What to do; medical issue.

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Waffl3s

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A throwaway account for obvious reasons.

Only living Parental has been in ICU for >6 months now. The doctors essentially informed us that they are attempting to assess the situation as it unfolds, but they currently lack a clear plan at the moment that would result in them getting better.

We held a family meeting with my siblings to discuss the situation, and I proposed that we wait for a week or two, decline any additional surgeries and procedures to establish a baseline, and then consult with the doctors to determine their next course of action.

My siblings took this to mean I want to kill said parent, which is not my intent, of course. Will has not provided any specific details about this situation, and we are currently facing additional payments of R600k to various providers, which the medical aid portion has already covered.

Doctors did mention this might be an issue as the medical aid needs weekly updates on the treatment plan; otherwise, they would request parental be discharged. We are unable to care for the parental as their condition is quite serious.

What would you do?

Edit : In total we've already paid close to R500k. Fighting additional R600k to atleast get it reduced. Removed any gender specific wording as some people I work with visit the site.
 
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What does the parent have to say about all of this?
 
Waffl3s said:
A throwaway account for obvious reasons.

Only living Parental has been in ICU for >6 months now. The doctors essentially informed us that they are attempting to assess the situation as it unfolds, but they currently lack a clear plan at the moment that would result in him being better.

We held a family meeting with my siblings to discuss the situation, and I proposed that we wait for a week or two, decline any additional surgeries and procedures to establish a baseline, and then consult with the doctors to determine their next course of action.

My siblings took this to mean I want to kill said parent, which is not my intent, of course. Will has not provided any specific details about this situation, and we are currently facing additional payments of R600k to various providers, which the medical aid portion has already covered.

Doctors did mention this might be an issue as the medical aid needs weekly updates on the treatment plan; otherwise, they would request parental be discharged. We are unable to care for the parental as their condition is quite serious.

What would you do?
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Can your parent speak for themselves ?

This is tough man, if you want I can find some someone who can advise you (NGO) depending on where you are.

I don't know all the details on your parent but its pretty unethical for them to keep an elderly person in ICU long term like that.
 
B-1 said:
What does the parent have to say about all of this?
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Nerfherder said:
Can your parent speak for themselves ?

This is tough man, if you want I can find some someone who can advise you (NGO) depending on where you are.

I don't know all the details on your parent but its pretty unethical for them to keep an elderly person in ICU long term like that.
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They are far from lucid at the moment thus me getting opinions from people that don't know me or the situation.

I'd appreciate the NGO contact. I'm in Gauteng
 
Tomtomtom said:
Me too, especially if my kids were blowing their entire inheritance trying to keep me alive only for me to die anyway and without ever really getting to enjoy life again.

What was the point...?
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Dealing other parentals estate still so kak situation all around tbh. Money is a sticky point right now
 
Waffl3s said:
Will ask about this
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No man! That's a horrible thing to do.

If parent is in a coma I'd pull the plug, if not what do they say about it? Or don't you want to bring up the subject, it's probably not something I'd like to chat about?

EDIT: I see parent is not lucid.
 
@Waffl3s Feel sorry for you being in this position - so sad :crying:

Pretty poor show that the doctors aren't offering you a "kind" way out. One would think they'd assess the situation and advise.
 
maumau said:
No man! That's a horrible thing to do.

If parent is in a coma I'd pull the plug, if not what do they say about it? Or don't you want to bring up the subject, it's probably not something I'd like to chat about?

EDIT: I see parent is not lucid.
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They are awake but not speaking and doctors assume they've gone deaf because of heavy antibiotics use for sepsis etc while they've been in Hospital :(
 
B-1 said:
You can try speaking to some of the hospices in your area. Even if all you get is advice they deal with this situation a lot and can give you options to explore.
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Bad experience with other parental so this might not be a possibility
 
B-1 said:
You can try speaking to some of the hospices in your area. Even if all you get is advice they deal with this situation a lot and can give you options to explore.
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A Hospice will be a good plan. My mother had cancer and when the doctors could not do more she was moved to Hospice. Most medical aids should cover it from the step-down benefit, at least mine does.

Talk to the doctors and the family and the medical aid and see what options are available to your loved one.

