My Dad had a Massive Stroke - I need advice please...

My Dad had a Massive stroke a 8 days ago. The DR’s say if there are no signs of improvement by now, there will not be any at all.

He can open his eyes and look at you, turn his head and his left arm and leg. He is breathing on his own but he cannot swallow or speak (at least the DR’s say that but I cannot tell because he has the feeding tube down his throat).

The DR’s say that if his family chooses to keep him alive this way, that they will insert a permanent feeding tube into his stomach and he will have to live in a convalescent home for as long as he lives. They said that even the best convalescent home doesn’t give great care because all they are responsible for is keeping you clean.

In my heart I think he is “there,” but no one really knows for sure. I’ve asked him questions and he has responded with long blinks like I asked for, but sometimes he doesn’t do anything at all.

Our choice is to have the feeding tube inserted and he will go to a convalescent home, or they can take the feeding tube out, put him on heavy sedation drugs, and he will die peacefully.

I don’t know what to do. I don’t want to let him go if he is mentally there, but he cannot answer what his wishes are. I don’t want to live the rest of my life wondering, what if we gave him one more week?

I know in my heart he would not want to live this way, but now that he is in this situation, what if he does?

I would appreciate anyone’s advice and prayers.

Thank you.

My condolences. It is a hard thing you are faced with.

Did your father have a living will, or express his feelings at all about what to do in this sort of situation? If so, please honor his wishes. If not, then I suppose the remaining family members need to decide what is right. That’s a very personal decision and I hope your family can come together and decide what they feel is right for your father.

Best wishes,
QtM

Tough one there. My sister and I had to stand in a hospital parking lot and decide about our mom. We both knew she’d not want to continue like they said she’d be.

We told them to pull the plug, and they did. FWIW, I’ve never second guessed or regretted that decision, but at the time it was very hard to do.

Peace to you at this time.

I can’t offer advice, but I send you all my best wishes. Trust yourself.

I am so sorry.
My father is almost 89, and this makes me think I’d better appreciate him now.

Living wills are so important. I dont even think my father has one.

(am praying)

Been there. Qadgop is quite right.

Same thing happened to my grandfather. He lived for nine years, about, after the feeding tube was inserted. He about died in a nursing home, so my grandmother took him home and converted a bedroom into, basically, a hospital room. Had someone to sit up with him at night, a registered nurse on call, and so on.

In time, she came to realize that there wasn’t much of anything left of him… but she could not bring herself to “kill” her husband by going through the legalities and nonsense involved in having the feeding tube removed.

Assuming he left no “living will,” or other documents stating his wishes under such circumstances, do what you need to do, and take the time you need to consider what to do. All of you, your whole family. This isn’t something you’ll all agree on, most likely, and reaching consensus will likely take a while.

There’s no hurry. Do what you gotta.

Thank you.

He did not have a living will. My step-mother said they only talked about it once and that he said he would not want to be kept alive by machines. I believe he would of said that.

On Tuesday we are meeting with all of his DR’s and they are going to spell it out for us. Then we will have to make the decision.

I think my biggest fear is that they want to put in the feeding tube so they can transfer him out of ICU. But they won’t do that if we decide to let him go because it’s surgery and trauma to his body. So basically they want us to make the choice as soon as possible. I just don’t know if 2 weeks is enough time to show any signs of recovery or not.

vanilla, it’s true. You just never know when the last time you get to talk to your loved one will be. Take that time now to tell him you love him. Thank you for your prayers.

Here’s wishing all possible comfort and strength to you, dreamer. You, your dad and family are confronted with one of the hardest situations around.
A formal living will would have made things as neat and tidy as they could be under the circumstances. (Though even with a living will the doubts and emotions wouldn’t have been much easier.) Lacking one, my guess is your best guidance your knowledge of your father and his spoken opinion.
It’s hellishly hard; I went through very similar situations with both of my parents at the end of their lives. Resuscitate again, prolong life how long through what measures to what kind of “life”, not knowing how aware they were and nowhere remotely enough time to sort out the impossible.
In the end my sister and I went with our instincts and knowledge of our parents. We chose not to resuscitate again and no heroic measures to prolong physical life. Part of our decision was there was no hope–none–that they could ever get better. The best medicine could do was possibly maintain their dire, fragile status quo for a while, prolonging their inevitable downward spiral into death. We chose to let them go.
I’m so sorry, dreamer. It’s hellishly painful but maybe it’ll help to remember that the decison isn’t between life and death. Death is inescapable for everybody. It’s more a question of whether it’s time to let your Dad’s life end, based on his life would be like otherwise.
I’m not arguing to let your father go. His and your situation may be completely different; medically, emotionally and spiritually. The only thing that counts is what feels right for him, you and your family. No matter what, best wishes to all of you. I’m keeping you in my thoughts.

