Advanced care plan

Can I ask who suggested this? Specifically rather than “the hospital”? It is significant.

Hi. It was the Hospital Dr rang me before she was discharged.

In the heart unit? Or was she on another ward?

Yes it was on the cardio ward.

I find this disturbing, the hospital are picking who they will or won't treat.
Chances of survival are low if left at home and they are shifting the care on to the family.

Yea it seems barbaric to me. It’s really upset me, I’ve hardly slept for the last two nights.
I’m going to have a chat with her Gp anyway as she has to have her bp checked next week. I’ll see what he thinks about it.

It’s a very personal thing to discuss on an open forum and I’m conscious that I would only be speculating on your Mums condition.

If you could talk to the GP that would be good. Can I also suggest talking to a specialist advisor on the British Heart Foundation helpline.

0300 330 3011

?

I have sent a PM Katyj.

Thank you H and Lathyrus.

A full Advanced Care Plan is about much more than opting in and out of hospital/home/medication preferences. It is a safety net to have one in place to and to be very specific about one's wishes. Several models are available online.

One thing I’d certainly want in any care plan for an elderly relative (I specified it for my mother with dementia) would be no resuscitation (chest compression).

Reason for that is that a neighbour in his 80s was given this after a 2nd heart attack, and told me later that the after-effects were so painful (presumably cracked or broken ribs) that he wished they’d just let him die.

He did in any case die just a few months later.

I can understand why you are very concerned about this Katyj!
Treating Her at home with morphine does not bode well. You are correct to speak to the GP about your Mum. Lathyrus has sound advice about ringing the British Heart Foundation Helpline. This must be a very frightening time for you and your Mum , access all the help / advise and support available. Please do not be afraid to voice your fears and importantly your opinions and wishes of your Mum . I wish you both well.

Thank you Shelflife. I must admit it’s on my mind a lot. I have a phone GP appointment next Friday so hope everything will become clearer. Mum isn’t too keen on the idea but said yesterday that if the pain was severe, she may be glad to take it.
But what then, if it didn’t relieve the pain I’d still have to call an ambulance. So many ifs and buts the moment.

if your mother has capacity to decide, he/she shouldn't have been discusing this with you but with your mother.

greenlady yes that’s point. She has got capacity at the moment although very forgetful. The hospital Dr advised me as a family, we should sit down together and discuss, but there’s only me.
But it’ll be her decision to accept the morphine at home or not. If she has it in cupboard at home it’ll be up to her wether she takes or not.

I can understand you are alarmed but I hope that when you talk to the GP you will be reassured. This advanced planning is not intended as a way to ‘write someone off’.
My mother had dementia but even right to the end she had sufficient capacity to make most decisions, your mum must be involved.
My elder son is a doctor, he has described to me what can happen when resuscitation is attempted on an elderly, frail person. His description was horrific and he has felt traumatised by what he’s been forced to do…
When my mum lay dying I knew the time had come, however much I didn’t want it to have; to focus on my mother’s comfort. She didn’t need needles being stuck in her and she certainly didn’t need aggressive and futile heart compressions which broke her ribs and forced blood from her little nose.
After my mum passed dad who had prostate cancer lived with me, when he decided to refuse anymore treatment I knew what he was doing and so did he. I didn’t attempt to argue with him although his GP did make clear the consequences of his decision. Our parents are adults and should be respected as such.
I hope your mum lives a good long while, well. I can understand that you may feel that this talk of advanced planning may mean you could lose her imminently, but usually it’s just a way to safeguard against making rash decisions in highly emotional circumstances.
This is a very tough stage of life, sending you a handhold.

Thank you Bluefox. Yes mum decided a while ago to put a DNR in place it is on her records because as you say no one wants to go through resuscitation at 90 with little chance of recovering.
I’m beginning to understand now about Advanced planning I’d never heard of it before.
She has said though that she’d be too scared to stay at home, maybe alone, if I wasn’t around. Whilst having a heart attack, I don’t blame her.
If she was in a care home, it might be different, but she won’t hear of moving anywhere let alone a care home.
It is very difficult, she had more chest pain last night. I spent the whole night with one eye open expecting the phone to ring. It hasn’t so hopefully she’s okay ?

Bluefox excellent perceptive post.

Katyj

Thank you Bluefox. Yes mum decided a while ago to put a DNR in place it is on her records because as you say no one wants to go through resuscitation at 90 with little chance of recovering.
I’m beginning to understand now about Advanced planning I’d never heard of it before.
She has said though that she’d be too scared to stay at home, maybe alone, if I wasn’t around. Whilst having a heart attack, I don’t blame her.
If she was in a care home, it might be different, but she won’t hear of moving anywhere let alone a care home.
It is very difficult, she had more chest pain last night. I spent the whole night with one eye open expecting the phone to ring. It hasn’t so hopefully she’s okay ?

Your mum wants to stay in familiar surroundings, I get that totally. I also get absolutely your concern, at one stage in my life if I saw or heard an ambulance I was covered in worry that it was headed for my parents, even now after I’ve lost them both it still puts me on high alert.
Please talk to your mum about your concerns, try and find solutions for worries you have. I found Age U.K. helpful.
If your mum is content to take certain ‘risks’ in order to stay out of residential care then that should be respected.
Tough times, big love. X

If I was your grandmother I'd definitely want to come home.,
Hospitals are hot beds of infections and I'm sure she'd be more comfortable in her own surroundings.

Good luck with whatever you decide to do

My husband has just returned home from hospital and on the form for the drip said no respect form not in place. We’re assuming it’s something like dnr but don’t know.
Poor bloke, he’s 69 had major abdominal surgery in October and then got infection in his heart valves.
I think it’s a bit early to be thinking about this,and it has quite worried me.He only feels his age when he’s I’ll,otherwise he could do more than most 45 yr olds,are they asking them?

GrannyLaine

Bluefox excellent perceptive post.

I agree GrannyLaine.

Hi sleepygran. I’ve just found a no respect form in mums notes that she brought home from hospital.I’m wondering if this is the same as the advanced care plan form the the Dr mentioned. It does say in there she has severe artery disease and a DNR is in place. Hopefully I’ll find out on Friday when I speak to her GP. Hope your DH goes from strength to strength