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Is this the end for my Dad?

User
Posted 15 Mar 2019 at 22:15

Hi All

My dad is 90 years old, diagnosed with prostate cancer 2 years ago.  It was only discovered when he almost died of kidney failure due to being unable to pee, he didnt tell anyone there was a problem. He underwent a TURP operation which removed the need for a catheter and his consultant advised that due to his age any cancer treatment would be too gruelłing, he would most likely die of something other than prostate cancer, he was put on watchful waiting. 

Dad has done amazingly well during the last 2 years, able to walk daily and keep himself active, loved a wekly pub lunch with me and took on the care of my mother who is 8 years his junior.  I am the youngest child of 5, i have a great relationship with my Dad and have been the one by his side through every step of the way.

Since Christnas Ive noticed small changes in Dad's health, problems with walking, this could be due to old age.  However in the last week or so Dad has become more immobile.  He looks pale, he only eats 1 bowl of porridge a day, he sleeps most of the day, he is breathless, he is unbalanced, he got angry with me today for the first time ever!

I'm concerned that things are taking a turn for the worst and I asked Dad to see a GP.  He refused and said that no matter what happens he doesnt want me to get medics involved, I think he is afraid that he will be taken to hospital.  The problem I have now is how to move forward, I believe that the end of Dad's life is approachimg and whilst at the moment he appears to be pain free what do i do if things worsen and he still asks that I dont inform his doctor. 

Ive no idea what the end of life will be like for Dad, I am scared and dont want to make the wrong decisions.

Thanks for listening

Jane

 

User
Posted 16 Mar 2019 at 02:38
Can you try to persuade him that this is probably a urine infection that can be sorted out easily with some antibiotics but which could kill him if left untreated?

Has he been having his PSA tested regularly? Does he discuss the scores with you?

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 16 Mar 2019 at 02:42

Doesn't sound particularly prostate related. (Well, anemia could be, but he'd have other symptoms before that.)

It is worth pushing for him to get checked out though. Something like a simple urinary tract infection can have all sorts of seemingly unrelated side effects, but would probably be easy to treat with a course of antibiotics.

Even once you know what the cause is, he doesn't have to accept any treatment for it if he doesn't want to, but it might be something really trivial and easily sorted out.

User
Posted 16 Mar 2019 at 08:33
Jane, this just sounds like a natural consequence of reaching one's 90s, unfortunately. It seems very unlikely to have anything to do with prostate cancer (which the overwhelming majority of men of his age have, by the way).

I understand exactly what you mean about reluctance to seek medical advice. My Dad is 88, and he's exactly the same. I think it's a generational thing! Could you perhaps see if you can arrange for your Dad's GP to ring him?

All the best,

Chris

User
Posted 16 Mar 2019 at 10:36

I can imagine how hard this must be for you, and I give you my thoughts which are written on the assumption that he is quite clear in his mind ...  Fact is, many old people - far more than most people imagine - make a conscious decision that 'enough is enough', and decide to let nature take its course.

Whatever is ailing him, you do not want your last days / weeks / months with him to be a memory covered in fights and broken trust.

So long as he seems comfortable, do try to respect his wishes: I'm no mind reader, but I suspect that he is dying, that he knows he is dying, and wants to do it on his own terms.

And why not? What ever happens at the end will be a difficult time for you, but you'll make it easier for you both by letting him have control.

Of course it would be a very different matter if he was in pain or distressed, in which case you may need to reassess.

I'd suggest that you let him know that you want to respect his wishes, and ask his permission to get a nurse to see him, just to see if anything can be done to make him more comfortable - if you talk to your local hospice, I'm pretty sure they could arrange that - and, failing that, your GP may be able to arrange something.

This is a time to be sharing fond memories, or just being together, not necessarily a time for needles and tests.

I'd like to add a caveat here - I could be completely wrong: you can read him better than any of us, and you must do what feels right to you, while respecting his wishes as far as you can.

Edited by member 16 Mar 2019 at 12:48  | Reason: Not specified

User
Posted 16 Mar 2019 at 21:38
Thank you all for your replies, very helpful. I saw Dad today, he looked so poorly, still not eaten. Another worry is that his lower legs are swollen. We had a good chat and he has agreed to see his GP.
User
Posted 16 Mar 2019 at 21:58
The swollen limbs could be oedema which can be a sign of heart failure or of lymph node mets.

If possible, try to see the GP with him so that you can discuss the thing about him not wanting to be taken to hospital. If something happened and you didn’t call an ambulance out of respect for his wishes you could be investigated by the police, so it is important that his medical notes start to record what he wants and how he feels. I had a friend who was investigated for manslaughter after her mum died because she hadn’t called 999. Her mum had terminal cancer and it was her strongly voiced preference but the police investigation hung over her daughter’s head for many months.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 16 Mar 2019 at 22:02

Thank you Lyn, I will definitley be with Dad when he sees the GP.

 
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