What to do when a doctor really screws up bad in prognosis?
The doctor also strongly urges that we put Mom on hospice then another says maybe not.
My sister and I were told by a doctor at the hospital she was in ICU at that she had absolutely no kidneys left and that even if we kept her on dialyses her chances of living past 6 months were not there. he suggested we put her in hospice and give her all she needed to be comfortable and let nature run it's coarse. so this was on a Saturday and they had just finished the last treatment that evening. We talked with her and she agreed to do the hospice but wanted to do it at home. We all agreed and went with that plan. My sister and i came home and rushed to get the apt ready for her to come home. We knew it would probably take a bit being it was the weekend then the stress really began because we really hoped we could get her home before her non kidneys and no treatments took her before we could get home. Then come Monday I finally get an assessment by a provider to get the ball rolling and I go to the hospital and we have the talk with her again presenting her the option of staying on the treatments and maybe living a bit longer but in a nursing home away from family and on a machine every other day which she already hated anyhow...or to quit the treatments and come home and die as she wanted to with help and meds for comfort. She asked how much time would keeping up with the treatments give her...I again told her what the doctor had said and she said ok let's do the hospice. Now mind you this woman is only 68 years old...
Then after we have all the papers signed and plans made i was on my way home to wait for the equipment to be delivered when i get a phone call from a different doctor that said he had been caring for her since she got there and that maybe we should know that he had seen an improvement in her that day and that maybe she could last a few years MAYBE on the dialysis and to consider that before having her discharged.
The first doctor had no doubt in his mind that she would not last the 6 months...we made our decision based on that. now this doctor says well maybe we were wrong...?
Do they not understand what they have done to this poor woman by blaintenly giving her a wrong prognosis and making this already insanely difficult situation just that much harder?
Should I seek out legal counsel on this? I feel I should. This kind of mistake is just plain unprofessional. And sadistic.
23 Answers
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I personally have no intention of languishing in a nursing home. I did volunteer work in both nursing homes and hospitals; sick, elderly people were kept alive as though death was an enemy. When the quality of life is gone, they should be allowed to gently, painlessly leave this earth. The way my life ends will be my choice. I was Bill's caregiver for all those years - I will not have a caregiver when I can no longer live independently.
I would never live with my son and his wife and my daughter as a divorced mother who shares custody of of her two pre-teen sons with her ex has a job that requires she travel 10 days a month has way too much responsibility already to have an ailing, aged mother on her hands; I wouldn't do that to her. I don't believe in "life, no matter what!!!" I plan to either take a long walk into the ocean or to simply stop eating and drinking should I be diagnosed with a debilitating disease which would eventually make me dependent on others. Bill wanted to live as long as possible and I made that happen but at great cost. I was hanging on by my fingernails when he died. Had a breakdown several months before his death; doctors wanted to put me in the hospital but of course I couldn't go so instead I had counseling twice a week until six months after his death. No...I don't plan to "gift" the responsibility of keeping me alive, to anyone.
So many people who write in this website say how they've come to hate the person they're responsible for taking care of. Caregiving is by far the hardest job anyone can do. You lose yourself. You're so many things to so many people and your responsibilities never end. Even thinking about what you need or want isn't an option. You don't count; there's no time for you. You haven't the energy, you're too exhausted and are so stretched to the limits of endurance that "you" disappear. I've shed tears over the messages I've read in this website because I understand so well what the caregivers are going through. The toughest responsibilities, by far, are those taking care of someone with Altzheimers. At least I was spared that! My profound admiration goes out to every single caregiver! God bless you!
Again, I am sorry she is having two different opinions, but the human body can surprise even the most gifted doctors. Keep being her advocate...
Doctors are human and make mistakes and have different honest opinions. And I think there are two kinds of doctors - ones who avoid the notion that their patient may be dying and others who are very honest and realistic. You've heard from two very different perspectives and right now you don't know which one is right. But you can still take some time to explore options - again, nothing is cast in concrete. I'm just sorry that you and your family (and mom) have to go through this very difficult time.
You can have one medical case with two different opinions from two different doctors, and of course we would all go with the doctor who gave the best answer even though in the end the other doctor could have been 100% correct.
And in the mean time while trying to decide which doctor is correct, that patient could have an unrelated medical emergency that takes the life of that patient... such as a heart attack or brain embolism.
If the patient is still of clear mind, have the patient decide what she wishes to do in this situation.
My father was in the hospital but wasn't recovering as expected from minor elective surgery. An oncologist came into the room, told us Dad had inoperable lung cancer and had 3 to 5 days to live. This is the first suggestion any one had made of cancer. We were shocked. Dad's geriatrician was still acting like Dad would be going home some. My brother was livid that this doctor we had never heard of breezed in with such harsh news and left. He talked about suing the oncologist for the distress he was causing us. My father died 3 days later, of lung cancer.
You do not know yet, Keepingmyword, how long your mother will last on dialysis. The first doctor's prognosis might still be correct. That there was some improvement needs to be taken into the decision-making process. But you still don't know whether Mother will live another 4 months or 4 years. Even if you get both doctors in the same room and they talk it out, you will still not know. Predicting life expectancy is something a necessary act, but accuracy can never be guaranteed.
We were told that our mother would probably not last the week and she needed to be on hospice care right now. We went that route. She was dismissed from hospice care four months later, greatly improved. My husband was on hospice care at home and the nurses and I all thought he had several more weeks. They were really surprised when I called to tell them he died.
Predicting life expectancy is pretty tricky business.
I am so very sorry that your family is facing this stressful and challenging decision. Hugs to you all.
I can only say what I would do - a brake-screeching U-turn when I got the call from the second doctor. I should go back to the hospital, gather all of your mother's notes, get both doctors in the same room and bang their heads together (metaphorically speaking, of course).
Forget complaints for the time being. Far more important than that is getting to the bottom of your mother's condition and sorting out what care she needs now.
Just one thing: no doctor deliberately gives his patient or their relatives completely wrong information for the sheer heck of it. They get things wrong, and in this case clearly they can't both be right. The first doctor made an assessment and told you what he believed. The second doctor, a little while later, has made his assessment and come to a radically different conclusion. Why in God's name they're not talking to each other I cannot explain, but neither is setting out to distress you or your mother.
Nevertheless, the outcome is distressing and you must be frantic. I hope you'll get some sensible answers out of them very soon. Best of luck, please update.
Who are these two doctors? one the hospital is and one the nephrologist, ie, the kidney doctor? The important question is, who is looking at the whole person and not just her kidneys? Is there a Palliative care team at the hospital who could give you an opinion?
I often find it helpful to ask physicians, if this was your mom, what would YOU do?
What does your mom hate about dialysis? Has she been on it long? Extended periods of being without kidney function can cause very fuzzy thinking. You might want to consider keeping her on dialysis for a bit longer to see if her outlook improves. Unless she has other physical impairments, I think I would encourage her to try to get used to a new normal.
I'm so sorry for all the stress you and your family are going through. We recently had a situation in which one hospital doctor wanted to do extensive followup testing and intervention for my mom's lung problems. She's 91. His older partner said, stop poking holes in your mom.