Yahoo News With Sydney hospitals in freefall, I’ve been forced to make an impossible decision about my sick, elderly dad
I spent a lot of time this past week googling “UTI” and “kidney infection”. Not because I got an enviable amount of action over the festive period but because my ailing 87-year-old dad with advanced Parkinson’s disease received the diagnosis and Mum and I were tasked with the impossible decision of sending him to an understaffed Sydney hospital riven with Covid or try to keep him alive at home ourselves.
Dad fell ill at the worst possible time: just as GPs were going on holidays, pathology labs were turning off their lights for a few days, thousands of New South Wales healthcare staff were furloughed with Covid or as close contacts, and as the state’s coronavirus infections jumped 90% in 24 hours to a new daily high of 21,151.
So when, last Thursday afternoon, Dad’s GP took one look at his symptoms and cloudy, blood-speckled urine sample and declared he had a kidney infection, our hearts went into freefall.
With no time before the pathology lab shut for the holidays to determine which antibiotic would best treat his infection, his doctor gave him a prescription for something generic and potent, and told my elderly Mum with no medical acumen to “monitor his pee”.
“If it still looks bad in 24 hours, call an ambulance and admit him to hospital.”
This was not my dad’s first brush with a misbehaving bladder – only four weeks before this he was admitted to a major Sydney hospital with a UTI where he was pumped with IV antibiotics, fluids and subjected to regular blood tests and imaging to ensure the meds were working and the infection hadn’t spread to the danger zone: his kidneys.
UTIs often present differently in the elderly compared with younger people, with symptoms including vomiting, falls and major personality changes (see Logan Roy’s deranged response to a UTI in the last season of Succession). These infections can also quickly become deadly.
Four weeks ago Dad received good care and was discharged in less than a week.
Oh what a difference a few weeks, a new Covid variant and a mask-averse premier can make.
The 24 hours after the GP’s ominous instructions were fraught. No one in the family could sleep and, as the last day of 2021 dawned, we monitored Dad’s pee like mad scientists.
Friday evening rolled around and, as Sydney was gearing up for New Year’s Eve celebrations, it became apparent Dad’s urine was not improving and neither was he.
So we called an ambulance.
With visitors now shut out of hospitals and no phones beside patients’ beds, we feared these could be our last moments with Dad. We hastily sourced a simple mobile and tried to teach him how to use it but, having never used a computer before, let alone a touch-screen phone, he struggled to understand.
His poor eyesight, his inability to control his fingers, his decimated short-term memory and the delirium from the infection made the task near-impossible, and I tried not to choke up as I repeated: “Just tap on the screen gently, don’t jab it.”
The paramedics arrived and tried to put on a cheerful front. One of them was remarkably frank.
He took one look at Dad, all shrivelled and gaunt in his wheelchair at the kitchen table, and said: “To be honest, I don’t want to send any geriatric to a Sydney hospital right now. Covid is everywhere – in staff and patients, and the staff shortages mean he won’t get the care he needs.”
The paramedic suggested Mum and I try treating him at home, even though most GPs were closed until Tuesday, no one was answering calls on the national home doctor service line, and we had nothing but Google to guide us.
He explained that because Dad had a kidney infection, he would initially be placed in the “hot room” of the hospital’s emergency department, where patients with any sort of infection, headache, diarrhoea, cold symptoms and fever were placed. AKA, the Covid room. (The “cold room”, the paramedic explained, was reserved for ailments such as broken limbs and heart attacks.)
Mum and I glanced at each other, alarmed. The paramedic offered to call the triage nurse at the hospital’s emergency department to beg her not to place Dad in the room full of potential Covid patients. The nurse was sympathetic but explained it was hospital protocol.
Also, given the number of patients in emergency that evening, Dad would be waiting in the hot room “for at least five hours” before he could be moved (provided he tested negative to Covid on arrival – we had performed a negative RAT test on him the day before).
Dad sat there in the kitchen, not understanding what was going on, the N95 mask we had placed on him slipping off his nose and down his face. I imagined him sitting in the ED’s “hot room” with the mask half off, confused and tired and unable to sit upright in the chair or access a toilet or water. In that moment, Mum and I agreed to keep him at home.
The past few days have been a nightmare. Armed with tap water, oral antibiotics, a thermometer and Google, we have monitored Dad’s every symptom or behavioural change. Sometimes he seems better; the next moment he is worse.
Related: ‘People will die’: doctors warn Covid surge is filling up NSW hospitals
We feel guilty that we are not giving him the care he needs, guilty for keeping him out of hospital, but also horrified as we read the news stories about overwhelmed wards and mounting Covid cases. We don’t know yet if we have done the right thing.
His GP is back on Tuesday, when the pathology labs reopen. We will know then whether our decision to keep him home has kept him safe or will kill him.
I wonder how many other families are in the same position right now; how many other elders, vulnerable people, everyone who thought they were invincible but are not, are making these decisions about whether to put their lives in the hands of NSW hospitals.
