Anonymous wrote:

Anonymous wrote:I'm a social worker in a nursing home and I do advance directives daily. When discussing palliative care, families often choose no antibiotics because they have also chosen no labs, which can be painful. If we can't do labs to find out what infection is present, we can't give antibiotics for it.

You can give antibiotics. This isn't true.

It was true in our case. Assisted living did a test for uti. The lab did not come back so they sent parent to the ER, which dispensed drugs. In other words, assisted living doctor did not dispense antibiotics without labwork.

OP

Anonymous wrote:

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've made that decision. My dad died suddenly and unexpectedly because I followed his advance directives. It actually made mourning his death easier for me. I was glad I respected his wishes and knew I did right by him. And that brought me a sense of peace.

My sibling did not and my dad had a massive heart attack. The doctors said let him pass and my doctor sibling refused, made him go through surgery to have to be on a vent for two weeks before she agreed to let him go. They weren't close so it was about her, not him. His advanced directive said no life saving measures in these situations. Its a blessing not to suffer when you die.

Anonymous wrote:I'm a social worker in a nursing home and I do advance directives daily. When discussing palliative care, families often choose no antibiotics because they have also chosen no labs, which can be painful. If we can't do labs to find out what infection is present, we can't give antibiotics for it.

You can give antibiotics. This isn't true.

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.

Sad but true. Don't let them linger for your needs/wants. They cannot talk, they cannot go do the bathroom on either own, they are scared because they don't understand anything...

Anonymous wrote:

Anonymous wrote:

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.

Thank you. This is helpful.

I was also thinking I could share the directive with others in the family because there are some mentally ill relatives who would say horrible things about me for following the directive.

OP

It is hard, and I have been there, but you made a commitment. If people are going to talk about you that can’t be your priority. If that’s kind of behavior, you’re expecting I would not share the advanced directive with them because they will just try to twist the words to mean what they want them to mean. Your answer to anyone who questions you is that you are acting consistent with your parents wishes and the advice of their medical team. Your sole focus at this point is the comfort of the parent who trusted you to take care of them when they could not take care of themselves. People need to get on the train or get off the tracks. Do not let them suck your energy.

Anonymous wrote:

Anonymous wrote:

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

Thought that was flu.

It's pneumonia, which can follow flu

Or Covid.

I'm a social worker in a nursing home and I do advance directives daily. When discussing palliative care, families often choose no antibiotics because they have also chosen no labs, which can be painful. If we can't do labs to find out what infection is present, we can't give antibiotics for it.

Anonymous wrote:

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

Thought that was flu.

It's pneumonia, which can follow flu

Anonymous wrote:

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?

Yes, that’s why you write down your wishes.

Good point.

OP

Anonymous wrote:

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.

Thank you. This is helpful.

I was also thinking I could share the directive with others in the family because there are some mentally ill relatives who would say horrible things about me for following the directive.

OP

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?

Yes, that’s why you write down your wishes.

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

Thought that was flu.

Advanced dementia is a horrible, drawn out death. If i had severe sepsis (the kind that kills you in 24 hours if untreated) it would probably be a very merciful death if I had dementia.

Antibiotics can have both curative and palliative effects. One of the problems with advance directives is that they cannot possibly cover every future judgement call.

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've made that decision. My dad died suddenly and unexpectedly because I followed his advance directives. It actually made mourning his death easier for me. I was glad I respected his wishes and knew I did right by him. And that brought me a sense of peace.