- Hamish McLeod, a 67-year old retired accountant
- Presenting with a left hemisphere TACS
- Previous stroke and wheelchair bound. Reports of depression post stroke
- Lives with a wife who is in good health
- He has 2 grown-up daughters both of whom are very involved and supporting their mother regularly on hospital visits
Key Points
The overall approach to care should be agreed by shared decision-making based on the expected prognosis for the patient.
Conversations about nutrition and hydration can take place both formally and informally with different members of the multi-disciplinary team. Treatment decisions are very likely to change over time and it is important that families do not feel they are receiving conflicting information.
Slide 1
The nurse places an NBM sign above the bed, which the granddaughter notices …
Granddaughter: “What does that mean, are we not allowed to give him a drink?”
Slide 2
Nurse: “That’s right. We have to be very careful to check that your Grandfather’s swallowing function is safe. If we let him eat and drink and it goes down the wrong way into his lung, he could get pneumonia and that can be very dangerous. At the moment he is having some difficulty swallowing and I am going to refer him to the speech and language therapy team who will come and see if there is anything they can suggest. At the moment it is very important that we don’t risk him choking.”
Slide 3
Granddaughter: “That sounds very scary, I wouldn’t want to see my grandad choking. I presume that is why he has a drip? I’m going to look up information about feeding tubes… We need to get him well.”
Page last reviewed: 16 Jan 2023
