My 80 year old mother had a large brain haemorrhage 8 years ago. She lost all use of her right side and suffered Apraxia and Aphasia. She has constant bladder infections and has just recovered from severe Urosepsis.
Unfortunately, she has now lost her swallowing ability. She has been fitted with a nasal feeding tube. It has a bridal because she was trying to pull it out. This was not the families decision but the consultants. She is now fit for discharge and they want to send her home. We feel this is cruel given her complex needs, she doesn't want to continue living and has felt like that for few years now. The Consultant mentioned withdrawal of the tube and mum going onto palliative care which we considered the kindest option. He then decided against it.
What would be best for my mum. Advice would really be appreciated
So sorry that your mom is nearing the end. In some instances, I would consider it a blessing. Like I would with my mom.
Hugs.
I can't imagine keeping someone alive with a nasal feeding tube it sounds cruel and barbaric and completely against your mothers wishes.
It sounds like mom would not want to be kept alive this way based on the information you provided above. It is too bad mom did not put these wishes in writing or have a living will made up. It would have saved a lot of heartache for your mother and the family to have to watch her continue this way.
I hope you are able to get this consultant on the same page as your mother and the family and let her go with peace, comfort and dignity.
Your mother has expressed her wishes to you, and you should follow them. Don't allow them to send her home. Insist on her being in a place where 24/7 caregivers can take care of her. That would leave you free to be there when you wish, soothing her and telling her she is loved. The palliative care or hospice nurses will be there to help and guide you.
Fire the consultant. I don't know who that might be or why they'd tell you upsetting things such as mother needing palliative care but "oh wait, I've decided against it." Whoever in the family is appointed to make end-of-life decisions for your mother should do so now.
I'm very sorry for your sadness and for your mother's situation.
I as an RN SOOOOO fear some well -meaning family member allowing a feeding artificially that ALL artificial administration of hydration and sustenance is forbidden directly and explicitly in my Advance Directive.
No one gets a feeding tube in the USA without family permission, so I am unclear how this happened. Consultants can order it but in all states I am aware of the family must approve the move. It can sometimes be tricky to get them removed once placed.
I would hope, knowing how she lived her life that the family member who is serving now to make decisions for her understands that this is not what your 80 year old would want (unless she indicated otherwise).
I am assuming YOU are POA in charge here. This decision will now be made by whomever is in charge of your mother's medical decisions.
I would recommend the doctors suggestion for palliative care, but in truth that will quickly move to Hospice without any intake.
This is going to require sedation as the body organs shut down, causing confusion and agitation.
Good luck to your Mom and to your family in this trying time.
Mum does not want to continue living. THAT is the only person you need to "consult" here! Fire the consultants and hire hospice immediately. Remove that horrid NG tube from poor mums nose and allow hospice to keep her comfortable as nature takes its course.
I'm sorry you're going thru such a thing. May God bless you and help you thru the process, with acceptance and peace.
Does your mom have someone that has been appointed to make decisions for her? Is that person the "consultant"? If not I would think they should have no say in the matter.
Is your mom able to make decisions and make her decisions known? That might be a very important point here.
Has mom ever signed a POLST or DNR indicating if she wants extraordinary measures taken?
If mom can not make decisions or make her decisions known have you or any family member had discussions with her in the past as to what her wishes are.
Gut reaction is if you can not care for mom at home to discharge her to home would not be safe. "Unsafe discharge" are the magic words.
I am also wondering why the "consultant" would recommend removing the NG tube and placing her on Palliative Care. At that point she should be placed on Hospice.
I am also guessing (have not read your profile yet) that you are not in the USA. So I do not know if there are different terms for medical personnel that we would use in place of "consultant"
My honest opinion...
Hospice
Hospice WILL take someone with a NG tube and will maintain it. (if the NG is in place PRIOR to Hospice admission. They will not do an NG after admission.
Use the guidance of the Hospice Nurse and Doctor as to when to remove the NG tube.
There are "consultants" in other countries whose opinions outweigh the patient and the family but really would appreciate more information on what the consultant is and where he is located.
Again, I hope you can convince someone to come to your family's and Mom's aid and help you all out of this. A bridal nasal tube is not fun!
Please keep us updated.
Peace!
"Consultants are senior doctors that have completed full medical training in a specialised area of medicine and are listed on the GMC's specialist register. They have clinical responsibilities and administrative responsibilities in managing SAS and junior doctors." -- British Medical Association
It's NOT like how a consultant is an outside party, like in the US. I THINK it's like an Attending Physician, here.