Dialysis and CHF experience

Voltex

Hi..Im just wondering if anyone else has had a similar experience to that of my mother?

Basically she has been very unwell for 18 months suffering from a large range of illnesses..but the most serious at the moment are; renal failure (she has maintenance dialysis 3 days a week), a large aortic aneurysm and congestive heart failure (I think her heart function is about 8-10%).

She has been in a nursing home for the last 6 months as she is unable to care for herself, but has also been admitted to A&E at least 5 or 6 times due to pulmonary edema and hyperkalemia (the latter giving her medic team the most concern). She is unable to walk and requires supplemental oxygen a lot during the day...but beyond all the above, she is mentally ok and completely with it - although the mental strain on her is starting to become very obvious.

The second last time she was admitted to A&E, one of the ER docs told me that my mother was really quite ill and that the team had advised on a DNAR in the event she arrests..and now last night in the nursing home, one of the nurses asked me to have a think about signing a DNAR for them..I understand why this is the best option, but still a bit shocked at being asked out of the blue.

Im her only child and apart from an uncle, we're her only family - so we dont exactly have a large family to lean on or get advice.

I suppose the question Im asking is if anyone has had similar experiences..and what I can expect in terms of remaining life..as always, when I ask the doctors, they're always non commital

Arbie

Voltex wrote: »

Hi..Im just wondering if anyone else has had a similar experience to that of my mother?

Basically she has been very unwell for 18 months suffering from a large range of illnesses..but the most serious at the moment are; renal failure (she has maintenance dialysis 3 days a week), a large aortic aneurysm and congestive heart failure (I think her heart function is about 8-10%).

She has been in a nursing home for the last 6 months as she is unable to care for herself, but has also been admitted to A&E at least 5 or 6 times due to pulmonary edema and hyperkalemia (the latter giving her medic team the most concern). She is unable to walk and requires supplemental oxygen a lot during the day...but beyond all the above, she is mentally ok and completely with it - although the mental strain on her is starting to become very obvious.

The second last time she was admitted to A&E, one of the ER docs told me that my mother was really quite ill and that the team had advised on a DNAR in the event she arrests..and now last night in the nursing home, one of the nurses asked me to have a think about signing a DNAR for them..I understand why this is the best option, but still a bit shocked at being asked out of the blue.

Im her only child and apart from an uncle, we're her only family - so we dont exactly have a large family to lean on or get advice.

I suppose the question Im asking is if anyone has had similar experiences..and what I can expect in terms of remaining life..as always, when I ask the doctors, they're always non commital

Probably the most difficult part of providing healthcare is when treating the patient may cause more harm than good. An example of that is resuscitating a very elderly or very ill patient who is likely to have a poor quality of life afterwards. Doctors and nurses may seem non-committal or unwilling to provide answers, but this is usually because the choice must belong to the patient, even if they find that choice difficult to make.

Dying is a difficult issue but it is important to discuss it when the person is relatively well so that you can avoid the pressure of making difficult decisions in a time of crisis. You say that your mother is mentally sound, which means she can make these decisions for herself with your support. I would suggest that together you speak with her GP and the nursing home. You are not the first people in this position, so they most likely have policies and guidelines to help. Ask as many questions as you need to, as many times as you need to. Some people find it helpful to involve a pastoral care team, etc.