Veb

Dreamer, you and your family have my prayers too. What a shitty world this is, sometimes. Hang in there.

I am sorry that you are facing this terrible situation. :frowning:
I would suggest doing some of your own research on stroke recovery, to make sure that you agree with the doctors’ view on his prognosis. They may indeed be right, but I know from personal experience that doctors sometimes underestimate what a patient is capable of.
Years ago, my dad had a pretty major stroke (not quite as severe as your dad’s, but still very disabling). He slowly improved over months, not just weeks. Initially the doctors told us that he would never be able to walk again. When he first started moving his leg again in the hospital, the docs said that it was just a “reflex”. However, in the long run, my dad did start controlling that leg again and could walk with a cane. He was never 100% back to normal, but he did better than the doctors had expected.
I don’t know if your dad’s situation is anything like my dad’s was, but from that situation (among several others), I learned that doctors are not infallible. Try to educate yourself from a few other medical sources before making such a major decision.
You and your dad will be in my thoughts and prayers. I hope that you make a decision you feel at peace with.

I’m so sorry about your dad. What I’m about to write may sound somewhat harsh, and I don’t mean it that way. This is just a harsh sort of situation, and there’s no way to really soften this kind of discussion.

Has your dad made any improvement at all? If not, odds are pretty good the doctors are right. It’s not a sure thing, of course; there’s no such critter in medicine. Sometimes people recover against all odds, and sometimes people die against all odds. And, of course, doctors are just people, and all people are flat-out wrong from time to time. Still, if a stroke patient hasn’t made any recovery at all in over a week, the odds aren’t good for him to ever make any recovery.

This is a horrible decision to have to make. You say he wouldn’t have wanted to live this way, but you’re afraid he might have changed his mind. You also mention him responding to questions sometimes with blinks. Maybe you should ask him if he wants you to put the permanent tube in, with one long blink for yes, and two long blinks for no. If he answers, you know what to do. If he doesn’t answer, I think then you’ll probably still know what to do.

Unfortunately, what you want and how you feel about letting him go can’t enter into this decision. It’s not your life, or your death, so your feelings aren’t really a consideration. It’s all about him and what he wants, or (if he can’t communicate what he currently wants) what he would have wanted.

I’ve searched around the web but haven’t come up with very much. I did find this other
Health Message Board, but for some odd reason it won’t let me register.

My Dad is an amputee so he only has his one left leg, which he has moved a little here and there. He also has diabetes (which is why he lost his leg) and phenomena. If he could use his leg again there would be no way for him to walk because his right side is paralyzed, or it seems to be now.

This is the worst thing I’ve ever thought I would have to do. I wish God would take him peacefully so we wouldn’t have to make this decision.

Thank you so much for your advice and prayers and if you know of any sites with stroke information, please let me know.

Well, when he first came into the hospital he could not open his eyes or turn his head. Now his eyes are fully open for long periods of time, he looks around, moves his head around, and responds to pain. Yesterday he grabbed the side of the railing with a lot of strength in his left arm, which I had not seen him do before.

I’ve tried that. He gave me the long blink when I asked him if he knew he had a stroke. He gave me the long blink when I asked him if he wanted us to take the tubes out of his throat. But when I asked him if he wanted us to let him go, I didn’t get a response. I will try again though. It’s hard because he fades in and out of sleep. The DR’s say that’s because he does not get enough REM sleep with the nurses and commotion 24/7.

Oh, Dreamer…I am sorry you have to deal with this…

I am a critical care RN w/ 20-plus years experience. (Mrs. Eggerhaus is also an RN, with several years of rehab experience.) Back when I was a baby nurse we were taught that long-term CVA (stroke) prognosis needs to be looked at six-months post event. As far as I know, that hasn’t changed. If dad is moving and responding to commands he should be getting physical therapy of some kind. If he’s not, insist that he get a PT consult and a consult from a rehab doctor! The feeding tube in his belly will be needed so he can ‘eat’ without aspirating (food going down the wrong pipe) if he cannot swallow properly. Make sure he’s had a swallow study to verify that he is an aspirator.

My strongest advice would be to watch dad for six months. What he has then will probably be all he’ll ever get back. When he gets out of ICU he should go to a rehab unit…if he has rehab potential…so that’s why you need that PT consult and visit from a rehab doc.

Hope this helps. Have a blessed Thanksgiving.

Dreamer, my thoughts and prayers are with you.

My Dad had a series of severe strokes during an operation that was intended to prevent such strokes.

