Anonymous wrote:Thank you for all your replies. My parent is 73 and in Europe.

My parent chose the treatment. I haven’t made any decisions for them. However, the recovery is grueling and staff is reaching out to me to “push parent” to try harder.

I do suspect depression and exhaustion due to poorly controlled pain (I have no say in this and the pain might be due to the type of surgery). It has been heartbreaking for the entire family to watch my parent suffer and I am torn between continuing the recovery and what, at this moment, my parent seems to be asking for. The thing is, if we stop the recovery effort, they would linger in even worse pain.

It seems like an impossible situation.

Doctors claim there is a real chance for a full recovery.

1. You need to push for better pain management. The medical establishment is horrible at managing pain, and I say this as the wife and aunt of doctors. Pain is not their number of 1 priority, and the system is not set-up to allow for optimal and continuous pain relief. Instead of accepting what the doctors or staff are telling you, tell them it's on THEM to give better and more timely pain relief to their patient. .

2. Also, your parent needs to be accompanied. They are probably very confused about what's happening, which is a common consequence of major surgery. Some loving friend or relative needs to coax out of them what they're feeling exactly and what they want, and act as go-between with the medical staff. This can be a very difficult role. My doctor husband has been the go-between for his mother (Parkinson's and cardiac insufficiency) and her specialists, and even with all his knowledge of his mother, and his medical training, it can be hard to address her needs with the right meds, procedures and physical therapy. Sometimes there are no good solutions and his mother cannot avoid pain and discomfort, which is very depressing. She has expressed regret that she ever approved her pacemaker, because now she will die of the consequences of her Parkinson's, which is becoming very debilitating. This is how hard it is.

3. Alternatively, if your parent wishes it, they can go to Switzerland and book an appointment to terminate their life. That is a legitimate choice too!

Continuing PP. Pain management is important especially before PT. Look into what they are doing. 73 isn't that old. I am now 75 and the pain I battled through for knee #1 and then #2 means I am very mobile 10 years later.

You don't say what surgeries but if any were orthopedic, rehab is painful but not doing it for that reason means a bad outcome and chronic pain. I was in inpatient rehab at 65 forva knee and my inspiration was a woman in her 80 who had w redone hip replacement. It hurt but she was game. Shorter sessions but more in a day. She walked out the door.

Depression is real.

The lesson I took from the above experienced is - someday I will get to that point myself.

I've had one grandparent and two parents who in their 80s just "gave up" and lost the will to live. The most recent one was my mom in 2022. She was in a facility locally and I could visit her frequently and try to provide encouragement. But it just didn't take. Refused to eat, refused to get out of bed (which admittedly was hard due to her physical limitations). She would not do what the caregivers asked her to do. Nothing was "very wrong" in her final months. She'd had a respiratory infection but she had recovered from those before. Basically, being old and physically incapable just wears you down mentally. It's frustrating to watch but at some point people are just ready to go and you have to let them go.

Thank you all. You nailed the situation to what is exactly happening (down to “not willing to move and risking new complications due to being uncooperative with physical therapists” - at least this is how it was described to me). I am currently visiting and doing everything in my power to help either way - listening and being supportive.

When my parent got sick, it was fast and hit us by a surprise. Surgery had a tiny chance of survival. I could be wrong, but looking back, I think my parent went in with a hope not to survive and has been in shock with the post-surgery pain and effort that will be necessary to recover.

Things are even more complicated by the laws that have to be followed in this country - no DNR orders and, if a patient shows up at the hospital, doctors are obligated to perform all the necessary life-saving measures. There is an option to refuse the treatment and go home, but no assistance is provided with the pain management unless it is deemed to be end-of-the-life situation, if that makes sense.

I agree with one of the previous posters that open criticism by doctors and nurses is only making things worse (my parent is not more motivated because hospital staff is openly upset with their lack of cooperation).

Even though it makes perfect sense, no one has mentioned a possibility of depression and anxiety and how to deal with it. I will try to ask gently.

As a nurse, I've seen this many times. Between the pain and the difficulty and length of recovery, the feelings of "why bother, I don't want to live the rest of my life like this" can become pretty prominent. Depression in this type of setting is real. Unfortunately, I've also had many patients who have gotten pneumonia or other post op complications from refusing to move or do things, and some have passed.

A few suggestions.

Listen and just be empathetic. It doesn't help at all that people are just frustrated with them. Including the staff. It's not encouraging and it's not going to motivate them. If depression is the trigger, it's going to make it worse. Instead, acknowledge that you understand how and why they feel this way.

