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My 98 year old WWII vet uncle cannot swallow due to car accident. Otherwise he is fine.  He uses his tablet, sings, recites poetry, and tells stories from his life. He still gets out of bed (with assistance because he is weak from no food) to use the restroom. He cannot swallow. The doctor has not mentioned any physical damage to his throat, but tests indicate that he partially aspirated the test fluid when he attempted to swallow. Before the accident he was driving (though he should not have been), self sufficient, and pretty much doing whatever he wanted. He has not been able to swallow and has not had anything to eat for over two weeks. Why won't his doctor give him a feeding tube? He has gotten IV fluids and glucose. They say that they would have to sedate him to place the feeding tube and feel that he might not survive this. My uncle has stated that he had rather die trying to do something that will help him live than starve to death. The doctor recommends hospice with no IV fluids. I just do not get it!

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Get his doctor and your uncle together in the same room and ask the doctor to explain in front of you, as your uncle's advocate, why he is withholding treatment that his competent patient has requested.

One way or the other, that should explain a lot. Either the doctor will accede to your uncle's request; or it will become clear to you why it is impossible (or strongly inadvisable) for this to be done.
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Unfortunately some doctors see a 98 year old with swallowing difficulties as someone who has entered end of life without bothering to take into consideration who they are and what their overall health had been like before. As already stated, either get this doctor to explain himself or get a different doctor. If the doc refuses to meet with you in a timely manner then get the second opinion immediately.
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The doctor states that he may not survive the feeding tube procedure. That is the only reason that he will give. My uncle told the doctor that he did not care and would rather die durring a procedure, that can save his life, rather than starve to death. They are testing his heart function today. I am hoping his doctor will change his mind if the results are good.
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"...may not survive..." doesn't quite cover it. "I'm not doing this because for other medical reasons it would be futile and it would risk causing my patient further needless injuries," on the other hand, would cover it; but he can at least do your uncle the courtesy of explaining himself in full.

I'd ask (assertively, if need be) for a second opinion.
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This has been a hot topic on another recent thread, the procedure to install a feeding tube is apparently quite simple and should not come with the dangers associated with major surgery. If your uncle's functioning was truly as high you are telling us then ditch this doctor ASAP.
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My mother survived a physically devastating stroke, was mentally intact, but couldn't swallow. She was quickly given a feeding tube for her water and nutrition. This was a quick and easy procedure. (Done when the docs believed she would recover from the stroke) Sounds like you need another doc, and soon.
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Gbmcmaha, I believe you should go along with your 98 year old Uncle's wishes.   He doesn't want a feeding tube.   He probably feels he had lived a good long life.   He  doesn't want to spend the rest of his life without ever tasting food again.

My own Dad passed away from aspiration pneumonia, which means any food or water would go into his lungs.   Poor Dad was coughing all the time and he would become very exhausted from that.

My Dad was also in his 90's and Dad said it was time for him to go.   So I respected his decision, as tough as it was.   Dad had a Living Will that spelled out his last wishes.  Plus Dad just couldn't picture himself never eating his favorite mashed potatoes and gravy. 
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But FF, the uncle has told the OP that he *does* want the procedure - better to die trying, he thinks, than to lie down and wait.

Let's hope tomorrow's test results are helpful.
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I really think it would be unethical for a doctor who believes that a procedure will be futile at best and harmful at worse to perform that procedure. Some might for the fees involved, I suppose, but I consider that unethical.

Another doctor may have a different outlook and be able to perform the procedure with a clear conscience, especially as it is your father's strong wish.

