At the age of 53, Ms. Soldo had a subarachnoid haemorrhage. She was living with her son's family and lost consciousness in October 2019 while caring for her grandchildren. Her daughter-in-law immediately called the neighbour for help and made an emergency call. The ambulance arrived very quickly. Since the diagnosis of a brain haemorrhage was also established very quickly, Ms. Soldo was flown to the central hospital within a short time. Although the time between the incident and the first operation was very short, she suffered many complications. After the operation, she continued to bleed and part of the skull bone had to be removed. At the beginning, she was paralysed all over her body. With time, she learned to react to stimuli again, pulled her arms back and was able to move her fingers when asked. After the reinsertion (reimplantation) of the skull bone, blood accumulated in her head and she had to undergo another operation. Since this operation, she had been completely paralysed. At the time of the interview with her daughter, Ms. Soldo had been living in a nursing home for over a year. She was in need of constant care and was mobilised into a wheelchair once a week by the nursing service. As we learned from contact with the daughter, Ms. Soldo died two months after the interview. Ms. Soldo was divorced, had two adult children and worked in the catering industry. Her mother tongue was Bosnian. In her free time, she cared for her family and looked after her garden. The interview took place with the daughter of the patient. The day before the bleeding incident, the daughter gave birth to her second child. She was overwhelmed by the challenge of caring for two infants and her own mother, who was in a coma in intensive care unit. Even though she knew her mother's will not to want to live in a wheelchair, she advocated for full therapy. In retrospect and under the experience of this very long history of suffering, Ms. Soldo (daughter of the affected person) regrets some medical decisions. Ms. Soldo (daughter of the affected person) is married, has two children and works as a childcare professional in a day-care centre. She became her mother's legal guardian and made every decision in consultation with her brother. The interview took place on two dates as we had technical problems on the first one. The second appointment took place in August 2021 at the daughter's home. As her children had visitors, it is very lively in the background.
VIDEO
Months after the first bleeding, Ms. Soldo received a phone call because blood had accumulated again in her mother's head. The doctor was unable to tell her exactly what the effects of the operation would be. Ms. Soldo was shocked and anxious about the upcoming surgery. Without the operation, her mother could have died within a short time. Although she survived the operation, she never learned to move her muscles or communicate again.
TRANSCRIPT

Suter (Betroffener)
Mr. Suter values clear communication
Mr. Suter experienced the conversations with the medical service as caring and direct and emphasises how important this is.
Decision-making
Gerber (Angehöriger, Sohn)
Mr. Gerber felt well informed by the discussions
The doctors communicated results and examinations in such a way that Mr. Gerber felt well informed. This enabled him to prepare himself for the decision to let his father go.
Decision-making
At the age of 53, Ms. Soldo had a subarachnoid haemorrhage. She was living with her son's family and lost consciousness in October 2019 while caring for her grandchildren. Her daughter-in-law immediately called the neighbour for help and made an emergency call. The ambulance arrived very quickly. Since the diagnosis of a brain haemorrhage was also established very quickly, Ms. Soldo was flown to the central hospital within a short time. Although the time between the incident and the first operation was very short, she suffered many complications. After the operation, she continued to bleed and part of the skull bone had to be removed. At the beginning, she was paralysed all over her body. With time, she learned to react to stimuli again, pulled her arms back and was able to move her fingers when asked. After the reinsertion (reimplantation) of the skull bone, blood accumulated in her head and she had to undergo another operation. Since this operation, she had been completely paralysed. At the time of the interview with her daughter, Ms. Soldo had been living in a nursing home for over a year. She was in need of constant care and was mobilised into a wheelchair once a week by the nursing service. As we learned from contact with the daughter, Ms. Soldo died two months after the interview. Ms. Soldo was divorced, had two adult children and worked in the catering industry. Her mother tongue was Bosnian. In her free time, she cared for her family and looked after her garden. The interview took place with the daughter of the patient. The day before the bleeding incident, the daughter gave birth to her second child. She was overwhelmed by the challenge of caring for two infants and her own mother, who was in a coma in intensive care unit. Even though she knew her mother's will not to want to live in a wheelchair, she advocated for full therapy. In retrospect and under the experience of this very long history of suffering, Ms. Soldo (daughter of the affected person) regrets some medical decisions. Ms. Soldo (daughter of the affected person) is married, has two children and works as a childcare professional in a day-care centre. She became her mother's legal guardian and made every decision in consultation with her brother. The interview took place on two dates as we had technical problems on the first one. The second appointment took place in August 2021 at the daughter's home. As her children had visitors, it is very lively in the background.
Soldo (Angehörige, Tochter)
Ms. Soldo struggled with many complications
After the operation, Ms. Soldo started bleeding again and had to undergo further surgery. Part of the skull bone was removed to relieve the pressure on the brain. When this was reinserted, another collection of blood formed in the head. Ms. Soldo never recovered from the complications and lived in a nursing home for a year and a half after the incident, unable to move or communicate.
Experience of disease
Brain damage
Soldo (Angehörige, Tochter)
"Just another morning"
The sister-in-law immediately called an ambulance when she found her mother-in-law unconscious.
Experience of disease
Brain damage
Soldo (Angehörige, Tochter)
"Now she is simply bedridden"
Ms. Soldo reacts with her eyes to familiar voices. She gets pressure marks everywhere from lying down and her joints are stiff. The daughter does not know if her mother can understand her surroundings.
Challenges after brain damage
Brain damage
Soldo (Angehörige, Tochter)
Ms. Soldo is now her mother's guardian
Until the brain haemorrhage, Ms. Soldo stood by her daughter with advice and support. Since the disease, the roles have changed and the daughter now makes all decisions for her mother.