I know it is not easy as we went through this with both our parents and my wife's father. It is a very heavy situation.
 
I just sent a PM of my situation. But I agree with others throwing money at it is not wise and moving the loved one to a hospice or special care is the right decision if doctors are not positive about recovery and improveme in quality of life.

Sterkte!
 
i'm assuming the parent is unconscious in icu

last yr i underwent surgery, then developed pneumonia.
oxygen saturation levels continued to decline to the point i was to be put on mechanical ventilation for 7 to 10days.
day 10 came and i did not wake up.

so there is a process of weaning you off ventilation and back to consciousness.
sedatives (inducing coma) were reduced - no response from me - remained "asleep".
this continued for beyond 6 weeks - long past the anticipated 7 - 10days.
during this time multiple blood tests, cat scans, mri etc were done - all showed everything was good, but i simply would not wake up.

complicating matters was a "do not resuscitate" instruction drawn up by my advocate (attached should anyone wish to use as a "template").
ultimately, desicion was given to the medical team - who decided to continue medical support.
and then one afternoon i woke up, like i simply went to sleep the previous evening.

the driving criteria was that of quality of life if / should i, regain consciousness.
the repeated and regular tests / scans showed no organ or brain damage - hence a very positive prognosis.

quality of life post icu is by far the most important consideration.
family members as difficult as it may be, need to place themselves in the same situation as the patient - what would their wishes be were they the patient, and had access to medical records and opinion available at the time.

in your case you would have similar considerations, but in addition medical costs and extent of cover.
as long as the patient is unconscious in icu, most costs will fall under pmb (prescribed minimum benefits).
however, should the patient be moved of of icu / hospital to a care facility , hospice etc - then medical cover moves from medical / pmb benefits to frail care.
frail care is covered by some medical schemes and not by others, and even when covered usually has very low benefits, leaving the bulk of cost to patient / family.

also, as far as the medical scheme requiring updates and looking for discharge (to cut their costs), ultimately a doctor had to sign discharge forms stating the patient is good for discharge.
this in itself carries a big medico-legal burden on the signing physician, especially now in our country where litigation related to medical negligence is at an all time high.
the doctor will probably try get a family member to sign some sort of consent prior to him signing discharge papers - this primarily to remove himself from liability in the potential event of any negligence litigation.
dont sign any such form.

1) above all, the highest priority is prognosis / quality of life.
2)for now knowing as little as i do, i would try keep the patient in icu for a while - in my case and in general, there is no real knowing when the person will wake up - we do this when our body is ready - despite medical intervention.
3) costs - frail care is expensive, either home based or in a facility.
home based you are looking at around at least R800pd for 24hr carer assistance.
add to that any medical devices - catheter, alternating pressure mattress (prevention of pressure ulcers) etc.

check the extent of cover the medical scheme provides for 24hr frail care.


also, look here (free signup) for further info / opinion - very helpful site regards icu / icu related matters as per screenshot
healthunlocked.com

HealthUnlocked | The social network for health

We are the world's largest online support network. Ask questions. Get answers. Talk to others who've been there before. #UnlockYourHealth
healthunlocked.com healthunlocked.com
the forum is moderated by health professionals and has association with kings college hospital (london)

Screen Shot 2024-05-31 at 12.46.28.jpg



also go here, read thoroughly, and understand your legal rights apropos medical schemes and cover

Prescribed Minimum Benefits | Council for Medical Schemes

Prescribed Minimum Benefits (PMBs) are defined benefits to ensure that all medical scheme members have access to minimum health services.
www.medicalschemes.co.za www.medicalschemes.co.za

if you have a dispute, dont hesitate to refer to cms - they have big teeth and intervene very quickly.
i have referred matters to them twice - on both occasions they responded very quickly and had the ceo of the medical scheme respond within 12hrs - giving disputed / requested authorisations.


**edit
added "no not resuscitate" / living will should anyone wish to use
pg1.jpg

pg2.jpg
 
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Grant said:
/snip
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Thank you for the advice. This was my thought process as well because I am worried about the quality of life post ICU. We tried a step down facility and they sent parent back to the hospital citing he was not ready for that kind of treatment.

Will share these resources with my siblings as well
 
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