Trying to feel my through stuff right now with an uncle of mine.
He is in his late 70's and had a pretty poor run of it.
Some self inflicted, in terms of years of poor diet, no exercise and poor hygiene.
This hasn't directly led to his recent diagnosis but has shrunken the available treatment options to zero.
He spent five weeks in the Beacon with a following diagnosis of Prostate cancer, aggressive, and no treatment aside from hormone injections to shrink the mass, which was causing massive issues for the bladder and kidneys.
This then was "re-assessed" to actually be bladder cancer, and he was discharged from the Beacon with bi-lateral DVTs, a course of anti-coagulants and no plan to manage his CA of the bladder, we were assured it would follow him to the care home.
I rhetorically asked the consultant that the scans and treatment had all been irrelevant as a result, he agreed.
But no new scan for the secondaries from the actual CA and no treatment schedule, and he was discharged to a nursing home to convalesce.
A week into that he continued to deteriorate, with his breathing becoming shallow and he unable to support himself.
Seen by a specialist insitu, he was discharged from there, after 6 days, to the Mater Private where within 5 hours they did more good work than the Beacon did in 5 weeks.
The Dr in the ED took me aside and confirmed secondaries, the palliative nature of his condition, the complex medial needs, the imminent risk to his heart and so on.
Also, a discussion was had on DNR status, and I had that talk with him, which was a most difficult thing.
I suppose I just need to talk about it, hence this post.
Ironically, I am a Clinical Nurse Manager in the real world, and I have managed service users through this process, and recently attended a conference all about it, but it's very very different when you are in the middle of it, trying to be strong, give good advice and try to organise everything else too.
So, I'm doing my best to support him, he knows his condition and what it means, but sometimes seems to not know, it's kinda fades in and out.
I'm at pains not to make decisions for him, but do worry that the way I frame a thing might be making an option a better one for me, rather than him.
This again is ironic, given my line of work and the focus here on capacity, consent and advocacy.
So that's kind of it.
In the middle.
Trying to make him as comfortable and happy as he can be, but not treating him as a child who needs to be protected from hard things, because good decisions and authentic choices can only come from having all the facts.