No more intervention

LisaLH · January 18

So my father is a type 2 diabetic, stage 7 c or d(per hospice), possibly in heart failure and on Hospice for 4 weeks. He is in a memory care facility and eats well(too well, big boy:). They have to work hard to get him up and to breakfast or at least get some OJ in him every morning because of low blood sugar. Hospice nurse goes twice a day because he use to require insulin 2 x per day. Its never high enough in the morning for them to give it to him or at least it hasn't for a few months. Last weekend Hospice nurse called me and said they couldn't get him awake, do I want him to go to the hospital? I said I would rather he didn't. She said EMS could come and give him something to get his blood sugar up. I said OK not really knowing any different. After talking to the EMS supervisor he made me realize I could of let him pass peacefully in his sleep. Those are my words not his. He just wanted me to know since I wouldn't send him to the hospital that he could go into cardiac arrest if it went down to 31 again. I spoke to hospice and they agreed I could have done that and he would have died in his sleep. Unfortunately the nurse that was there last weekend had never worked with my dad so she didn't suggest it. The facility(not hospice) is not real happy about my decision. My dad is a favorite. I talked to one of the Hospice nurse about what would happen if he doesn't get any insulin and it gets too high/ketosis. She said it would be similar to it being so low but I got the impression it would take longer for him to pass. Currently they are still giving him insulin in the late afternoon/evening because it gets real high. I've discussed it with family members and they are all in agreement for him to pass as peaceful as possible but honestly the sooner the better. Its breaking all of our hearts to see him like this. I want to do what's best for him. I am his POA and he has a DNR. I would like to know everyone's thoughts on this?

SiberianIris · January 19

I'm so sorry you're at this point. If I were to ever find myself in this situation with my mom in MC, I would want her to pass as peacefully as possible. That has been her wish since before she had dementia. I would want the same for myself as well.

Quilting brings calm · January 19

I woukd continue with the afternoon insulin shot - but I would work with hospice to NOT wake him up if he is sleeping- or unconscious. The hospice nurse that asked if you wanted him to go to the hospital or have EMS called basically ignored the hospice concept of giving comfort care rather than curative care.

terei · January 19

If it was my dad, all meds including insulin would stop

Chance Rider · January 19

My husband is T2 diabetic. He’s only late 4, early 5, but at 7 c or d I would stop meds with the exception of for comfort.

H1235 · January 19

I’m so sorry you are in this situation. You are facing some incredibly difficult decisions. Regardless of what you decide, go easy on yourself. There is no “right” answer. Do what you think is best and try not to beat yourself up over the decision you make.

harshedbuzz · January 19

@LisaLH

The answer is the one your dad would have chosen for himself.

Making the choice to optimize the odds of a peaceful passing is what many of would and have chosen. While I can appreciate that staff do become fond of their residents, your father's wishes should be honored.

If you have concerns about the MC in what are likely his final days, you might consider a hospice house instead.

HB

LisaLH · January 19

https://alzconnected.org/discussion/comment/263854#Comment_263854

My father would be so mad to know I've let him go this long and spent so much of his money but until he went on hospice there wasn't much I could do. He was a tightwad:)

LisaLH · January 19

https://alzconnected.org/discussion/comment/263831#Comment_263831

Can I ask why you would continue the insulin? I know nothing about diabetes so any information is helpful. Thanks

Quilting brings calm · January 19

https://alzconnected.org/discussion/comment/263875#Comment_263875

I guess I would consider it a comfort thing. What was Hospice’s reasoning for continuing the insulin shots? I assumed they had one.

LisaLH · January 20

https://alzconnected.org/discussion/comment/263921#Comment_263921

Honestly not sure. I'm new to this but I know the hospice nurse I met with first, when discussing about taking him off all insulin, she said I could but she said something to the fact of intervening if it got to high. I know nothing about Diabetes and wish I could find a nurse that knows a lot about it so I could ask questions. Sometimes I feel between the facility and hospice they are trying to keep him alive. My cynical husband says its all about the money.

harshedbuzz · January 20

@LisaLH

Do you have a PCP you could ask about this?

LisaLH · January 20

https://alzconnected.org/discussion/comment/264000#Comment_264000

I don't unfortunately. I am going to find someone. Just like today the hospice nurse called me and said his blood sugar was over 100 the last 2 days. That hasn't happened in months. I think the facility is feeding him before bed to ensure his blood sugar isn't low. They have done that in the past. Not sure how I feel about that. Seems like an intervention of sorts.

No more intervention

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