http://healthday.com/Article.asp?AID=612980

This article asks some disturbing questions which concern me. Seems that our society is moving more and more towards withholding treatment as people become more affected and closer to the end of life. Are we jumping the gun or making decisions based on reasons other than patient care?

What do y'all think? Please read the linked article before responding...

Notveeeeraa, you aare right, we have to be very careful when they speak of with holding any meds

Having just finished off a bottle of antibiotics for a UTI I can say with sincere enthusiasm; don't withhold the drugs!!!! BUT, I can understand about overuse causing antibiotic resistance. I just don't agree that practicing that method on suseptable elderly dementia patients that can't speak up for themselves is the right way to go. If it won't hurt and it might improve quality of life, even if for only a day, then why not?

Like the rest of you, I am leery of this. They say it should be case by case, but it sounds more like they want to trade one routine for another.

I understand the concerns that the antibiotics might be worse than useless in the end, painful, aggravating, but what's the "end"? First they talk about the last few weeks and then,,, They say advanced dementia patients average 53 days on antibiotics out of a 1000 days. Where is the "end " in that?

I am afraid they will write up their "new" guidelines and proceed to follow them or push them no matter what the famiy wants.

quote:

I just wish this were viewed on a case by case basis WITH the family

Eggsactly MB.
For my MIL antibiotic therapies do not work for her simply because there is an extenuating circumstance for her, the surgery site from the partial hip replacement was infected which spread to the prosthetic, once infection sets in it attaches itself to the prosthetic and gets embedded in it. The only way to get rid of it all together is to either take the prosthetic out and replace which happens to be quite invasive, more so than the original surgery (at her age and ailments its not worth the risk) or just take it out which will leave her bedridden.

with all my experiences I make sure they consult me before making any decisions about meds.They view a person as one shoe fits all.
I HAVE FOUND THAT TOO MANY ARE QUCK TO PRESCRIBE CERTAIN MEDS AND NOT QUICK ENOUGH WITH OTHER THINGS.I had to remind the doctors and nurses so many times with my husband what to give and not to give him.Too many times they do what is easy for them and no consideration for the patient.
Have to be careful when they say too much of a meds is given.Too much is done to save their costs.I found with my husband the doctor did not recall the correct antibiotic that worked the best for him.

I just wish this were viewed on a case by case basis WITH the family, instead of the doctors just doing what they damned please. It's one thing to present your reasoning to the family; it's another to ONLY present this side to them... Medical ethics is a tough area because it IS so very individual. I tend to resist any efforts to control, streamline and "automate" the process of dying - it just might not suit someone's best interests or wishes. It's like steering people toward a position, rather than presenting options and allowing the patient and/or family choose one or none of the above. The "my way or the highway" approach by doctors doesn't offer a lot of choices...

This is a very difficult question.
Some people want to fight tooth and nail to the end of life. Others want to slip away as peacefully and naturally as possible.
This is why Living Wills and DNRs exist.
I, for one am glad that people can make that decision.

Baby you know how I feel about antibiotic therapies if they worked great but in every case Ive seen that antibiotic therapy is administered they (the patients) are STILL getting infections so what is the reason for prescribing it if its NOT working???
The reason for resistant strains like staph is because we keep giving folks antibiotics for every dang thing, the body has lost its ability to fight off bugs whats it gonna take for the medical community to realize this?
Over use, not taking it as prescribed (which my MIL has done in the past) this all leads to the big bad bug like MRSA.
In my MIL's DPOA we state prescribing antibiotics is to be at OUR discretion NOT a doctors they must speak to me FIRST. If I deem it a necessary step I give the go ahead and ONLY me.
If at anytime she is in pain give her a pain med thats it.
That poor thing has been through the ringer already I will not have someone prolong her life that does not believe in what I believe in and thats QUALITY of life NOT quantity.
Sorry thats just how I feel if that offends anyone I apologize.

The part I find insidious about this (and have already experienced with Mom's care) is that the docs make these decisions without consultation (despite what the article says) because they always believe that they know best. So when do they start doing this stuff - when someone is 70 or 80 or 90? Maybe they have set up the infections by the care the patient has previously received (at their wise direction)...

MB I did read this and find it a little scary. Am I reading right that they seem to be grouping antibiotics, feeding tubes and ventilator together. After an incident with my Mom I will not sign a DNR or anything else that restricts the care given. Mom had a heart attack, was taken to the hospital from the facility she was in, left alone in the waiting room(thank goodness the home phoned my bro. Guess he hit the roof when he got there-their excuse was they had been told there was a DNR. They hadn't even given her oxygen or made her comfortable. Guess that changed real fast after a few threats of lawsuits, reporters etc. They did miss the fact that when she fell she had fractured a vertebrae.(She was in pain everytime they got her up to walk but would bet up and push her overbed table because it kept her straighter. Finally after several days they did an x-ray-oops don't walk. Her DNR was ripped up and I have never signed one for Mike(if I thought it really meant what it says I would-actually he wouldn't be here if he had had one two different times. Even the Dr. said he was glad there wasn't one the last time. Oops guess I better get off my high horse. Gypsy