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Those are questions that need to be answered before you make the decision about having a PEG put in him, because if he's not ever going to get any better, why put him through that?
If the prognosis is not good, you may want to instead talk to his doctors about either putting a PICC line or Midline in his arm so they can at least administer any medications needed, and get hospice on board for his comfort care.
And had your dad made his wishes known(MOST form or advance directives) about to what extreme he wanted to be kept alive? Hopefully he had and that just helps make your decision making a bit easier as you will be doing his wishes instead of yours.
When my husband at the age of 48 had a massive stroke and was having swallowing issues they put a PEG in fairly quickly only to have to take it back out a week or so later as my husband began to swallow on his own again. But my husband was much younger, and while he survived the stroke it left him with many permanent disabilities that he lived with until his death at the age of 72.
I'm sorry that you're having to go through this, but at this point I would do what is best for your dad and what you know or think he would want done.
God bless you.
Are you expecting that he will suddenly wake and he can go home to a normal life? You may be looking at a life in a nursing home. You really need to find out the severity of the stroke.
Did he ever make his end of life wishes clear in a written document?
I think you have to ask yourself if you want to see your father in such a condition. Others have mentioned important points of view such as speaking more thoroughly with the doctor as to his future health wise. It is also wise to understand more fully the affect of the stroke.
Sometimes a life is over before the body gives up. I don't see the point of an elderly compromised person having a feeding tube.
Are you doing the right or best thing? Only time can tell. You make the best decisions you can given the information and guidance you have at the time. Ask the doctors for their best judgment. I truly hope you’ll see progress and a great recovery soon if that’s what is possible. In any case, I wish both you and your dad peace
What is your dad's long term prognosis? With dementia at play, it can't be good at all. Nobody can tell you if you're doing the 'right' or the 'best' thing for him, but ask yourself this question: if this were you in his shoes, would YOU want YOUR life extended with PEG tubes and the like?
I know how hard all these decisions are, especially if there's no advance directive from dad. But if he's in the hospital now, or has been recently, they will have asked him about a DNR and things of that nature. Take that info to make your decision from.
Best of luck
*Good* being very subjective.
If my LO had a very poor chance of recover to a decent quality of life or a life-limiting progressive illness, I would thank the Doctor's for their service & advice but welcome in Mother Nature. Trust her to guide & be at peace with it.
If only 76 with previously no other serious conditions or life-limiting disease - well it is all going to depend on the severity of the stroke.
Stroke varies considerably. Some are milder & leave little trace. Some leave slurred speech, word finding problems, a weak hand. Some take all speech, bring hemiplegia, mood disorders.
The most severe will cause loss of consciousness with no recovery.
Get as much info on the severity of the stroke. Then wait & hope Dad wakes up I suppose is all you can do.
Has Dad has reached a time when he needs a PEG to reduce malnutrician while you wait?
Had his relentless delusion that your mom was having an affair ever resolve?
I understand your distress at the current state of his health. Has a speech language pathologist been by to assess him?
I would ask for a different Hospitalist to be assigned to him. If you get nowhere with asking nicely, call the Patient Advocate and insist.
The speech pathologist should be doing exercises to help strengthen his throat muscles so hopefully he can eat again on his own.
It sounds like the doctor is just writing him off so you will need to continue to be dad's advocate (like you have been doing) and fight for him.
Watch, wait but keep asking questions to the Neuro team.
My mom is 78 and after spinal surgery has acute dysphagia as a result with no time frame for resolution. Could be weeks, months or never 😢. After two weeks on TPN she and family made the decision to do a PEG tube. I can't believe that doctor said your dad doesn't "want" to swallow!
Sounds like your dad is relatively young and was OK before for his age. Just like my mom minus the intense spinal pain which was was why she elected surgery, who knew this would be the nightmare outcome.
My mom is now in rehab after a month in the hospital, it's been traumatic, she hates it esp at night and in the morning it's like she's gonna have a nervous breakdown. I suspect hospital delirium.
All of this to say I think pending an uncertain outcome go forward with the feeding tube. Worst case he will swallow in a couple days and it will have been for naught. These decisions are very difficult I'm sorry you are going through this. I know my mom's situation is not an exact parallel as she is able to communicate her wishes and we are certain of her physical prognosis, unlike your dad.
The procedure itself was not terrible for her even after all she has been through, that was our biggest fear another invasive procedure...
Will be thinking of you.
Peg tube is a good option in the situation where dad can't swallow.. at risk of aspiration..Not too early..your dad can still be regularly assessed for swallowing..
-These are my recommendations:
-Insist that a " girdle" be placed on top/around after to avoid that your dad pulls it ...
- Peg tube are known to get infected, under ,so you 'll have to daily : check ,clean with sterile water,put small dressing around....Nurses should teach you that..
- you'll probably use a "pump" so arrange in advance the space at home and get help..from visiting nurses etc..so you can get respite..
- Important..Important to Flush with water before and after feeding.
All the best for you& dad..
With my situation, I've updated with my wishes known with three relatives and had it registered with Kaiser to not prolong my life by machines if full recovery is not expected in one day. That includes feeding tubes.
If your dad can communicate with you in any way, then ask him if he wants the PEG tube.
Don't be afraid to stand your ground and ask questions.
IF there is no chance that he will recover I would not do the feeding tube.
Over the years had your dad ever expressed his thoughts, wishes if something were to happen? Maybe even in an off hand comment about someone he heard or read about. That might give you a clue as to what he would want.
What type of person has he been through is life? Active, independent? would he want to be kept alive via tubes?
Search your heart, your mind. Listen to both, but as difficult as it is, allow your mind to make the tough decisions.
I took the decision not to have it done and moved him to hospice. He died 3 days later. I still think it was the best decision I could have made because it is what he wanted. Before you agree to the procedure consider how invasive it is and the significant impact it will have on his life. If there he won't improve and the only reason for the PEG is to keep him alive, consider if this is the best option for him.