advanced lung cancer - unsure of rights

Apologies in advance for the lengthy post.

My 82-year-old father was taken into hospital in Scotland two weeks ago with suspected pneumonia which turned out to be  cancer in both lungs and his lumph nodes. I live in Western Canada, and was called by the doctor and told that I needed to get on a plane.

On arrival, I was told he had very limited time, there were no treatment options, and that we needed to sign a DNR.

Since then, dad has rallied somewhat - he is eating and off the oxygen. Because of a serious illness suffered 20 years ago, he has severe mobility issues that have exacerbated since I last saw him 18 months ago. He is unable to stand, move from bed to a chair, or use the bathroon unaided. He lives alone.

Yesterday, he was transferred from the city hospital to his local community hospital. My concern is, that from the moment dad rallied, we are constantly being asked by different doctors and nurses what we want to do next. Dad doesn't want to go home, and I am struggling to understand why the same conversation is being brought up again and again - unless they just want to wear us down.

This morning I went to see my dad and he had forgotton he had cancer at all, and was talking about going home. It was very upsetting to have to explain it all again to him. Then the doctor came in and asked the "so what now?' question.

I have been out of the UK for 13 years and don't know the ins and outs of his rights. I did get a power of attorney registered last week, and I told the staff this morning I had that and I expected all discussions about my father's care to include me.

Does anyone know where we stand legally? His finances are a complete mess, as he was persuaded to take out a home equity loan and has lost the majority of the value of his house. I don't know if I can insist that he stay in the community hospital. His prognosis has been described as "weeks rather than months".

Many thanks for any help.

 

 

 

  • Hi and welcome to the forum.  This situation must be very difficult and distressing for both you and your father.  I am not sure how they do things in Scotland but when  my mother was hospitalised and unable to deal with living alone she was firstly assessed by an occupational therapist (they should not discharge anyone who lives alone unless a care plan is in place) and spent some time in a rehab ward.  When this did not improve her ability to look after herself we had to take the decision (I am joint power of attorney) to place  her into residential care (I was looking after my terminally ill husband at this time and could not take on the role of carer for her). I think perhaps it would be a help to speak to your Father's GP (I am assuming that your power of attorney gives you control over both health and financial issues (we had to have two separate documents for this - I am in England).  If there is a local Age UK charity near you or Citizens advice bureau then this may also help you understand what may now need to be put in place.

    I hope others will be along soon to offer some support/suggestions so that you can make your father as comfortable as possible during these latter stages of his life.  Regards Jules54

  • Thank you for your welcome and response. I believe my father's GP will be the doctor on call at the hospital next week, and I am hoping that does make things easier - at least in terms of gaining clarity around the situation and what options we have.Meanwhile, I'm hoping a weekend of no doctors' rounds will help ease his anxiety and calm everything down.

  • Hi,

    What an awful situation to be in, I hope you are coping OK. This isn't an easy question to answer but I noticed you'd only had one reply and thought I'd try to add my bi, I just hope it is of some use. 

    I'm not exactly sure of the law in Scotland but no-one has the right to sign off DNR's on behalf of someone else unless the patient does not have the Mental Capacity to decide for themselves and this has been formally assessed and documented. This is covered by EU Human Rights Legislation, so the principle applies in all the countries which make up the UK. 

    Even if someone does have the power of attorney (or its Scottish equivalent), the clinician by law needs to take steps to ensure that the patient is consulted as far as is possible given their condition. I know from personal experience just how hard this can be if someone has dementia. 

    If there genuinely are no treatment options, the hospital will be keen to move him into more appropriate accommodation for a variety of reasons. Hospitals are busy, noisy, environments and not really the best place to spend your last weeks of life. A care home with appropriate nursing care or a hospice might provide a better, more peaceful, environment. Finally, the NHS across the UK is short of hospital beds. For every patient who is inappropriately placed in hospital there will be others waiting for a bed to become available, people are dying whilst on hospital waiting lists. As a result of this, clinicians are under constant pressure to discharge patients as soon as their treatment is over. If no further treatment is planned the pressure on them will be intense, this might explain why you keep getting asked the same question over and over again.

     

    Best wishes

    Dave

     

  • Dave, thank you. I appreciate your response. It has been good having the weekend without any official doctors' rounds - I think it's been calming for my father and, quite frankly, myself. The staff have been compassionate and it has helped put the rest of the issues aside at least for a day or two

    Dad has required three extra doses of morphine today for pain. I'm hoping that his GP, who knows him well, will be open and transparent with us tomorrow, and we can take it from there. I've also asked the staff to contact the community Macmillan nurse and find out when I might be able to talk to her.

    Again, thanks for taking the time to respond.