End of Life care for my Father in Law

[My old FIL]

I am writing this in the hope that you may be able to offer some advice regarding After care/Palliative care for my elderly Father-in-Law.

My Father-in-Law, aged 88, has been quite ill for some time now, suffering from numerous upset Stomach aches and severe chest and Back pain. He has plaques on his lungs, caused by Asbestosis, and has an extremely bad memory, which has now been diagnosed as Alzheimer's decease. Despite this he has still gone out for short walks, has taken local bus trips into town, and has met with his friend for lunch on a Friday, although he has been slowing up more recently.

About a month ago, my wife noticed that he looked quite frail and his skin colour was yellowing. He said that he did not feel very well and had bad back ache. Of course, he had not seen his Doctor. A few days later my wife visited him again, and promptly called the Doctor out. He was then examined, and after some questioning the Doctor said that he would have to have some scans, and if his condition worsened he should contact the Hospital immediately.

When my wife visited him again, after a few more days had passed, his condition had worsened, and he was very Jaundiced. The Doctor was again called out, and she said that he would have to go to Hospital. An Ambulance was called and he was eventually taken to the Hospital. He was seen, examined and put onto a drip, and was then taken to an Investigatory ward, later that night, to await for some scans to be taken.

His condition seemed to worsen, now very frail, and sleeping for most of the day. The scan was never done but he did have an Endoscopy. The next day we were informed that the Endoscopy results were in, but the Hospital staff would have to speak direct to my wife in Person. The following day my wife visited her Father and they were both informed that he had Pancreatic cancer. This Cancer was at an Advanced stage and was untreatable. A ‘Stent’ would be fitted, and was, but the Doctor was unsure as to how long this would remain operating, as it could become blocked within weeks, or even days.

Since that ‘Stent’ was fitted, his Jaundice seemed to get slightly better, and for a few days he was less yellow. But now he looks very frail and thin, his Jaundice seems worse, and he sleeps for most of the day. He has good and bad days with his Alzheimer’s, but even on a good day he can only hold a conversation for a very short while...often just minutes. He is totally Bed bound and is on a ‘Soft’ food diet, often just having a Supplement type Drink when he feels like it. He has little energy and often just lays there motionless.

Last Sunday, during a visit we spoke to his Doctor. We were then told that he requires palliative Care, which cannot be given at home. Specialist staff at the Hospital would look into finding a suitable Nursing/Care home, and then provide us with a shortlist.On Wednesday we received a telephone call during which we were given a list of 4 care Homes who specialize in the care and comfort of those with dementia or similar mental-health conditions,to consider. This would have to be done sooner, rather than later.

Yesterday, I telephoned the Nursing/Care Homes to enquire about their services, and ta ask for their advice regarding such a move from the Hospital. I then learned that although they all had some facilities for 'End of Life' care, 3 of the homes were not able to provide these facilities at the present time. In effect, No vacancies.

Today, my Sister in Law visited her Father, in Hospital, and spoke to him for a very short length of time. That was all he could manage. She spoke to the staff about the move out of Hospital, and was told that they were having a meeting about him on Monday. We do not know any more than that.

In view of his current condition, can you please advise as to whether he should be admitted to one of these Specialized Nursing/Cares. At present we only know of one that could care for an ‘End of Life’ patient, who at the moment is completely Bed Bound. He has to be regularly cleaned, washed and changed throughout the day. If this, or any other Care Homes are suitable, what sort of questions should we be asking about his constant care. Or should he be cared for in a specific ‘End of Life’ home, or even a Hospice.

I am sorry if I have rambled on a bit, but any advice would be appreciated.

Thank you for your assistance in this matter.

Yours Sincerely,

Derek and Pauline

Portsmouth.

Hampshire.

[cestrian]

Derek & Pauline

Have you had support from MacMillan? My sister was cared for in her last days at a local hospice that they arranged for her. I have subsequently been diagnosed with PC but am doing fine with my chemo.

They are very supportive and should be available at the hospital where your father in law is being treated or via your GP.

Love and Peace

Mike

[Lels]

I agree with Mike, contact Macmillan and they will give you all the help that you need.

My thoughts are with you at this difficult time

Lesley x

[J_T]

Yes, certainly sounds like a hospice would be the ideal place for your fil.

Speak to Macmillan and/or your fils GP.

Hope you get this sorted soon so he gets the best possible care.

Julia