If they haven't met with a therapist yet, get one on board. I've seen big turnarounds on patients who end up on some meds to get them through the situational depression

If you, or any of your siblings or close family members don't live in Europe and are able to visit, do it. It will bring a great serotonin boost for them and may give them some motivation.

After these things are done, then it's time to talk to your parent about their wishes. Do they have advanced directives and all that? Do they want their code status revisited? It's hard, and it's sad, but ultimately, the best thing you can do is honor what someone wants for their care. I had to make the difficult decision to not have my dad undergo life saving surgery because I knew he didn't want to live with the outcome of the surgery. It meant he died. Horribly sad BUT I've never once regretted it because I knew I was honoring what he wanted.

Sometimes miraculous recoveries are a disservice to the person going through them.

I followed my mom’s wishes not to be put through extraordinary measures. She was an ICU nurse for 38 years and absolutely did not want to live like many of her patients lived.

Listen to your parent when they are done.

Anonymous wrote:Pain definitely can contribute to this. I suspect it's a normal or at least common reaction to dealing with surgery and pain. Show empathy, but also encourage support services and an evaluation. Even if parent isn't open to therapy, meds can make a big difference and sometimes doctors know how to frame it in a way an elder can handle.

I found it helpful to also get my own therapy so I could be supportive, but not enmeshed and still able to be there for the family I created without feeling emotionally drained.

Forgot to also mention-meds can not only help with depression, but sometimes antidepressants even help with physical pain since so much is intertwined.

Pain definitely can contribute to this. I suspect it's a normal or at least common reaction to dealing with surgery and pain. Show empathy, but also encourage support services and an evaluation. Even if parent isn't open to therapy, meds can make a big difference and sometimes doctors know how to frame it in a way an elder can handle.

I found it helpful to also get my own therapy so I could be supportive, but not enmeshed and still able to be there for the family I created without feeling emotionally drained.

Thank you for all your replies. My parent is 73 and in Europe.

My parent chose the treatment. I haven’t made any decisions for them. However, the recovery is grueling and staff is reaching out to me to “push parent” to try harder.

I do suspect depression and exhaustion due to poorly controlled pain (I have no say in this and the pain might be due to the type of surgery). It has been heartbreaking for the entire family to watch my parent suffer and I am torn between continuing the recovery and what, at this moment, my parent seems to be asking for. The thing is, if we stop the recovery effort, they would linger in even worse pain.

It seems like an impossible situation.

Doctors claim there is a real chance for a full recovery.

How old is your parent? It most countries they are doing difficult surgical interventions on elderly patients. Let your parent recover on their time. If they don't have it in them to fight, then so be it.

Did you choose the interventions, or did they? Are they in a facility or whats the situation?

Surgery and recovery is difficult physically and emotionally— especially for someone who doesn’t feel as though they have things to look forward to. So one thing to do is genuinely empathize with the difficulties of what your parent is going through — and see what things can be made better. It’s hard to be vulnerable, uncomfortable, and dependent. Listening, bringing in familiar foods and fragrances, music, reminders of things they used to enjoy might help. It seems small, but having your own soap and lotion vs hospital stuff can be a mood lifter.

Depression is not uncommon following surgery, so an assessment of that might be in order, along with talking with your parent about what matters most to them, so that you can perhaps provide resources and experiences that they genuinely value. Help them find small things to look forward to. I’m not clear how you’re sure you know your parent’s “true desires”. It does make me feel that you might benefit from some support as well.

It’s hard to make suggestions about the medical staff being “annoyed” — without more info. If this is true. I’ll add, too, that I highly recommend the National Rehabilitation Hospital, so if your parent qualifies for one of their programs, that could be an option as part of their hospital discharge plan. Knowing that their situation can get better — having realistic hope of genuine recovery— could be a key part of regaining a willingness to continue with an arduous process. You might also want to meet with a hospital social worker and a hospital chaplain— to get their support and guidance with a situation that they are likely to be familiar with.

Wishing you and your parent the best during this difficult time.

I am sure this is unique to each individual, but I have a parent who has miraculously survived very difficult surgical interventions. Recovery will not be easy, but now that doctors are optimistic about pretty good recovery, my parent seems to have lost a will to fight to recover.

Please be kind. I know my parent should have a say about their own life, but I feel this is exhaustion talking, not their true desire not to keep fighting. Medical staff is annoyed with the parent’s attitude too.

If you have been there, what helped?