Hospice for dad; did we make a mistake?
My dad fell in the bathroom in March, 911 called in. He went to the hospital. There he stayed in the hospital for 25 days. He had Acute chronic congestive heart failure unspecified heart failure, acute kidney injury, atrial fibrillation with RVR, Atrial Flutter and AMS. He started to have sundown syndrome. He stayed at my brother's house for 14 days.
Again he ended up in the hospital for same issue. This time he was having a breathing issues, edema, fast heart rate. Medicines treatment was not working for him so they decided to Cardioverson on him, that didn't do well with him. He was feeling the same. Then they did Catheter Ablation for Atrial Fibrillation & Atrial Flutter. During the surgery, his esophagus got damage due to the heat, his esophagus got lots of ulcers. They did not give him to eat any thing for 4 days. They did EGD, CT, lot more test to see if there is any leakage in his esophagus. They were thinking to put feeding tube. But they didn't because they didn't see any leakage. At this time my sister call the nurse and ask for advance direct form to nurse so that my dad can sign. My dad wants us to make decision for his health. We are 3 siblings and decide to go with home Hospice care for him. We did not want him to stay at the hospital for longer period time. He has been to the hospital for 30 days this time. Yesterday he got back home. His Cardiology called me yesterday when he found out that we decided to go with Hospice. He was convincing us that my dad will be fine. He just had a some issues but he will get back to normal. He is on semi-liquid diet only. He told us his esophagus will get better with time. But my dad on other hand he is very weak and his health one day is fine next day he is again struggle to breath.
I don't know what to do at this point. Did we make mistake by sign him up with Hospice? Since it's coronavirus no one was allowed to the hospital. We were scared that our dad will die in the hospital alone what we can not see him. All 3 of us had a meeting and discussed about dad's health. I know for sure we decided no more surgery for him, no ventilator, my dad didn't want a feeding tube. So no feeling tube. It is so confusing since his cardiologist called us. That make you think did we make a mistake. Oh my dad is 83 year old. His heart is only working 20% and his heart cover with water.
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I know that pretty much immediately after signing up a LO for Hospice there comes this overarching 'did we do the right thing?' But your DAD made the decision. Accept that and be there for him in whatvere capacity he needs.
I'm glad you were able to get him home. So many people want their LO's to come out of facilities and they are not being allowed.
Bless you. Just do your best under Hospice's guidelines and love the remaining days with dad.
Drs are not God. I know, 2 of my kids are drs and they honestly do not know that much. I am constantly surprised by the 'lacks' in their medical education--mostly in the patient/family dynamic. Their JOB is to do everything they can to prolong life. Just remember that, thank the dr for their care and then go with your heart.
((HUgs))
I am surprised that the cardiologist would make that commemt. Dad has many underlying issues and will not recover from all of them.
You all did the right thing you want to keep dad comfortable. Hospice is not a death sentence. There are those that actually improve under hospice care. So, try to rest easy knowing hospice will help to care for him and he could get better.
Dad did not want a feeding tube, you are following his wishes.
I want to add that hospice should not be about discontinuing all medications or interventions and just letting him die, many of his heart drugs could (should?) be continued as a quality of life consideration, and efforts can be made to help him eat/drink whatever he wants in a safe way ((hugs)).
Hospice would not have excepted Dad if he did not meet Medicare's criteria since Medicare is footing the bill. I think your decision for Hospice is a good one. He will not improve with CHF. What will happen is he will, if not already, continually fill up with fluid because his heart cannot pump well enough for the fluid to leave his body. This means trips to the hospital to have the fluid drained. Then AFib. My husband has bouts every few years. We were told while your heart is in AFib, clots can form. Once they have it under control those clots could go to the brain, lungs or heart killing him.
I personally would not put Dad thru anymore hospital stays. I would enjoy whatever time he has left. You really have been given a blessing. You are able to be with him so many other people haven't been able to have that with these lockdowns.
He had just been diagnosed with prostate cancer a few days before the first hospital stay .It was advanced and had spread to the bones causing. During the first stay his Doctors advised us that he was a candidate for Hospice Care but neither he nor we were ready to stop treatment. We were told that if a patient is not expected to live longer than 6 months they are eligible. Your Dad’s Doctors would have had to certify this as would the Hospice Doctor. If he does improve he goes off Hospice and can go back to Hospice Care if needed again.
After rehab my Dad went back to the Hospital due to some complications. At that point we knew that when he was released we would be putting him under Hospice Care and we did. They wanted to take him to their facility but my Dad desperately wanted to go home so we took him home and had a Nurse or Hospice Representative there 24/7. He was so happy being home his last few days. We brought him home Wednesday Night and he passed away Saturday morning with my Sister, Niece, and I by his side.
I think you made the right decision and so did he. I wish you the best.
May God grant you grieving mercies and comfort during this difficult time.
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