Reply to Advanced Directive says to not give antibiotics

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[quote=Anonymous]I actually had to make this exact decision for a parent in almost the exact same situation. It's really hard when the parent has comorbidities that cause suffering like a UTI.

First time they had a UTI that went septic, I did IV antibiotics. Made that choice because it seemed at the time that it would cause less suffering.

Second time, I did not. Basically, the previous hospital stay for sepsis caused their condition to deteriorate and I decided no more hospitals, etc. I wanted a calm, supported passing. To do IV antibiotics again, I would have had to take them off hospice (oral was fine on hospice at my discretion).

Well, it didn't exactly go that way.

I had to push very hard to get the pain meds where they needed to be. Parent had a high tolerance to opioids. I familiarized myself with signs of pain in nonverbal patients. I had to basically sit there for the full time it took them to pass (4 days) making sure meds were administered at the first sign of a grimace (this was in a memory care place -- they were asleep/nonverbal). This was with a top rated memory care/top rated hospice.

I just want to say, these answers aren't easy. They are hard. Sometimes you make the wrong ones because you are doing the best you can. The parent may have made a boilerplate advanced directive and never talked to you about it or what they truly wanted. Of course, no CPR is clear cut. But other stuff is more of a gray area. It's really hard. Take care of yourself! I flip flopped on a lot of stuff, because this decision is one of the hardest you will make![/quote]

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