You've gotten excellent advice, including Alva's response as a medical professional. Her questions really determine how to evaluate whether or not to allow a trach and PEG tube to be inserted.
I can only offer some experiential insight: my father was intubated, then trached as he hadn't progressed to the point of being able to sustain himself w/o this assistance. He had multiple serious medical complications, was 85 at the time.
He went through an extensive period of recovery, although he had many co-morbidities at the time. The trach remained in for several months, until he had improved enough for its removal. There's no question that it was key to his recovery; there's also no question that was a challenge for him, and for me, b/c tube feeding had to be done 4x daily and a larger feeding later at night. First feeding was 7 am, last one at midnight or 1 am. Neither of us got much sleep, but at least he was at home with me in my sister's house for the last 3 or 4 months.
I was on more than one occasion advised he would not survive. He did. Eventually the tube was removed and he was able to resume a normal life.
However, it was a difficult journey: unable to speak for months, communicating with a tablet I made up, deprived of the pleasure of food, enduring speech exercises, and was very reliant on me as well as his friends.
However #2, he lived for another 15 years and was active until the last few months of his life.
Is your aunt strong willed, determined, able to tolerate restrictions and bland liquid diet for a period of time - short or long?
For me, in my situation, I wouldn't want a PEG tube unless it was for a specific interim amount of time, but I don't have access to the support that my father had.
Have you checked your LO's paperwork for a Living Will (aka Advance Care Directive, or "My 5 Wishes")? Or ask her/his regular physician/clinic or facility if they have one on record? This would give you guidance as to what ongoing intervention (or not) your LO wishes to have. I'm so sorry you are in the position to have to make this decision. I wish you peace in your heart no matter what transpires.
I am sorry. What is left out here are all the details that will help you in making this decision, and I am assuming you are POA and will be the one making it. Is the patient recovered, or recoverING. Is this tube feeding considered temporary, or has there been an incident such as a stroke preventing the patient from eating? In general a PEG is not placed until it is looking as though tube feedings will be going on for a good long time. So questions: This is not a symptom or a side effect of Covid-19 unless there has been serious injuries as side effects of the disease, such as stroke (the most common illness that causes swallow deficit.) How long has patient had Covid-19? What is the current condition of the patient? Is he or she on a ventilator? For how long? How old is the patient? What is the patients condition in general BEFORE Covid-19? What are the wishes of this patient as expressed when well as to heroic measures to maintain life? What is the PROGNOSIS of this patient according to the doctors? All these things will be things you must consider in making a decision. I have already, as an old retired RN, written into my advanced directive that I will not under any circumstances accept nutritional support via parenteral(IV) or tube administration. You will need to look at the chances of quality of life and whether or not this is a temporary measure recommended as nutritional support during recovery, or whether this is meant to sustain life in a patient who is unlikely to be able to eat food in future. I wish you good luck in your decision and am so sorry you are going through this tough time, and have these hard decisions to make.
I am so sorry that you are going through this tough time with your Aunt; have you ever had any conversations with her about her wishes in this sort of situation?
What sort of health was she in prior to getting COVID? If this is a matter of a temporary fix until she heals and then she'll be back close to her previous baseline, then I would do the procedures. On the other hand, if she has multiple co-morbidities and didn't have a good quality of life before, then I would think seriously about palliative care or Hospice.
I can only offer some experiential insight: my father was intubated, then trached as he hadn't progressed to the point of being able to sustain himself w/o this assistance. He had multiple serious medical complications, was 85 at the time.
He went through an extensive period of recovery, although he had many co-morbidities at the time. The trach remained in for several months, until he had improved enough for its removal. There's no question that it was key to his recovery; there's also no question that was a challenge for him, and for me, b/c tube feeding had to be done 4x daily and a larger feeding later at night. First feeding was 7 am, last one at midnight or 1 am. Neither of us got much sleep, but at least he was at home with me in my sister's house for the last 3 or 4 months.
I was on more than one occasion advised he would not survive. He did. Eventually the tube was removed and he was able to resume a normal life.
However, it was a difficult journey: unable to speak for months, communicating with a tablet I made up, deprived of the pleasure of food, enduring speech exercises, and was very reliant on me as well as his friends.
However #2, he lived for another 15 years and was active until the last few months of his life.
Is your aunt strong willed, determined, able to tolerate restrictions and bland liquid diet for a period of time - short or long?
For me, in my situation, I wouldn't want a PEG tube unless it was for a specific interim amount of time, but I don't have access to the support that my father had.
Is the patient recovered, or recoverING. Is this tube feeding considered temporary, or has there been an incident such as a stroke preventing the patient from eating? In general a PEG is not placed until it is looking as though tube feedings will be going on for a good long time.
So questions:
This is not a symptom or a side effect of Covid-19 unless there has been serious injuries as side effects of the disease, such as stroke (the most common illness that causes swallow deficit.)
How long has patient had Covid-19?
What is the current condition of the patient? Is he or she on a ventilator? For how long?
How old is the patient?
What is the patients condition in general BEFORE Covid-19?
What are the wishes of this patient as expressed when well as to heroic measures to maintain life?
What is the PROGNOSIS of this patient according to the doctors?
All these things will be things you must consider in making a decision. I have already, as an old retired RN, written into my advanced directive that I will not under any circumstances accept nutritional support via parenteral(IV) or tube administration. You will need to look at the chances of quality of life and whether or not this is a temporary measure recommended as nutritional support during recovery, or whether this is meant to sustain life in a patient who is unlikely to be able to eat food in future.
I wish you good luck in your decision and am so sorry you are going through this tough time, and have these hard decisions to make.
What sort of health was she in prior to getting COVID? If this is a matter of a temporary fix until she heals and then she'll be back close to her previous baseline, then I would do the procedures. On the other hand, if she has multiple co-morbidities and didn't have a good quality of life before, then I would think seriously about palliative care or Hospice.
Can you ask her what she wants?