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He may soon not to able to digest the tube feedings and then faced with a terrible decision- leave the tube in for hydration or pull the tube. Think wisely before making your decision. At stage 4 pain relief would be a priority.
this might be an uninformed question, but is he on a waiting list for a transplant? If so, then it might help. My uncle had a gastric feeding tube and it did give him more meaningful time. He had cancer of the esophagus, which spread to his bones. It was difficult for him but in his situation it gave him time to put his life in order and say his goodbyes. His death was graceful and bittersweet. My father had a head injury from a car accident, complicated from a perforated ulcer. The required surgery left him with infection that damaged his liver (he already had autoimmune hepatitis with no symptoms). After surgery he developed hepatic encephalopathy which was awful for him and family. He the had surgery for a broken neck. 😣 We don’t know how it happened but suspect he fell playing golf ( a plus, as it was his passion) I will try to shorten this long post by saying he did have a feeding tube through his nose toward the end. The process was awful and I wish I had not agreed to it, though he wanted to try everything. He was a Marine. Your decision is difficult and it is best to discuss it with him, based on his health and prognosis. I feel for you and for your dad and will pray for you all, including doctors, to make the best decision in a tough situation.
We are all assuming the doctor suggested it to try to squeeze out more money, but he/she might have suggested it due to a hysterical patient or family requesting that they do anything/everything to keep the father alive.
Chelli, please trust those of us who tell you that your best route here is no feeding tube and put him on Hospice now.
It is very normal to fear death for ones self or one's loved one. But fear causes us to make unwise decisions. A feeding tube in a stage 4 liver cancer patient is an unwise decision in my opinion.
I would just ask yourself do you want to put him through that for what will probably be a very uncomfortable painful short extension of time. My mom has Alzheimer, lives with me and I have already decided the day she stops eating is the day her body had decided she has had enough and it's time. I am not going to extend her life just for my selfish desire to have her around longer. We did a DNR and I informed the hospice people...no feeding tubes. That is just my take on it. If your father is in his right mind, maybe let him make the decision. If he is not, just ask yourself why would you want to do that.
Will a feeding tube bring him back to the level of health he had before he had cancer or will it prolong his life with no chance of that level returning ?
the advance directive my husband and i each have state no life prolonging devices/whatever but thats personal to our opininions.
I even have a tattoo saying no code/no cpr/stroke meds ok. But i forgot to list pain meds ok and have been too lazy to go back again. But its in my paperwork. All that will probably be ignored so ive told my daughter to sue whoever does ignore it.
But again ... its all personal. Just imagine how you would feel on getting life sustaining whatevers with no chance of recovering your life abilities.
My son died at home with aids so I understand how helpless you must feel.
My stepfather had a gastric feeding tube put in at direction of his biological daughter. He lived for 15 months, slowly losing his mind (his body was paralyzed from stroke). Recently I saw her at her husband's funeral some 25 years later, and she said she did NOT have gastric tube put in for her husband who also had stroke. based on her experience with her dad. I also refused gastric feeding tube for my husband when he had a stroke 5 years ago. Yes, it is difficult to see someone slowly starve, but the patient doesn't feel any hunger, but will need mouth care for dry mouth. Your dad is ready for hospice NOW.
You can research this on the internet; you might check out a site called PubMed that has journal articles about medical research on every topic. You can scan the articles and get the gist even if you don't understand much medical lingo.
Liver cancer is almost always terminal. Feeding tubes are uncomfortable and as someone here mentions, don't extend life or by much. What does your dad want?
So very sorry that you and your dad are going through this.
NO feeding tube. There can be problems with them as the patient no longer requires food if it is still being given it can lead to problems. With a Stage 4 I would contact Hospice and let them guide your Dad and you in decisions.
My husband's family is dealing with a similar situation. Google "Will a feeding tube prolong life". Feeding tubes used as a temporary measure while people are recuperating from an illness do prolong life. Feeding tubes used because the body is no longer able to process food do not prolong life. In fact, forcing the body to accept nutrition when it is shutting down can cause discomfort.
See if your family can have a consultation with Palliative Care. Hospice is a form of palliative care but, hopefully, you will have access to the other forms of palliative care that are available. Best of luck.
Please, NO! It will not extend his life. One cannot survive stage 4 liver cancer. Support him with love and pain management . At this point nutrition doesn’t really matter.
Did your Dad have his wishes known in case something like this should happen? Did he have anyone assigned as health care proxy? Did he ever express his wishes verbally if he got sick?. .Personally, my mother never wanted feeding tubes & told me so when she had her marbles...now she don’t & Im health care proxy, & if she doesn’t eat or drink....,I just keep trying to give her protein drinks ...or you can try Ensure... but she’s 91 1/2 with dementia & I would not prolong suffering....
My mother had a feeding tube placed after a stroke when there was great hope of recovery. We have no regrets doing this as she needed to be fed as she went through therapy and attempted recovery. Your dad’s situation sounds vastly different, I’d ask the doctor about the goal of the feeding tube, is it for comfort, to sustain life, to provide nutrition temporarily or permanently? In an illness so cruel as liver cancer there are likely better ways to provide for his comfort and nutrition does become less important in terminal illness. I’m sorry you’re walking this road, not easy I know
I would consider quality of life before imsert feeding tube. If there is hope of full recovery and does it change the overall prognosis. The other suggestions here are wonderful.
Most definitely you need a hospice consult. And you need an understanding of Stage 4 liver cancer. Your dad will likely need pain management by hospice as his cancer takes over more. If his doctor hasn’t suggested it, then I am leary of that doctor. What does your father's advanced directive say about feeding tubes? Can your father eat or is he refusing food? Partly, that could be the body preparing to die. A hospice consult is invaluable.
