Dad has liver cancer and is combative and agitated but also drowsy and unresponsive sometimes. Is this the end?

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The Dr found a mass on dads liver about 2 yrs ago. They only recently biopsied it and found cancer. His ammonia levels have been high but were under control with medication. His skin is jaundiced and he is in pain and won't eat at times. he can barely swallow and his mouth and lips are dry and cracked. Last week the NH found him unresponsive in his wheelchair and had him hospitalized. He had no urine output until they hooked him up to a IV. They couldn't catheterize him because he has a large prostate. (their words) and had to use a condom cath to catch any urine. His ammonia levels were ok in the hospital so they sent him back to the nh after a 2 day stay. He has slowly woken up. Now dad is back in the hospital again with high ammonia levels and low platelets. He was admitted this time for aggressiveness and agitation. he won't take his meds, eat, drink and has thrown himself off the side of the bed and he is hitting the staff etc. This started 4 days ago and they said that he didn't want to see me. he has said that before so it was no surprise. The big surprise is that he didn't want to see his "DO NO WRONG" son. The one who wants Guardianship even though he hasn't visited more than 8 times in the last 4 yrs. The nurse said he is quiet and drowsy right now. What I want to know is if this erratic behavior and ammonia and platelet levels are a sign that he's nearing the end of his life. Has anyone gone thru this before? Maybe you can answer from your experience with Liver Cancer.

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Liver, toxins, the brain, nervous system, muscle loss, rapid weightloss, swallowing, toxic drugs, and more
Check bloodwork for Liver (Enzymes, ALT, AST)

Reasons and alternative help for malabsorption.

Hepatic (Liver) Encepalopathy

Good flora, vits, minerals, enzymes, amino acids
Life Extensions have doctors on board to speak to. Suzanne Somers is a member. Known for high quality lab inspections.
Lef.org
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Oh and they CAN hear hear you. I asked my husband to try to say my name if he could hear me. He struggled so but did say it! And said it repeatedly as best he could until his very last breath. He died in my arms. He left me with an unforgettable gift.
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It is probably too late to answer the original question. I would have said yes; i went through this in the spring of this year. A good hospice company is hard to come by. I had to fire two before found a good one.

You cared and you were there till the end. May that give you peace. The loved one appreciated it. I know it.
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Rosie he will soon be at peace and you can start the healing process. You will always miss him but he will stay in your heart. It is just possible that he will wake up and be lucid the day or hours before he dies. Hospice sounds as though they are managing his pain and agitation in the best way possible and being an inpatient facility they have more options. Remember that hearing is the last sense to go so continue to talk quietly to him and say your goodbyes. If he liked music play his favorites at low volume. Avoid wearing strong perfumes this can be very to the patient at this stage. Don't exhaust yourself at the bedside or have regrets if he dies when he is alone. he may have wanted it that way - it is often the case. As Butterfly said you did everything right given the information you had, you reached out to people who had gone before and most importantly listened. Be at Peace.
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Thank you for your update rosie123; you've done everything right and bless you for caring enough to follow through. You'll always wonder if you could have done more, don't second guess yourself. A calm and peace will wash over you and you'll know you did the very best you could with what you knew. Just hold his hand if he will let you and spend as much time as you can with him. Hugs.
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Hugs to you and your family as you go through the end of his life's journey. As much as you want to see them at peace and pain-free, it's still hard to go through.
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Thanks for all the answers they have been very helpful. he is in a Hospice facility. He is now a DNR. They allowed me to consent for that because I am his medical POA. he has been unresponsive since being admitted 3 days ago. he is to have nothing by mouth because he will choke. he gets pain meds and ativan in his arm where they put in a port. His urine is orangish red and he has a catheter in place. He only makes noise when they turn him or he tries to clear his throat. he does get the hiccups. he always had them before he was sick. Its kinda like his body is saying "whoa.. parts of us still work in here"..
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Please get Hospice involved ASAP like today. They will take care of everything with the NH, his doctor and also DNR. His body is starting to shut down and giving him an IV will only confuse his organs; morphine under his tongue will give him some relief from his pain and agitation. Do not let the NH make the decisions for you especially if you don't agree with them. That is where Hospice is so great. Call them today, please. Keep us posted and bless you for caring. It is so very tough to watch a loved one deteriorate; tell him you love him, hold his hand and do it as many times a day as you can. Make sure you also tell him it is o.k. to die when he is ready, or if he sees the "gate opening with a bright light" tell him to go. It's a hard decision - I know as I've been there recently, but it is the right one. Hugs, blessings and prayers.
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If there is not a DNR, wouldn't a POA with medical authority allow you to call the shots for palliative care only going forward?

That is what I would suggest with or without hospice. Enlist drs and care managers help to get this ordered.
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Everyone keeps mentioning the DNR... isn't it a little late now for that if it was not done earlier?
Thinking common sense, the patient would have to be cognizant and aware of the ramifications of a DNR, and this guy sounds like he really is not thinking rationally. Therefore, trying to get a DNR now may be impossible, but I am not completely sure.
Just a thought.
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