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Simon, it seems that you and your sister won't accept stepping back because of the effect on your martyr (you used this term in another post) mother.

How is your sister's mental health? Is it deteriorating quickly as yours seems to be?

I don't see it mentioned anywhere in your other posts about a therapist, although I could have missed it. ARE you seeing a therapist? And, if you are, are you discussing all of this with them? (I had to write the previous sentence because it seems that there are posters here who have been seeing therapists for a long time who never help them decide on courses of action.)
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I’ve read your replies. You’re being ruled by FOG, fear, obligation, and guilt. Please take a minute to look this up and do some reading. Your depression needs help, after all what good are you to your parents or anyone else when you don’t care for yourself? Let your dad’s medical decisions be between him and his doctors. Let your mom’s choices in caring for him be her own, she isn’t going to change and you constantly jumping in will keep her from accepting other, needed help.
A dear coworker of my dad’s was strongly recommended to have an arm amputated. He quickly chose not to, said his life could end before he’d allow it. He wasn’t mean or crazy, he just knew the right choice for himself. He didn’t live long, and he passed without regret.
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People who think they would rather die of gangrene don't know what gangrene is. Alas by the time they find out it's too late for them to change their minds.

Simon, I'll put it a bit more bluntly and hope you'll forgive me. This decision is not up to you. Or your sister. Nor would it be up to your mother even if you and your sister vanish from the scene.

As long as you children and your mother keep arguing the case, your father is free to concentrate on opposing you and to console himself by believing that his opinion is more valid than yours (he's right. It is). Step back, and he will be left to oppose only his medical advisers whose only interest is in their correct assessment of the risk : benefit ratio. Let them do their job.
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Simon53 Dec 2021
My mother will never step back and he is an arrogant SOB.
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Simon - you said your dad scoffs at his doctor's advice, but I think he understands the seriousness of his condition. Leg amputation is a major surgery which comes with posible major complications and NO guarantee of success.

I get the impression that you think once your dad gets the surgery, gets prosthetic leg, and voila he can walk better again, then your life will be much better. You won't have all the appointments to take him to. No more stress. Yay!

Well, the reality might turn out to be very different.

What if he gets worse after the surgery. He for sure will have a lot of pain. He could develop infections, he might not learn to walk with a prosthetic leg, he might become even more disabled and end up in a wheelchair. There will be even MORE appointments for you to take him to.

Perhaps he would rather die soon from gangrene than chop off part of his body, just to waste away for years in pain and be confined to a wheelchair and be even more of a burden.

Can his surgeon guarantee success? Of course not.

If I were 82 y,o., I wouldn't go through with this.
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MargaretMcKen Dec 2021
Interesting perspective. I might even feel that way myself! Bring it on with cream sugar cakes, perhaps.
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I would suggest (or arrange if you can) counselling for him. Amputation is a huge deal.

I would also kindly suggest counselling for you & your sister. To accept that Dad will choose his fate - as awful as it may be.

You may even feel that you are starting the grieving process now - as keeping the leg or not, this could be the beginning of the end.

A friend went through similar with her Dad before I met her. He refused & refused. Finally, crises, hospital & accepted amputation. Could never self-care for himself again though & was forceable moved into NH to see out his remaining time. His memory clouded & faded, he regularly forgot he couldn't walk & sustained many falls.

His adult kids accepted he choose this fate. Accepted they could not save him from old age, diabetes or his own stubborness.

If me, I woupd try to have a very frank taking Doctor tell him how it is. They be equally frank & tell him, if he cannot look after himself, he must move into care. That I will visit but I am not his maid or nurse.

I do wish you an easier time that I suspect is ahead.
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Simon53 Dec 2021
Thanks. Obviously I am not dealing with any of this very well. Sorry can't muster much more right now.
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Simon you might find this link useful - https://www.diabetes.org/

The American Diabetes Association (I've only had a quick skim through a small selection of pages, mind) seems to accentuate the positive, and so you'd expect, but you might find articles and information that your father would pay more heed to. There are also sections for families and caregivers - worth a look, anyway, I hope.
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I can understand that your father at 82 thinks that he can cope – hobbling around with one gammy foot is not all that bad. My suggestion would be that you write out the bad news, along the following lines, and print it out in a point size he can read. ‘It frequently leads to gangrene and death. If you won’t follow doctors’ advice, we don’t have time to waste that is useless and is breaking our hearts. No use to you, no use to us. You need to work out other plans that can help yourself independently of me and my sister. Tell us when you have the other plans in place for taking you to wound control, or when and if you decide to work with doctors and their advice’.

