I wouldn’t want to keep my parents alive if they developed dementia.
Working is a care home is a eye opening and heart breaking experience. Watching people rot away slowly and painfully is brutal.
I wouldn’t wish it on my worst enemy.
> Her son, Tony Stowell, said if end-of-life care had been discussed, he would not have agreed to it.
Does he have to agree with it? As I understand it the medical professionals act in the patients best interests, they can (and should when possible) discuss it with the family and hopefully they come to an agreed plan, but ultimately if the patient cannot consent for themselves the doctor makes a decision unless there’s documentation in place like an advance directive
And to be honest that makes sense. No amount of “I don’t want my Nan to die” changes the fact she’s dying.
I get he’s upset but hes also completely in the wrong here.
In the acute setting, where Respect forms (pt agreed ceiling of care) are an obligation, getting the required medics and next of kin (if no capacity) together to discuss and sign off is a genuine struggle…in the community it must be even harder. If she agreed her DNACPR/ EOL pathway when she had capacity than it supersedes her NoK wishes if still within review date – these agreements can be as detailed as ‘if I develop a CAP I do not want abx treatment’. If she didn’t have an agreed ceiling of care prior to this event, then he may have something to discuss, but it’s such a complex area – feel for all involved.
What this story doesn’t state is whether the family had a Lasting Power of Attorney, LPA (care) or relevant Court of Protection Order.
If they did not, then there is no obligation to be consulted, nor do they have a say. Not every care home resident, especially those paying full fees, as a private, not LA funded resident, has an LPA/COP order.
The law being proposed already exists- the Mental Capacity Act and Court of Protection.
If LPAs have been ignored by medical professionals and care homes, ok they are too frequently, then it needs to be policed properly and those involved prosecuted.
ETA: Used to work in Social Care Finance- CFA, Court of Protection clients whose Deputyship was held for safeguarding purposes by the LA/Social Services. Just because someone is in a Care Home doesn’t mean they fall under the MCA and a lot of families whose relatives are liable for the full cost of care, never get one.
I really feel for her son here, but he is in the wrong. It must have been incredibly difficult to feel so helpless while someone he loved was dying and to not be able to even be with her. It certainly seems like the communication between the doctors and the family was not good enough.
However, there seems to be deep misunderstandings about the nature of end of life care. Anyone in healthcare will be able to tell you that an elderly care home resident with dementia (and the physical health problems that inevitably come with it) who is dying from COVID is not going to be saved by a 48-hour spell on a ventilator, as his solicitors seem to suggest. Regarding antibiotics, they might not even have been indicated if the cause of death was COVID. Our duty as doctors is to serve the best interests of the patient, not the family, and when a person is clearly dying and will not survive resuscitation or being put on a ventilator, that means preserving their dignity in the final moments of their life.
This seems like an awful cause of a grieving son wanting to find reason and fairness in a situation where there is none. The people we love die and it’s unfair and heartbreaking and changes us for the rest of our lives but that is the nature of life, and death.
So did they euthanise her or something? How can you decide to put someone on end of life care. Either they’re dying or they’re not it’s not a choice. Remember that medazalam conspiracy…
Sue for something that is not against the law? Medical professionals are legally bound to act in the PATIENTS best interests. Doctors don’t need to run anything past relatives for their consent, they do it as a courtesy. Clearly there was a break in the communication chain here and I do feel bad for the family bit come on. What are you fighting for the right to keep an incapacitating person with no quality of life alive for? Death is kinder than the ICU for an elderly person who can’t understand what is going on and who will likely never come back out of the hospital ever again. She would NOT have been sent to ICU upon arriving at the hospital and would have more rhan likely been sent to an elderly care ward to doe therw. It really would have been much kinder to have just let her die comfortably at home instead. Again, there was an unacceptable failure in the communication process, but that’s where the right to complain ends.
8 comments
I wouldn’t want to keep my parents alive if they developed dementia.
Working is a care home is a eye opening and heart breaking experience. Watching people rot away slowly and painfully is brutal.
I wouldn’t wish it on my worst enemy.
> Her son, Tony Stowell, said if end-of-life care had been discussed, he would not have agreed to it.
Does he have to agree with it? As I understand it the medical professionals act in the patients best interests, they can (and should when possible) discuss it with the family and hopefully they come to an agreed plan, but ultimately if the patient cannot consent for themselves the doctor makes a decision unless there’s documentation in place like an advance directive
And to be honest that makes sense. No amount of “I don’t want my Nan to die” changes the fact she’s dying.
I get he’s upset but hes also completely in the wrong here.
In the acute setting, where Respect forms (pt agreed ceiling of care) are an obligation, getting the required medics and next of kin (if no capacity) together to discuss and sign off is a genuine struggle…in the community it must be even harder. If she agreed her DNACPR/ EOL pathway when she had capacity than it supersedes her NoK wishes if still within review date – these agreements can be as detailed as ‘if I develop a CAP I do not want abx treatment’. If she didn’t have an agreed ceiling of care prior to this event, then he may have something to discuss, but it’s such a complex area – feel for all involved.
What this story doesn’t state is whether the family had a Lasting Power of Attorney, LPA (care) or relevant Court of Protection Order.
If they did not, then there is no obligation to be consulted, nor do they have a say. Not every care home resident, especially those paying full fees, as a private, not LA funded resident, has an LPA/COP order.
The law being proposed already exists- the Mental Capacity Act and Court of Protection.
If LPAs have been ignored by medical professionals and care homes, ok they are too frequently, then it needs to be policed properly and those involved prosecuted.
ETA: Used to work in Social Care Finance- CFA, Court of Protection clients whose Deputyship was held for safeguarding purposes by the LA/Social Services. Just because someone is in a Care Home doesn’t mean they fall under the MCA and a lot of families whose relatives are liable for the full cost of care, never get one.
I really feel for her son here, but he is in the wrong. It must have been incredibly difficult to feel so helpless while someone he loved was dying and to not be able to even be with her. It certainly seems like the communication between the doctors and the family was not good enough.
However, there seems to be deep misunderstandings about the nature of end of life care. Anyone in healthcare will be able to tell you that an elderly care home resident with dementia (and the physical health problems that inevitably come with it) who is dying from COVID is not going to be saved by a 48-hour spell on a ventilator, as his solicitors seem to suggest. Regarding antibiotics, they might not even have been indicated if the cause of death was COVID. Our duty as doctors is to serve the best interests of the patient, not the family, and when a person is clearly dying and will not survive resuscitation or being put on a ventilator, that means preserving their dignity in the final moments of their life.
This seems like an awful cause of a grieving son wanting to find reason and fairness in a situation where there is none. The people we love die and it’s unfair and heartbreaking and changes us for the rest of our lives but that is the nature of life, and death.
So did they euthanise her or something? How can you decide to put someone on end of life care. Either they’re dying or they’re not it’s not a choice. Remember that medazalam conspiracy…
Sue for something that is not against the law? Medical professionals are legally bound to act in the PATIENTS best interests. Doctors don’t need to run anything past relatives for their consent, they do it as a courtesy. Clearly there was a break in the communication chain here and I do feel bad for the family bit come on. What are you fighting for the right to keep an incapacitating person with no quality of life alive for? Death is kinder than the ICU for an elderly person who can’t understand what is going on and who will likely never come back out of the hospital ever again. She would NOT have been sent to ICU upon arriving at the hospital and would have more rhan likely been sent to an elderly care ward to doe therw. It really would have been much kinder to have just let her die comfortably at home instead. Again, there was an unacceptable failure in the communication process, but that’s where the right to complain ends.