Impact for loved-ones
Brain damage
Soldo (Angehörige, Tochter)
Ms. Soldo had given birth to a child the day before her mother suffered a brain haemorrhage
Ms. Soldo only found out about her mother's brain haemorrhage a day later, as her family did not know how to tell her when she was in childbed. Tears still flow at the memories of those days almost two years after the event.
Impact for loved-ones
Brain damage
Soldo (Angehörige, Tochter)
Ms. Soldo lives in a spiral of grief
As a result of the decisions made, Ms. Soldo feels partly responsible for her mother's condition in need of care. She moves between the sadness of seeing her mother in the condition and the guilty conscience when there are moments of happiness in her life.
Impact for loved-ones
Brain damage
Soldo (Angehörige, Tochter)
The children kept her alive
With children, you are forced to get up and cope with everyday life. Looking back, Ms. Soldo sees that she would not have been able to cope with the difficult time without her children.
Impact for loved-ones
Brain damage
Soldo (Angehörige, Tochter)
The nursing home costs CHF 15 000 per month
The costs for the home are paid by the disability insurance and the municipality. Beforehand, however, the closest relatives were checked for their financial means.
Impact for loved-ones
Brain damage
Soldo (Angehörige, Tochter)
Ms. Soldo learnt not to get upset about little things
Ms. Soldo is now aware that life is too short to argue.
Lessons and strategies
Brain damage
Soldo (Angehörige, Tochter)
Friends and family stood by her during the difficult time
Ms. Soldo seeks distraction in nature and with her children. The crisis showed her that she can rely on her social environment.
Lessons and strategies
Brain damage
Soldo (Angehörige, Tochter)
As a family member, you get to hear a lot from other patients.
Ms. Soldo remembers sounds and images that she finds irritating.
Procedure after brain damage
Brain damage
Soldo (Angehörige, Tochter)
For the staff, the patients were just numbers
Ms. Soldo criticises that she often overheard the staff telling each other the bed numbers instead of the patients' names or having educational talks in the corridor. She would like to see a more personal approach.
Procedure after brain damage
Brain damage
Soldo (Angehörige, Tochter)
Since her mother has been living in a nursing home, Ms. Soldo has had to deal with many authorities
The costs for the place in the nursing home were paid by different institutions. Ms. Soldo had to disclose her finances and regularly work through many documents for this. She found this additional work very stressful. The support of Fragile Suisse and a social worker from the rehabilitation clinic were a great relief for Ms. Soldo. At the time of the interview, Ms. Soldo also had a professional representative who also helped her with administrative tasks.
Procedure after brain damage
Brain damage
Soldo (Angehörige, Tochter)
Ms. Soldo does not get a chance to discuss her mother's therapy goals with the doctor treating her
The mother has been in a nursing home for more than 1 ½ years. Ms. Soldo would very much like to evaluate the therapy. She does not get a chance to have a medical consultation because she is denied contact. This indirectly deprives her as a carer of the right to dispose of her mother.
Procedure after brain damage
Brain damage
Soldo (Angehörige, Tochter)
Ms. Soldo did not know the consequences of the interventions
Ms. Soldo suffered several complications. Her daughter was involved in each of the upcoming decisions. She was unable to assess the consequences. In retrospect, she would have liked to have decided against the last intervention, as her mother had to be cared for afterwards with severe impairments.
Decision-making
Brain damage
Soldo (Angehörige, Tochter)
"You are selfish as a child"
Due to her state of health, the affected person was no longer able to express her desire for therapy. The relatives knew their mother's presumed wishes, as she never wanted to be in a wheelchair. Since the mother did not put her will in writing, it was up to the relatives to pass on the mother's will. They decided in favour of full therapy, as they could not consent to the mother's death.
Decision-making
Brain damage
Soldo (Angehörige, Tochter)
The induced coma
After the operation, the patient had to be put into a coma again because of post-operative bleeding. Artificial sleep allows painful treatments to be carried out and stress to be reduced. However, those affected cannot express their wishes and needs in this state.
Decision-making
Brain damage
Soldo (Angehörige, Tochter)
Ms. Soldo received a phone call to consent to another emergency operation for her mother
Months after the first bleeding, Ms. Soldo received a phone call because blood had accumulated again in her mother's head. The doctor was unable to tell her exactly what the effects of the operation would be. Ms. Soldo was shocked and anxious about the upcoming surgery. Without the operation, her mother could have died within a short time. Although she survived the operation, she never learned to move her muscles or communicate again.
Decision-making
Brain damage
Soldo (Angehörige, Tochter)
Ms. Soldo wished she had been informed of the possible consequences at an earlier stage
Ms. Soldo could not assess her mother's future quality of life when making surgical decisions. She was also not aware of the long-term consequences of the planned interventions such as the tracheotomy or a permanent drainage of the cerebrospinal fluid (shunt). She criticised the fact that she had been informed about the measures and complications, but not about the long-term effects on her mother's life.
Decision-making
Brain damage
Soldo (Angehörige, Tochter)
"Her life is somehow no longer worth living"
Ms. Soldo describes in a few words the apathy of her mother, interpreting it as if she had already “left” while still alive.
Decision-making
Brain damage
Soldo (Angehörige, Tochter)
Ms. Soldo can see from her mother's face that she has given up on herself
Her mother has been incapacitated in a nursing home for well over a year. Ms. Soldo sees in her mother’s face how her expression is changing.
Identity
Brain damage
Soldo (Angehörige, Tochter)
Ms. Soldo grew up in two cultures
When asked about faith, religion and spirituality, Ms. Soldo describes her cultural background. This shows that religious themes and culture can be intertwined. For Ms. Soldo, character is more important than religious affiliation.
Faith, religion, and spirituality
Brain damage
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