Hugs,
Nina

Last edited by ninamarc; 02-05-2012 at 11:14 AM.

 
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Old 02-05-2012, 07:18 PM   #5
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Re: need information regarding what to do

thanks all,
I donno what hospice is, here in kingdom i don think so we have such fascility, neither he had written any health directives to us...
we want to move him to his homeland before he departs... is it possible for him to travel??? atleast it doesnt seem to
we are confused, we don have any life other than roamin in hospitals and to cut down house expenses to meet hospital expenditures.
+ we want to do everythin possible to just keep him alive, is it possible for him to just sit and eat atleast??? he is on bed, he cant sit straight anywhere... docs say his right side is completely paralyzed as well
pray for his peace... now its gettin difficult to see him in such miserable condition (

 
Old 02-05-2012, 08:38 PM   #6
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Re: need information regarding what to do

Quote:
Originally Posted by rikkhan View Post
thanks all,
I donno what hospice is, here in kingdom i don think so we have such fascility, neither he had written any health directives to us...
we want to move him to his homeland before he departs... is it possible for him to travel??? atleast it doesnt seem to
we are confused, we don have any life other than roamin in hospitals and to cut down house expenses to meet hospital expenditures.
+ we want to do everythin possible to just keep him alive, is it possible for him to just sit and eat atleast??? he is on bed, he cant sit straight anywhere... docs say his right side is completely paralyzed as well
pray for his peace... now its gettin difficult to see him in such miserable condition (
Hospice is palliative care - it is the same. One can have home hospice as well. I don't know what country you are in, but it is really up to his doctor to tell you how long he has left. We cannot tell you what to do.
If he will die soon, you may move him to his homeland (if not far away by flying... Regular ambulance can drive him.) for comfort care.
I don't know what is the laws in your country, here in USA and Canada, the laws allow the hospital or some people to operate hospice provided that the person will die in 6 months.
For example, a cancer patient in end stage will die in pain so the hospice gives the person lots of morphine to make sure he/she is painless. Your country must have something like this.

Only a doctor can tell you. If he will get better, the doctor will tell you. If he can go home and die, the doctor can tell you.

I understand the family want to do everything possible to keep him alive, but please think about how he is suffering.

Only a doctor or nurse can answer your questions. I don't know how his hospital handles people who are dying and etc.

Hope you will learn about it soon before you decide what to do.

Take care,
Nina

Last edited by ninamarc; 02-05-2012 at 08:42 PM.

 
Old 02-05-2012, 10:43 PM   #7
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Re: need information regarding what to do

Rikkhan... Hospice in the US is comfort care. They do not use the extended measure to keep a person alive. There are no IV's, feeding tubes, or ventilators. The patient is kept comfortable and the death process is allowed to take a natural course. It is a choice that many here make in advance. It is only used when the situation is terminal and there is not hope that they will live normally again.

If he is on a breathing machine he can not be transported. He can be moved only if he can breath without the assistance of the ventilator. If he is in the final stages of dementia he will not get better. If it is a result of the stroke you will need to talk to his doctor to see if he will get any better. If he is on a feeding tube, it is doubtful that he is going to sit up and eat again.

Many here prefer palliative (comfort) care because they do not want the patient to linger, suffer, in a medical state that they will not get better. As I have said before, I did this for my Dad and my Mom is now under the care of Hospice. It was painful to lose my Dad but I did not want him existing in a bed just to keep him alive... knowing he would never be out of that bed. My FIL was also under Hospice care after a massive stroke that left he paralyzed. He lost the ability to speak and swallow. It was decided to just use comfort care and not use a feeding tube.

It is a decision many make and there are legal papers to accomplish this. I am not sure what is available in your country. You would have to ask the doctor's there. Ask your doctor if his medical condition is going to improve. Will he be able to get off the ventilator? Will he be able to eat or will he always need the feeding tube? Is there any way to transport him back to his home country?

Love, deb

 
Old 02-06-2012, 07:12 AM   #8
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Re: need information regarding what to do

The eating issue happens when the person is in the end stage of dementia. The stroke/paralysis is about stroke itself. Did the stroke just happen? Did he just fly?
At this point, given the oxygen and food pipe, it is difficult to fly him back to his homeland. Long-distanced ambulance transportation may be possible unless they cannot take the breathing machine.
If it is money issue, you should ask the nurse or doctor about your plan. Ask them for advices and opinion to decide what to do.

Traditionally people want to live as much as possible. My parents have the same feeling and so they don't want to write any directive about artificial means. My sister(s) did. I have not as I am still younger (middle age.)

Your family may need to consider if it is worthwhile to feed him like that and make him breathe like that. It is really personal. No one can force him to go through hospice although this makes sense.

Take care,
Nina

Last edited by ninamarc; 02-06-2012 at 07:13 AM.

 
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