Do I allow my father, who has severe, swallowing problems continue to eat and remove the stomach feeding tube?
My father is in a Veterans Home of California. In June my sister visited him. She neglected to assist him with walking. He is 90 years old, frail, has equilibrium problems, vertigo, and no eardrum in one ear. He is not stable. She barked at him to hurry up while he carried way too much stuff. He was trying to hurry so he did not take his cane or walker. My sister is at fault for neglect. My father fell and fractured his hip. Hallucinations caused him to fall out of bed in the hospital only to fracture it again.
A severe swallowing problem was discovered while in the hospital. He was taking food into his lungs causing aspiration and pnuenomia (sp). A stomach tube has been inserted for nutrition. My father doesnt understand the risks of eating food. He could choke and die or get pnuenomia again and die. He understands for the moment then is back to complaining and harassing the nurses about wanting to eat. Now the VA home has given me a decision to make. To my father eat or stay on the tube. Each with their own set of problems. If he is allowed to eat then he will expect to sit down with a steak. They will have to puree his food which has already complained about and refused to eat. Then there are the risks that he may get pneumonia from aspiration and or choke and die. If we refuse his request to eat and keep him on the tube then he will hate me and continue to harrass and complain at his nurses.
I dont know what to do. They are going to forward me an article about the subject to help me make an educated decision. They said they would not judge me in my decision. Family members are torn...some say let him experience the problem then go back to the tube. Some say no. If we let him eat and the problem be fatal...there is no lesson to be learned as my father doesnt understand the situation for very long. Thoughts?
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Did your father make out a health care directive while he was fully competent? If so, that may give you some clues. If not, do you know his attitudes toward such measures as feeding tubes when he was fully competent?
A feeding tube was recommended for my husband, then 78, several years ago. He was still reasonaly cognitively OK. He refused it. Knowing that was fully consistent with his attitudes for as long as I've known him, I supported his decision. Yes, we knew he could choke and die. We knew he could aspiriate, get pneumonia and die. (By the way, a person on a feeding tube can aspirate his own saliva, get pneumonia, and die. It is less likely with a feeding tube, but still entirely possible.) And still we made the choice -- no feeding tube. This year he had another swallowing test and we were urged to at least put him on a soft food diet. We declined. Both his geriatrician and his nuerologist supported that decision. (The speach therapist who administered the test was preplexed, but it wasn't her decision.) My husband does not eat steak. He doesn't eat salted nut rolls. He doesn't eat things known to cause him to choke or that he has particular trouble swallowing. But we don't thicken his liquids or puree his solids. This is our choice, made in the interest of quality of life.
Would our choice be the right choice for you father? I have no idea. Each decision has its own set of problems, and its own rewards. Make your decision in love, and in your knowledge of your father. Then don't beat yourself up over it. We can only do our best.