Advanced Directive says to not give antibiotics

[Anonymous]

I will check with the lawyer but just was curious about this now.

I just reviewed the advanced directive for my remaining parent. The gist of the info says not to perform life-saving maneuvers, including chemo, radiation, antibiotics, etc if they are in an end stage.

While not offering chemo or radiation seems sounds, I actually am not sure if I could deprive them of antibiotics. However, they are a shell of their former self. They sleep nearly all day, have moved into a hospital bed and wheelchair, and require assistance with most (if not all) activities of daily living.

I did not prevent antibiotics from being given to my parent when they were in the hospital and had two infections. Was I wrong?

Is advanced dementia considered an end-stage disease?

Has anyone else been in this situation? What did you do?

It just struck me that, if they get sick again, I would technically have to follow their advanced directive to not give antibiotics??

[Anonymous]

Why would you not respect their wishes?

[Anonymous]

Advanced dementia is a terrible way to die. Its end stage based on your description. You eventually lose the ability to swallow and are likely to get painful bedsores from immobility. I would far rather die sooner of an infection than a lingering death from dementia.

[Anonymous]

I get what you are saying, but the antibiotics are life saving or at least life prolonging. I wouldn't have known this either, and I don't think you will be haunted or anything, but a person who is "living" like that doesn't need their misery prolonged.

[Anonymous]

I get that you don't want to say goodbye to your parent. It's the most natural thing. But it sounds like you're not respecting what they wanted and unintentionally prolonging their suffering. They aren't getting better. They are dying. The kind thing to do is to let them die.

[Anonymous]

I would be pissed if my kids gave me antibiotics in this situation. If I have advanced dementia and can't make decisions on my own... do not give me anitbiotics. It just prolongs the inevitable.

[Anonymous]

There is a reason pneumonia is called the old person's friend.

[Anonymous]

Anonymous wrote:I would be pissed if my kids gave me antibiotics in this situation. If I have advanced dementia and can't make decisions on my own... do not give me anitbiotics. It just prolongs the inevitable.

+1 an infection is a blessing in this situation. My MIL did not want to be kept alive so when she got a kidney infection, the doctors recommended hospice. FIL would not accept it (MIL not able to make her opinion know and family has ultimate decision despite living will), insisted on the antibiotics, and she went on to live another couple miserable years.

[Anonymous]

I lived through my mother's dementia and have decided that I will put in no antibiotics once I am determined to be at stage 6B. I would much rather pass quickly of sepsis than be continually revived, only to have what little functioning is left decline even further.

[Anonymous]

Your parent wants pain relief.

Not life-saving or life-prolonging interventions (and those include antibiotics).

Please be there are much as possible to insist they get sufficient pain relief. Death is usually painful.

[Anonymous]

Anonymous wrote:Why would you not respect their wishes?

Do you not understand how awful it is to be the person making the decision for them?

[Anonymous]

Anonymous wrote:Advanced dementia is a terrible way to die. Its end stage based on your description. You eventually lose the ability to swallow and are likely to get painful bedsores from immobility. I would far rather die sooner of an infection than a lingering death from dementia.

Thank you. In the case when they had the infection in the past, the assisted living sent them to the hospital. By the time I arrived in the ER, treatment had been provided already.

Perhaps I need to remind them of what the advanced directive says and what her wishes are.

OP

[Anonymous]

Anonymous wrote:I will check with the lawyer but just was curious about this now.

I just reviewed the advanced directive for my remaining parent. The gist of the info says not to perform life-saving maneuvers, including chemo, radiation, antibiotics, etc if they are in an end stage.

While not offering chemo or radiation seems sounds, I actually am not sure if I could deprive them of antibiotics. However, they are a shell of their former self. They sleep nearly all day, have moved into a hospital bed and wheelchair, and require assistance with most (if not all) activities of daily living.

I did not prevent antibiotics from being given to my parent when they were in the hospital and had two infections. Was I wrong?

Is advanced dementia considered an end-stage disease?

Has anyone else been in this situation? What did you do?

It just struck me that, if they get sick again, I would technically have to follow their advanced directive to not give antibiotics??

It sounds like hospice would be the right choice, which would mean no future hospitalizations, and no antibiotics.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Why would you not respect their wishes?

Do you not understand how awful it is to be the person making the decision for them?

I'm sorry OP. I'm not PP but I do know how awful it is to have to make these decisions. But with the advanced directive, your parent already made the decision. You just have to honor it.

[Anonymous]

Please follow your parent's wishes. I know how hard it is when you know that it may cause their end of life.

I had to make that decision for my dad. I said no to a life saving surgery because I knew he would not want to live with what that surgery would do to me. It was difficult knowing he would die by my declining it, but I've always felt rather peaceful about his death because I knew it would be what he wanted.

I'm also a nurse and have seen this professionally many, many times. Please, please respect their wishes. They are ready to go, that's why they made those choices. Going against them, and prolonging their life is for you, not them. And that's really unfair.

See if you can get a palliative team involved in your parent's care. They can help walk through decisions and choices that can/need to be made.