Anyone have to make medical decisions for an elderly relative?

[Historic NY]

I left work early this morning since I have to be at the hospital about 8 or so. My 91 yrs old uncle lives with me, he took my brother and myself in after my father died back in 68. Well for years he had an active political life (Democrat of course). A little after Oct 26th I began to notice he was eating less & less, he only complained about being tired and moving about. I used to leave the paper in the mailbox so he would have to go out and get it. On thanksgiving morning he called his step-daughter and said he didn't feel like going to dinner. He said he was tired and didn't want to have to rush home. Since I work nights I didn't know about his phone call. I asked him if he wanted to go and he said no. I went about getting ready to go and his (s)daughter arrived, she found him lying on my couch (which he has never done) curled up, she took him off to the ER. For several days prior we both had been taking him to his Dr's. for various checks and blood work, they did find a urinary tract infection. Well now I sit here wondering if we made the right decisions for him, he is scheduled for a laproscopic biopsy tomorrow as they found a mass in his abdominal area. I am worried, will he make it through, is this decision in his best interest. The surgeon who is one of the best in the area said they could do a needle biopsy but doing this will allow them to see the mass and evaluate treatment. My uncle tells both me and his (s)daughter to do whats best. I don't know if it is or not. I'd sure hate to mess up. All day I've got calls from different relatives, of course none offering any advice. What is one to do for someone so old? He loves growing his tomato's, believes in the apple a day thing, and was a real chow hound until now. I knew something was wrong when he refused my cooking. We first thought it was from some of his new medications but now we know that may not be the cause. He is not in any pain other than normal movements, hell I sometimes can't get around.

I'm really worried and scared, his mother my grandmother lived to 98.

How do you know your doing the right thing?

[The empressof all]

1. Yes it's hard

But at some point you need to trust. If you are comfortable with the surgeon and your uncle is otherwise healthy it would seem to me he would be in no immediate danger with a needle biopsy. It sounds like you are more afraid of what they might find.

You really didn't say whether he was thinking clearly enough to make his own decisions. At any rate if he is competent obviously it's important to respect what he wants. You also need to realize that your uncle may be putting the decision in your hands because he doesn't want to be a burden in any way to his family. He may need assurance that no matter what you will help in what ever way you can to make his life both pleasurable and comfortable.

I have an aunt who had a leg removed when she was 86. We all thought it would kill her. She lived another 10 years and delighted in chasing her grandkids in her wheel chair.

[azoth]

2. First, I'm sorry your uncle is ill.

More folks could use a nephew like you.

Second, a laproscopic biopsy isn't all that invasive and I'm sure the doctor wants a good sample of that mass. It'll be more accurate than a needle biopsy. I think it's the right way to go.

Finally, get your uncle to discuss what *he* wants in terms of his medical care, treatment, etc. in the event that a serious condition or accident happens in the future. It's important to know what he'd like done so you're never put in the position of guessing. While he's in the hospital, take advantage of the system and find a Patient Advocate or whatever they call the patient representative in your area - talk to them about Living Wills and Advanced Medical Directives. These are legal documents that would allow your uncle's wishes to direct his care in the event that he was unable to direct it himself. He can also name you to be the go-to person if he's ever rendered unable to make his own decisions.

These needn't be scary questions and there isn't any reason to assume the worst. However, at 91 (wow that is so cool!), he does need to be prepared. That is what's gotten him so far, after all!

Best of luck with the biopsy. I hope he's feeling better soon!

[proudtobeadem]

3. Ask him what he wants to do

and get a living will, or because if the worst happens -God forbid, at least you know those decisions were made by him and you are not burdened with that.

[proudtobeadem]

4. Sorry I hit post by mistake, I was going to say Good Luck

[KT2000]

5. The doctor will tell you the results

of the test. Then you will probably have to make decisions about the direction of his treatment if any. But I really think a diagnosis is necessary.
You don't need to do too much right now except gather the information. With all the available information, you will feel confidence with your decisions.

It is not an easy situation. I have a 92 year old friend who broke her hip in a fall. The doctors did not do surgery thinking she would not last very long. She rebounded but was in such constant pain from the break that they ended up doing surgery on her hip. She came through it just fine.

[Erika]

6. He Reminds Me of Saint Francis of Assisi

Don't let him suffer.