Keep multiple copies of it. When he argues, just hand him another copy. If he won’t change IT IS NOT YOUR FAULT.
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Simon53 Dec 2021
Thank you for the words/suggestions
Youre asking my sister and I to step back. That's a hard decision. And if we do, my 82 year old mother will not ever step back and she alone can't handle this.
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It is for your father's doctors and specialist nurses to deal with this. If you and your sister can, in your own minds, accept that you have no responsibility either for communicating the medical information or for your father's decisions, I hope you will both feel relieved of an unreasonable burden.

Does getting him to the wound clinic pose practical problems for you? - distance, time off work, simply getting him out of the house, for example? Or is it that the futility of it is frustrating and perhaps embarrassing?

The conversation between your father and his diabetic team, over time and the course of repeat appointments, goes like this: the wound will not heal. It will make you very sick. If we amputate the leg soon, you can have a prosthesis fitted and with therapy you will adjust to it and regain your mobility. If we do it as an emergency, the outlook won't be so positive. If at that stage you continue to refuse, ultimately it will kill you.

Because clinicians must not put undue pressure on patients to obtain their consent to treatment, they're not going to threaten him with certain death until it is a realistic prospect. So when they say "surgery or else" there is a limit to what they can tell him the "or else" is at this stage. What does your father believe it is? Has anyone had that conversation with him? He doesn't accept the recommended amputation, okay; but then what does he think the alternative will look like?
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Simon53 Dec 2021
1. I've considered mentally accepting it is not my decision or responsibility but that alone is painful.
2. The trip to the wound clinic is hell especially now if doctors are saying we can't do anymore.
3. He is willing to get the amputation only if and when it becomes an emergency otherwise everything is "fine"
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Simon, I second Barb's opinion. You really must take at least a temporary break, not only for you but for them, and same with the sister, for the same reason, which is to bring him around to reality so that he can make better decisions.
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Simon53 Dec 2021
I know you mean well but I honestly don't know what that means take a temporary break.
He has upcoming medical appointments.
Just don't take him?
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Simon, presumably you and/or your sister attend nedical appointments with your dad.

Does he scoff at the doctor's advice in their presence, or does he feign compliance and save the scoffing for later?

I strongly think the only avenue is to get his attitude towards the prescribed treatment out on the table, i.e., "Dr. F, our dad is unwilling to consider amputation and my sister and I will be stepping away from his care. Can you describe to dad what will happen if he doesn't proceed with the amputation and advise him as to the level of care he will need, since we will no longer be available to assist him?".

It seems that perhaps you are enabling your father to deny his condition by providing free hands-on care. Maybe if you leave, he will realize that he actually DOES have to listen to the docs.

Why should he do anything if you are willing to give up your life and livelihood to wait on him? Nothing will change until you do.

To quote one of my fellow posters, Beatty "No new solution will be sought as long as YOU are the solution".

Stop being the solution.
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Simon53 Dec 2021
1. Yes my sister/I also attend appointments. Scoff would be as accurate as can be.
He thinks doctors etc. are a joke and it's all a show.
2. My sister has hinted at stepping away if his attitude continues along the lines of "if you don't care, then we don't care either."
3. You and my sister are on the same page but I believe he would rather die than be told "what to do."

I am so depressed that this arrogant, I know best, #%&hole is my father.
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Gangrene and sepsis, potentially leading to multiple organ failure, could result. Meanwhile, there would be multiple and very painful debridements to deal with.

Has Dad understood fully that his decision means accepting death? Is he willing to consider hospice?

Or is he still in denial thinking the leg will be fine while doing nothing about it? Well
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Simon53 Dec 2021
He thinks it's ok to limp around with a diseased foot.
Meanwhile he thinks it's not a big deal for my sister or I to keep taking him to clinics to treat/debride the wound. His sugar and blood pressure levels remain high. I don't think realizes his foot problem is actually the least of his worries.
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