I seen a LOT of research how feeding tubes do not increase lifespan any more than no feeding tubes, especially with risk of infection at the surgical site, sometimes the patients pull them out...and they can also still aspirate tube feed include vomit which will cause the fluid to go in their lungs and cause pneumonia. They can also get diarrhea due to "dumping syndrome". Sad doctors would rather profit from their patients instead of a more common sense hospice option, but that is how they live champagne and caviar lifestyles...and the holiday season is coming up time for vacations and presents.
Younger healthier people on tube feeds such as post stroke--do better than the bed ridden elderly. Look on Google Scholar and find research on feeding tubes. Here is one example. but someone with stage 4 cancer..you and your loved one has to decide. But advancing cancer means organs are shutting down. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3401731/
Money for hospital and GI doc is a pro. Dad would probably be fitted with the bulky one that would be wheeled around with him everytime he wanted to walk around
While that may be true, I would be fascinated to see how a doctor could persuade a concerned family member that a bigger contribution to the Poor Underpaid Doctors' benevolent fund is in the patient's interest.
The doctor may not even have permitted himself to think of that. I was wondering what other arguments he might put forward :)
What does your dad want? I had this conversation long ago with my parents. No tubes.
Perhaps you should have another conversation with the doctor or another doctor about what the prognosis is. In my experience, doctors are very pragmatic about it. When they ask if we want resuscitation or not every time we go to the ER. I say no. They agree. They are expecting that the family will want everything possible done when they know that it won't do much good. So they are relieved that I'm not pushing for that.
Perhaps the doctor suggested it because it was the only positive offer he had to give and he is unwilling to accept that he can't cure your father. I can't imagine the prognosis is very good even with tube feeding, I agree you need to better understand the pros and cons.
Ask the doctor to explain the pros and cons to you. It might clarify his own thinking, as well as help you to understand what the risks and benefits are.
Is your father able to understand the care plan and express his own wishes?
A palliative care or hospice consultation sounds like a good idea. My understanding about that a feeding tube is not recommended for someone who is desperately ill and not likely to recover. However, his doctor has recommended it. Have you questioned him about it? If it were me and my parent I would ask for a thorough explanation and probably another opinion,
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
At stage 4 pain relief would be a priority.
My uncle had a gastric feeding tube and it did give him more meaningful time. He had cancer of the esophagus, which spread to his bones. It was difficult for him but in his situation it gave him time to put his life in order and say his goodbyes. His death was graceful and bittersweet.
My father had a head injury from a car accident, complicated from a perforated ulcer. The required surgery left him with infection that damaged his liver (he already had autoimmune hepatitis with no symptoms). After surgery he developed hepatic encephalopathy which was awful for him and family. He the had surgery for a broken neck. 😣 We don’t know how it happened but suspect he fell playing golf ( a plus, as it was his passion)
I will try to shorten this long post by saying he did have a feeding tube through his nose toward the end. The process was awful and I wish I had not agreed to it, though he wanted to try everything. He was a Marine.
Your decision is difficult and it is best to discuss it with him, based on his health and prognosis.
I feel for you and for your dad and will pray for you all, including doctors, to make the best decision in a tough situation.
Chelli, please trust those of us who tell you that your best route here is no feeding tube and put him on Hospice now.
It is very normal to fear death for ones self or one's loved one. But fear causes us to make unwise decisions. A feeding tube in a stage 4 liver cancer patient is an unwise decision in my opinion.
the advance directive my husband and i each have state no life prolonging devices/whatever but thats personal to our opininions.
I even have a tattoo saying no code/no cpr/stroke meds ok. But i forgot to list pain meds ok and have been too lazy to go back again. But its in my paperwork. All that will probably be ignored so ive told my daughter to sue whoever does ignore it.
But again ... its all personal. Just imagine how you would feel on getting life sustaining whatevers with no chance of recovering your life abilities.
My son died at home with aids so I understand how helpless you must feel.
Make sure he has pain meds.
Be kind.
Liver cancer is almost always terminal. Feeding tubes are uncomfortable and as someone here mentions, don't extend life or by much. What does your dad want?
So very sorry that you and your dad are going through this.
There can be problems with them as the patient no longer requires food if it is still being given it can lead to problems.
With a Stage 4 I would contact Hospice and let them guide your Dad and you in decisions.
See if your family can have a consultation with Palliative Care. Hospice is a form of palliative care but, hopefully, you will have access to the other forms of palliative care that are available. Best of luck.
.Personally, my mother never wanted feeding tubes & told me so when she had her marbles...now she don’t & Im health care proxy, & if she doesn’t eat or drink....,I just keep trying to give her protein drinks ...or you can try Ensure... but she’s 91 1/2 with dementia & I would not prolong suffering....
The other suggestions here are wonderful.
Younger healthier people on tube feeds such as post stroke--do better than the bed ridden elderly. Look on Google Scholar and find research on feeding tubes. Here is one example. but someone with stage 4 cancer..you and your loved one has to decide. But advancing cancer means organs are shutting down.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3401731/
The doctor may not even have permitted himself to think of that. I was wondering what other arguments he might put forward :)
Perhaps you should have another conversation with the doctor or another doctor about what the prognosis is. In my experience, doctors are very pragmatic about it. When they ask if we want resuscitation or not every time we go to the ER. I say no. They agree. They are expecting that the family will want everything possible done when they know that it won't do much good. So they are relieved that I'm not pushing for that.
Is your father able to understand the care plan and express his own wishes?
This sounds absurd to me. Is dad competent? Does he have living will in place? What does dad want?