[man4allcats]

7. On doing the right thing...

I have been making medical decisions for my mom for 3 1/2 years now. She is in a nursing home and will be 80 on December 27th. The answer to your question is that you don't always know if you're doing the right thing. You try your best to do what you think is right for the particular person you're concerned about and hope the hell you're right. Each person is an individual. What's right for my mom who is bed bound and suffers from vascular dementia may not be right for your uncle who, though 91, sounds from what you say like he manages fairly well. Since it appears from your information that he is in relatively good condition and has some quality to his life, I think your decision to opt for the more comprehensive though more invasive laproscopic biopsy makes sense. If it provides better information for treatment, perhaps it will turn out to have been instrumental in allowing him to have a few more fairly good years. Yes, it is true that he might not survive - a risk in any surgery at any age which admittedly gets higher as we get older. Still, I think you should try to have a little faith in the fact that you did what you thought was best. I know it's hard. Early in my mom's illness, her cardiologist discovered a major blockage in her coronary artery. He said normally with people of her age and in comparable states of health, he would not attempt to clear it because of the risks involved. He asked me if I wanted to go through with it and whether I would be willing to sign a waiver. It was not an easy decision, but I knew my mom would be dead soon if we didn't try. We proceeded, and she came through it fine. She could have died, but she didn't. If she had died I would have been sad, but I don't think I would have felt guilty. I hope everything works out for you. I know how you feel, but don't spend too much time second guessing yourself. It's clear you care a lot for your uncle. In terms of your morality and love for your uncle, you've already done the right thing regardless of the outcome. Doing the right thing has to mean acting out of love and good conscience. You've done that. Best of luck.

[me b zola]

8. A short note

to say that you have already received some wonderful advice, so I just wanted you to know that I wish you and your family well.

[Spinzonner]

9. There probably isn't time if the procedure is tomorrow

but he should make his wishes known about if he wants heroic measures, life support, etc. if there are problems with the procedures. Even low risk is not no risk.

Also, if possible before and surely afterward there should be a durable power of attorney for health care executed where he designates who he wants to make medical decisions if he isn't competent to do so. If he doesn't, by default it would be his next of kin - his daughter. If there are multiple children specifying one will avoid conflicts that leave the medical people with unclear instructions. If he wants you instead of his daughter (especially if she doesn't want the responsibility) you would need to be so designated.

And whoever it is needs to talk with him and understand his wishes and feelings about things and how he would decide things. Hospital social workers may be able to help you with the forms and advice.

And you never KNOW you're doing the right things. Often doctors can't give you exact information or foretell the future and they give you their best guess and the possibilities. You then have to roll it all together and make the best choice you can with incomplete information.

And don't get rushed into things if there's not an emergency situation just because the medical people are pushing it. My mother is in a nursing home with Alzheimer's (moderate) and some physical infirmities. I came in one day and the nurse told be one of the doctors wanted to put in a feeding tube because she wasn't eating well enough and her albumin was low. I thought it sounded drastic and wasn't convinced by a talk with the doctor (by phone). In any case, I didn't see any rush so I said no. I went home and did some web research and found that there are significant complication rates down the road though the procedure itself is relatively safe. It made me more comfortable with my decision and within a few days she was eating more or less normally (being fed) and is now feeding herself though her appetite sometimes comes and goes because of inactivity.

[Stinky The Clown]

10. Look in your heart ..........

..... if your motives are pure, you'll make the right decision. I recently faced this with my mother and got that advice. It worked.

[GingerSnaps]

11. I have to make a decision about my Dad real soon

He has Alzheimer's and dementia. Sometimes he is here and other times he is in his own little world.

I can't take his outbursts anymore and I am getting afraid of him.

It's hard to make decisions on an elderly parent or relative.

I'm sure your uncle with be alright we will all pray for him :hug:

[Historic NY]

12. Thanks all .

He had been in fairly good health for years. He need a pace maker some years back since he had a low heart beat but that was it. A little hard of hearing, but so am I. Mostly he has been active all his life and his great joy is gardening. I used to have to yell at him for overdoing it, but then again that is the way he is, has to do it all today.

Hopefully things will work out, thanks.

[Historic NY]

13. They did the least evasive proceedure - needle biopsy.

Had a very long day on 3 hrs of sleep and travel back & forth between 2 hospitals. The end result they were able to remove about 2 liters ofr fluid before his BP dropped. He was complaining about being hungry, which made me happy. The Dr. ordered him a meal, finally. We are no means out of the woods but seeing him actually feeling slightly better was heartening. I should have results of the test soon and perhaps some treatment options. It doesn't appear surgery is one right now since he is so old and weak. Since he was feeling better I told him I would come in the afternoon so I could get some rest. He agreed.

[AmyDeLune]

14. Warmest Wishes to You and Your Uncle.

In addition to the living will and Advance Directive that others have mentioned, don't forget Power of Attorney! This will give you the power to make sure your Uncle's wishes are carried out and won't be overridden by well-meaning relatives who won't have to deal with the long-term consequences.

Wishing you the Best of Luck and Good News. :)

---Amy