Initially, he was partially paralized on his right side, could not walk, nor feed himself, nor speak intelligibly <spelling?>. It was a miracle he survived at all, as he had also arrested on the table.

Yet with good therapy, he was able to learn to walk again, feed himself, talk, although not necessarily converse, and be relatively independant. He had 9 pretty good years after that.

The neurologists explained to us that the therapy could get him to use parts of his brain that were previouly unused to learn to do these things again, and to replace to a certain extent the parts that were damaged by the stroke. The progress was very slow at first, but accelerated as we went along. Most of the progress took place 3 months after the event and onward.

If you do decide not to withold feeding, may I suggest that in addition to all the therapy, that you make sure your Dad gets lots of mental / verbal stimulation, i.e. lots of people talking to him as though he’s there, touching his hands and face, and encouraging him to fight on, and to get better. Even a TV or radio tuned to a favourite channel can provide lots of stimulation when you’re not there.

Perhaps you can try the blink once for yes, twice for no, means of communicating, but you have probbly tried that already.

Speaking from experience (albeit Canadian experience) if he does go to a long term facility, your family will have to visit him often, and make sure that he gets the care and stimulation he needs. I’m afraid that the patients who don’t get a lot of attention from their family often don’t get a lot of attention from the staff either. Don’t alienate the staff, as they could retaliate against your Dad. Bring them little presents and learn their names. Offer to help them care for your Dad by doing small things like small grooming tasks, etc.

Also, allow me to offer you some advice about taking care of yourself, regardless of what you decide. When one is distraught over a loved one’s health crisis, it’s often the case that doing things for yourself can lead to feeling guilty, or to feeling like you are somehow betraying your Dad, and that you have a duty to fell bad all the time. Please believe me that it’s OK for you to take some time for yourself, to rest, to eat if you can (whatever you like, forget calories for the next month) and even to spend some time with your friends. It’s OK, if you can, to laugh at a funny story of a buddy/GF’s date gone wrong, or a funny movie, and forget about your troubles for a while. You are recharging your emotional batteries to be better able to care for your Dad, or for your family.

It’s also OK for you to cry, to feel it isn’t fair, to be angry, and to want to break things. Pillows and matresses make great punching bags. Make sure you have some friends or loved ones with whom it’s OK to cry, or to rant. Please don’t try to “be strong” in front of everybody.

Finally, if you are so inclined, you can pray for guidance, for strength, for peace for you and yours.

{{Big warm botherly hug}}

I have no advice, but offer my best wishes for you and your family through this difficult time. Whatever decisions you make, you will make out of love - just be sure you are getting good medical information. It’s not even remotely a waste of time to get second, third, even fifth and sixth opinions.

Best wishes for strength and wisdom, Dreamer.

Should you wish to learn the account of one who suffered a stroke, read ‘My Year Off’ by Robert McCrum.

No decision will be easy, yet I’d offer that understanding will afford reassurance in the weeks and months to come. Be well.

dreamer I am so sorry to hear this awful news.

Can your Dad communicate through blinking at all. Once for yes. Two for No.

Have to gotten a second opinion?

Well said. This situation, regretfully, does not go away over night or with the wave of a magic wand. Exhaust your resources and see what happens with your father and his condition. Waiting a couple of days-weeks-months ( which blur together after awhile in a fog that never seems to lift.) will only help you ( I would think) make a more informed judgement call that no one should ever be put in that position to make.

I am truly sorry for what you are enduring.

I’m really sorry to hear about this. I know how hard this can be as I have been through a similar situation.

My Mom has had 2 strokes over the past couple years. From what you’ve described it sounds like she showed improvement quicker however. She started out paralized on her right side, unable to eat & could only say a couple words.

From what her doctors said, most of the improvement would be in the first 3 months, which was about right.

She walks & eats fine now, but she’s still unable to use the right words to say what she wants to most of the time (which is called aphasia).

She started out at one hospital & was then transferred to a better hospital that offered speech, physical & occupational therapy. Unless your Dad is in a top notch hospital, I would seek at least a second opinion from a good neurologist or someone who specializes in strokes.

I would also suggest reading Trupa’s post a second time. My family was emotionally drained by these events & it made my Mom’s recovery that much harder.

I truly hope he becomes well enough to recieve good therapy. If a second or third opinion does not give hope for this, then take your time & try to determine if your Dad would want to go on this way.

Best of luck & God bless.

No advice, unfortunately, except to echo all the folks who said to listen to your heart. I am so sorry you and your family are in this situation. You mentioned a stepmother–are there other family members as well? What do they think?

All the best to you as you live through this very hard time.