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My relative experienced GI bleeding, recovering from surgery after a broken hip which was infected. Told it was septic and should be amputated. A few days later, relative had a stroke. Was recommended dialysis be discontinued and placed on hospice. No care is being provided. A week later heart rate isn't low, but signs of overload are there due to no dialysis. It's this the best decision?

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If it's hospice vs amputation for an 87-year-old man, I'd definitely go for hospice.
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My relative passed away. Please know your answers brought me comfort!
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OncehatedDIL Jan 2023
My condolences on your loss. I am so sorry that it happened so quickly, I hope they kept your relative out of pain.
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I personally think it is never too early to contact Hospice. They will let you know if Hospice is appropriate and if not there is Palliative Care. The benefit then is that with Palliative Care Staff coming in when Hospice is appropriate the transition will be fast and easy.
YOU can contact the Hospice of your choice they will make the appropriate calls to the Doctor(s) and get approval.
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Concernedmae Jan 2023
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I’m sorry your relative is experiencing such a storm of things going wrong. It often happens in our elders, one thing happens, than another and another. It becomes overwhelming. Hospice was a wonderful help to us when this happened with my dad. He chose it for himself when he was so very tired of endless treatments that weren’t working anyway. I’d recommend you meet with a hospice nurse and let them explain what they provide and what a typical course looks like. Our very good hospice nurse met with both us and my dad and explained so well and answered all our questions. You will have a better idea of how to proceed then. I wish you peace
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Concernedmae, I am so sorry for your loss. May The Lord give you peace, comfort and strength for this difficult time.

You did the right thing. He didn't suffer endlessly having modern medicine goes to any length to stop his body from dying. You were very brave making the choice you did. Great big warm hug!
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Concernedmae Jan 2023
Thank you so much. Your answers give me peace.
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A broken hip in the elderly can be deadly even if surgery is performed. Now throw in its septic. Which can also be deadly. Then they have a stroke. How much damage did that cause? As daughter said "a storm of things" have happened to them. Under theses conditions, your relative probably can no longer do dialysis. So what happens is the toxins build up in their system and they become confused and out of it. He passes from the toxin build up.

Not sure what you mean by Hospice not giving care. He is probably getting morphine for any pain he may have and maybe an anxiety med. Their body maybe shutting down so they no longer want to eat or drink and forcing it causes problems for them. If u mean by care he isn't being medicated for his problems, no medication is given for these problems. Thats what Hospice is, allowing nature to take its course. Hospice is keeping the person as comfortable as possible and pain free.

I really think the relative is on Hospice not because of everything that happened to them so much but because what happened to them caused the need for dialysis to be stopped. Once dialysis is stopped, death is imminent. For my friends both passed within 2 weeks of dialysis being stopped.

To answer ur question, yes Hospice is appropriate in this case.
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Cover999 Jan 2023
The OP has said the relative has passed..
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This depends upon decision of patient, doctor and family. There must be recognition that the withdrawal of dialysis means that the patient will die. You do not mention either the age or the mental capacity of this relative to make his or her own decision. If he or she cannot make it then it is for the next of kin or the POA to make it with the best advice of medical personnel.
The sad truth is that further treatment is likely to lead to the same outcome, the death of this dear one. But it can now be a longer, more drawn out and torturous death, or a peaceful death with medications to keep the patient medicated below the level of dreaming.
I was lucky in that my brother, with his sepsis, BEGGED to go home and die there with the help of hospice. And it was only on me to see if done for him. My option was clear and there was great peace and clarity. It is more difficult when you must make the decision for someone else. As a former nurse my own choice would be clear were I in a decision making situation here, but it may be less clear for you.
I wish the best for this relative of yours and for the person left to make these last decisions for end of life care. I am a great fan of Hospice, just wish it was a good as it once was.
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Cover999 Jan 2023
The OP said the relative has passed.
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I’m sorry for your loss and wish you healing and peace in the days to come
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Concernedmae Jan 2023
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So very sorry for your loss.
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So very sorry. He clearly had family who cared for and loved him through his life and I know that he sensed this. Prayers for comfort and peace.
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