GP Stories - Flu Vaccines in nursing homes

Flu season starting and people are calling up to try get them done. Normal winters, most people can't be bothered but with Covid as well floating around, people are desperate to get it (in fear that they'll be a shortage). Nursing home residents usually get top priority as just like any transmittable disease, it can spread like wild fire in an enclosed space like a home. It usually is a given that most residents will get it but one relative of a resident did not want his dad to have it.

On the phone, the patient's son rang up, asking about the flu vaccine for his dad. I said that all the residents will get it at that home, and I reassured him that his dad will get one. 

"No, I don't want him to have it." he replied.

I asked why.

"He's lived too long now, and that we [his brother and him] didn't expect Dad to live so long. He's got dementia and was told he would only live for 2-3 more years, but he's lived on for another 7 more years! We are having to pay a lot just to keep him in the home and it's cruel to keep him alive. I don't want anything that will keep him alive, I have LPOA."

Now as he has LPOA he can refused treatments on behalf of his father, given he has no capacity on the account of his dementia. He explained further:

"Whenever we visit, he doesn't recognise us, he recognises the nurses more than his own sons, it's heartbreaking. That's why I haven't visited for over a year now."

It was quite sad to hear all this from a family member, and whilst it does sound extremely cold, it was important to understand it from his point of view. To him, this wasn't his father that he was paying for, it was an empty shell of what his father used to be. If his father knew this was the way his son talked about him, I wonder what he would have wanted to do. I discussed his case at a GP meeting, and it seems this is relatively common thing for relatives to do. Not much we can do if they have the authority, just like parents can refuse vaccines for their child. 

Euthanasia is dangerous topic for doctors, and there was a controversial vote this year by the RCGP. 47% of voters opposed assisted-dying and 40% supported a change in the law. Personally, I can't see the laws changing anytime soon; Shipman is a still a name that people recognise and fear and anything that will remind people of that, will not be started in the near future. It is a shame then that patients (and relatives as well) may have to suffer to wait for the inevitable end when a possibly quick and painless option could be available. 

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