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He has Hepatic encephalopathy (HE) He sleeps day and night but is more wakeful between 5-10 pm. He also hallucinates... Thinking he sees people or hears people. He was diagnosed over a year ago. I'm trying to find out if he's close to death. I can wake him for meals and meds but he eats very little and now not drinking enough either.

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He was diagnosed a year ago ... I have a POA but liver specialists (in Canada) aggressively treat the liver until the last minute unwilling to discuss the end until "all options" have been used up ... It's a mind set ... Our healthcare system, although "free" doesn't give a second opinion option. All they say is that his heart, lungs and kidneys are good. It's his mind! I have to try and get him to the lab for blood tests but that's really hard with him sleeping so much. I am his primary caregiver and I just need to know when to call his kids ... Out of country. I'm going to be talking to an RN next week but I'm a bit worried right now.
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FrazzledMama Apr 2019
Do you think calling an ambulance and having him taken to the hospital would be the thing to do, or do you feel it might be past that point? I'm thinking the hospitalist there would be able to run tests and determine if he is at the end stage or not and how to proceed from there, i.e. if it's treatable vs. if a hospice referral might now be an option if it's not.
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Hepatic encephalopathy? I second talking to his doctor to about his symptoms and what his options are, and perhaps trying to get a second opinion should you not he able to reach his primary doc, maybe even call the nurse line at the local hospital. I know with cirrhosis they sometimes use lactulose to help keep ammonia levels in the brain from building up. It could be what's happening here (ammonia build up) causing the hallucinations and drowsiness. It also depends on what other symptoms he is exhibiting as to whether he is in the end stage of the cirrhosis or just dehydrated and/or fluid build up, and whether or not the HE is correctable at this point.
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Janeanne Apr 2019
Yes hepatic encelopathy HE ... He's been on treatments for over a year. Lactulose, Raxifim, milk thistle ... He gets weaker and sleepier every day now. He still has some good days but they are fewer and fewer. He doesn't qualify for a transplant ... Too old 😢
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HE? Hepatitis?

So there is not a HIPPA or POA in place signed by hubby?

You are out of luck. A doctor's responsibility is to his patient and to keep information private is that is patient's wish.

Does he look jaundice? Tremors? Belly protruding? Maybe search online for symptoms of end of life with cirrhosis.
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JoAnn29 Apr 2019
In this situation, she already knows what he has. I can't see why the doctor can't tell her what to expect. Thats kind of cruel. My daughter says, most Drs. and Nurses bend the rules when a spouse is involved unless told by the patient spouse is not to be given no info.
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You need to call the doctor and tell him you need to know what is going on. He has a responsibility to his patient. I would ask about getting Hospice. An RN will come out to evaluate him. She will tell you if he will be excepted. Someone will have to be with him 24/7. You will get an aide, not sure how often but she/he will bathe him. Depends will be provided and I think medication. He will be kept comfortable. Hospice nurse will come every few days to check vitals and available by phone 24/7.
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