Hospital to care home, end stage of prostate cancer

Hi all, the forum has been a great source of information lately and I decided it is time to register and post. My situation:

FIL of 79 diagnosed with metastatic prostate cancer in March 21, PSA sky high and immediately put on hormone treatment which is ongoing (monthly). Catherter in place. Palliative care offered throughout but thankfully relatively symptomless. Remained at home. I was full time paid carer. Steroids prescribed - worked well. Mobility and cognitive decline over the 8 months but nothing drastic. Would actively take themselves to kitchen to eat (overeating!). Cancer had spread to bones. 
 

Admitted to hospital via ambulance December last year for ulcer type on legs (lymphorea?) and has been in 6 weeks now. Before admission was mobile using wheeled walker able to transfer and go from sit to stand vice versa. Has been bed bound for most of stay with reluctance to get out of bed, hospital taken to using hoist. Now they say he is medically fit (despite the heavy dressings on the legs and pressure sores on heels, antibiotics administered throughout via IV and now orally) so have suggested an interim bed at a care home, with the view of trying to improve independence and back to baseline as much as possible ie transfer or sitting standing etc.

 

I have some reservations and fears:

Whilst it is an incredibly long time in hospital I worry they are discharging without sorting the leg and heel problem, or is this something that might remain with end stage cancer?

I worry he is being put in a care home on the pretence he will rehabilitate but if he cannot or will not comply they will say that's it and has to remain there (ie not coming home, but would have care in place and adapt with hoist etc if needed)

Appetite is greatly reduced.. 72 hours ago he stopped eating and drinking, urine output was almost black, became unresponsive and almost like he was heavily sedated or drunken sleep.. very much expected that he was dying but vital signs obs ok and kidney and liver function ok. I am worried if I am doing the right thing allowing this move and wonder why he is not going to a hospice. But I don't want to write his ability to possibly recover some mobility off,  but do wonder if it's all too much now. 

Has anyone had any experiences like this or offer any insight into end stage PC. Thank you. 

  • Hello ColaFan and a warm welcome to Cancer Chat, 

    I am pleased to hear that you have found this forum to be a great source of information and I hope that you will hear from the experience of others who have found themselves in a similar place before and have had to face similar choices for end stage prostate cancer care. 

    Your poor father in law has been in hospital for a long time and it's so sad that his mobility has got a lot worse since being admitted and that his appetite is very poor. I can completely understand your fears and reservations. Is there any way you could talk to his medical team about it? Could you perhaps try and talk to his consultant about the options that may be available to him at this stage?  Make sure you are completely open about your reservations and don't hesitate to ask for any clarification you feel you might need. If you are struggling to get in touch with his specialist, you could perhaps try and speak to his GP for expert advice on what the best solution might be for him. 

    Don't hesitate also to give our nurses a call if you need to talk things through with them on 0808 800 4040 - their helpline is open Monday to Friday from 9am to 5pm. 

    There is information on our website on advanced prostate cancer which may be useful to you and I would also suggest you have a look at the Prostate Cancer UK website. They have a section on thinking and planning end stage prostate cancer care on this page as well as their own team of specialist nurses who might be able to enlighten you further on this subject. 

    I will now let our members come and say hello and share their stories with you based on their individual experiences of looking after a loved one with advanced prostate cancer.

    I hope that you find the best possible option for your father in law so that he is as comfortable as possible in the coming weeks.

    Best wishes, 

    Lucie, Cancer Chat Moderator