I think consulting another doctor is the next step.
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A small tube can be put through his nose for feedings and removed afterwards. Some people learn to put it in themselves. Normally at 98 I would agree to let him die but since he is so aware and able to do so much he should not be starved to death.
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Yes, his personal desire for feeding tube is the key here. Most people say they don't want that--is this to be a nasal feeding tube, which is usually temporary until patient recovers enough to swallow, or a gastric feeding tube which is there for the duration? The latter requires surgery, and perhaps the MD is concerned about anesthesia with this patient. My husband had requested no gastric feeding tube after a stroke left him unable to swallow, so he did not live but two weeks after the stroke....but he was not hungry, and his mouth was cleaned and moisturized for comfort.
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If ur Uncle is of sound mind and physically OK I don't see why he won't do the procedure. The previous discussion about feeding tubes was that they are more harmful than good if the patient is in the final stage of life. Their bodies can no longer handle food. Is this doctor his primary? Or a hospital/facility doctor? If not primary, call his primary. Tell him the situation. Even if he doesn't have privleges at this facility he probably knows a doctor who does. These facility doctors never look at the patients history. In the medical field today you have to be your own advocate. If it doesn't look right or seem right it probably isn't.
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Get another Doctor if you can find one who believes in a right to a healthy life for the elderly. Take whatever steps necessary to get him help. My Mother is going to be 100 years old in October. Her Eye Dr sent us to a specialist for Glaucoma who said that even though her condition was severe he wouldn't do anything for her because of her age. She was losing her eyesight due to a bad attitude and improper administration of her eye drops at a Personal Care Facility. We took Mother to a leading specialist in Glaucoma in a practice associated with a large University. He wrote a letter to the Facility asking for an intervention with me giving Mother her eyedrops as I had done for two years when Mother was forced out of her Independent Living apartment and in to Personal Care. They said "no" and they would not allow me to watch as Mother got her eyedrops. They further retaliated by cutting my hours to be with Mother in Personal Care from 8 am to 8 pm seven days a week to 11:00 am until 2:00 pm weekdays with no visitation on the weekend. My son stepped in to help us. We removed Mother from that facility and placed her in another facility in Assisted Living (similar to Personal Care but with more attention to the resident) where she is getting top notch care. Mother was having visual hallucinations at her former facility which was diagnosed as a Charles Bonnet Syndrome. It is the last stage before blindness. Mothers' Glaucoma has stabilized and she has not had a visual hallucinations in the new facility. The Specialist had scheduled Mother for a Laser Procedure and per out last appointment he congratulated us that we resolved the situation. Don't let anything stop you from getting your parent the care he needs and hooray for him for wanting to live. I am with Mother every day and I watch as the Nurses properly administer the eye drops. I had to coach them at first as the Dr. had coached me. They are all in. It was no easy job getting Mother out of the facility where she has lived for 15 years. They had there hooks into the family and did not want to let go. They made a personal attack on me. Mother is the winner for getting out of a bad situation. She made up her mind she wanted her sight and that she wanted me to be with her more than 4 hours a day only 5 days a week. She is regaining her health and vitality in a better facility. My Greatgrandpa on my Mothers side lived to be 106 at a time when life spans in the US were to the 50's and 60 was considered very old. Be creative and keep searching for answers on the internet and elsewhere. It was through getting ideas through Aging Care that we were able to focus on a solution. We will keep you and you parent in our prayers.
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It has been 25 days since Gbmcmaha posted this question, and there have been no updates since that time. I think by now the issue has probably been decided one way or the other.
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Get him to the ER right away. Yes, he's 98, but at least give him a chance at a feeding tube. This elder is EXTRAORDINARY!!!! I have never, ever heard of an elder who has the ability to use a tablet! Amazing centenarian!
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'Fraid so, CW.
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Update... We got mY uncle to the ER and he agreed to the feeding tube once he realized that it would be through the belly. He spent a few weeks at a nursing home. Now he is at home, walking, doing stairs, externally is fully healed, and is working on swallowing therapy. I think the next hurdles will be financing and the anterior spurs on his spine in his throat. I believe he was already having trouble swallowing before the car accident and the airbag trauma exacerbated the trouble swallowing due to the spurs. Now I need to convince him to have these spurs removed. The spinal practice states that this surgery will be minimally invasive through a small incision. Wish us luck. What do any of you think of gofundme?
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Does he not have Medicare and Veterans medical benefits? What requires financing?
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The laser spinal surgery is not covered. Also, I wanted to thank everyone that has given their advice. It helps to hear from others. For any that are interested, the following is a link to a video of my uncle when he was 95. I hope to have a new one after this weekend. 

https://www.youtube.com/watch?v=2hc0QcOa4Vw&sns=em

The link must be entered all on one line in your browser's address field. If the link to YouTube does not work, it is under one of his niece's accounts; jackrtmama on YouTube.
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I know of stem cell therapy that was funded through Justgiving - it was for someone from my old school, so I chipped in my modest tuppence. Maybe it's a generational thing, but I do get collywobbles at the thought of respectable healthcare being funded by a whip-round. Still, here we are in the 21st century, and if social media can help then why not? Make sure you follow all the security and safeguarding instructions to the letter, won't you.

And thank you for the update: it is so good to hear, at the very least, that your uncle is home and looking forward. Well done!
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I'm glad your uncle is doing better, but, earlier you said your uncle wanted the feeding tube. Just now you say that once at the ER, he was convinced to get the feeding tube. I'm confused. So, was his doctor actually refusing to do one or was it your uncle's decision?
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Go for "Go Fund Me" if needed. A 98 year old has a right to life. So many Dr.'s and senior facilities take the easy route and says let them die. I had to fight for my Mother's right to change her health care directive that would have placed her on the death row when she was admitted to the hospital when she had pnemonia. It had said, no antibiotics, no fluids and DNR. The facility she was at fought me. I have her POA health Care and she left everything blank for my decision. When the wording talks about weighting how much she will suffer compared to letting her die by withholding food and water it is to easy to have the nurses or doctors decide on the assumption that the POA is not there or not available. I have been with my Mother 24 x 7 since I moved back when she asked me for help. My son is with her when I take time off. Back to the POA, I had help from a Hospice counselor on this who ran a Caregiver Support Group. Mother is now in another facility, doing well and she will be 100 years old in October God willing. She is doing well, remembered the name of the famous Ernie Pyle this morning when I could not, walks around her apartment by herself and every day she is alive is a blessing to the family. My son had rallied around her like I have. We are 5 generations.
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So glad your Uncle got his J tube I totally support his decision if he was not experiencing organ failure as a pre cursor to dying. It is his right to make that decision. Completely understand his refusal of the NG tube they are quite uncomfortable and may be useful for a couple of days but long term not pleasant.
As you have observed that insertion of the tube is a very minor procedure and clearly did him no harm.
I would take expert advise on the bone spurs because this is not such minor proceedure and will probably involve an overnight stay in the hospital. It is done through a small incision in the front of the neck and does carry some dangers as they have to pass vital structures such as the carotid artery. It also requires general surgery unlike the J tube insertion which only needed sedation.
I do have a J tube and would personally be reluctant to have neck surgery as I can eat many soft foods in small quantities.
Do whatever your Uncle wants he is competent and is the boss. As someone else said everyone needs an advocate in todays medical jungle.
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