My dad developed MRSA endocarditis with severe sepsis but was responding to antibiotics....but he stopped eating and drinking during this 2 week illness.....he was kept going with IV fluids and dextrose but his albumin was 1.5 - apparently that signifies severe malnutrition....since my dad was a voracious eater before this illness = his weight loss didn't look dramatic...he was a strong muscular almost 90 yr old....but they told me he would need a feeding tube before going back to rehab for 8 weeks of IV antibiotics...…..I couldn't imagine him in a rehab, bedridden with picc line, feeding tube, stage 3/4 bedsore and urinary catheter for what I was told MIGHT work for healing his endocarditis......but perhaps I should have sent him there without feeding tube...since im reading he could have survived a long time without eating...I feel like I killed him prematurely with hospice...I also was never told about parenteral nutrition ie via vein.....I always thought tube was thru the nose and didn't want him to have that pain....but parenteral might have been ok.....I wish I was more educated on all this when I made hospice decision....after the fact, his dr told me the feeding tube wouldn't have made a difference (why tell me then?) and that parenteral would be prone to infection, etc and it would be a revolving door back to hospital from rehab, etc....so confusing what they tell you before and then after they die!
I think you did the right thing letting him go peacefully. Sometimes thats the best gift we can give someone. He was 90 and lived his life.
As Daughter stated "Drs are obligated to give the LO every options." Your dad's Dr couldn't tell you that a feeding tube wouldn't have made any difference in the beginning because they (Drs) can not influence a person's decision. Believe me there are Drs that would love to tell people their opinions but they can't. The decision has to come from the pt or family.
My mother had a surgery in 2012 and was sent home with a feeding tube and she told me that it was painful and she never wants one again.
You did not kill your dad. You made the best decision in a very difficult situation.
Your dad had a long life and now he is at peace. Try to focus on the good memories.
Hugs!!
You are correct about low albumin reflecting poor nutrition. Normal albumin is between 3.5-4.5 & dad was 1.5. Low albumin is associated with increased mortality. The possibility of C.diff is high as well due to prolonged antibiotic therapy and Lord knows how hard constant diarrhea would be for your father to cope with.
Parenteral nutrition takes months to be effective. To me I am not sure it is even worth the cost (& it is expensive). You wouldn’t see a change in his nutritional status for a long long time. Plus it has to be given in a large vein and your doctors were correct in pointing out recurrent infection is an issue. Parenteral nutrition is high in glucose which is perfect feeding ground for bacteria.
He lived a long life. His body fought with all his strength but at 90 he might not have had much.
Pleass don’t feel guilty. You allowed nature to take its course.
I am so so sorry for your loss.
BUT I do not think that can have been true for your father.
I can't know this, I wish I could say something absolutely certain, but it sounds as though your poor father was so sick that even if he had got past the endocarditis, been lucky with that slim chance, he would have been so destroyed by the infections that his quality of life and his life expectancy would have been dreadful. You would have put him through invasive, distressing treatments for the sake of more suffering for a little while longer.
I am as sure as any non-qualified person can be that you made the right decision, in spite of how difficult and complex the decision was to make. I'm so sorry for your loss, and for how it happened, but I honestly don't think anyone could have handled it better - no matter how theoretically knowledgeable you might be, when it's for real and it's your Dad nothing is simple about these choices.
My Mother's false teeth became very loose a while back and I thought about getting her a new pair, but after researching and getting advice from others, I figured at 92, it would be much more trouble and frustration for her to adjust to a new pair of dentures, so for her sake, I decided not to. If she were much younger I would have made a different decision.
I think today, so many people are kept alive a lot longer than they would have survived naturally. I know I would not want to have my suffering prolonged at that age.
Sometimes no matter what you do, its their time. My Mom just wanted to be left alone. Nurse tried to put a bp cuff on her and she pulled her arm away.
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