[cargal]

It is a tough job- from the recent husband who thought "hospice would come in and take over" to the obsessive and fighting sibling offspring that try to draw you in and get you to take sides, to the son who did internet research on alternative meds, herbs and vegan diet to reverse cellular death, althewhile eschewing the prescribed meds his mother was supposes to be taking. A sister actually called me and said to do something as "my brother is nuts." I stated that her mother was alert and oriented and of sound mind and it was her choice to follow her son's advice. He since has been banished and the pt is doing much better. I have had families where a meal could not be cooked in the kitchen due to gross messiness, garbage, stink etc and all the mom and dad did was sleep (drugs?) all day when the mom was not at her job as a privately employed cook. The patient, once again, was competent and denied any nutritional deficit. I doubt that she has adequate intake. A nutritionist would be lost on these folks. It is all very sad, and you do what you can. I agree with the comment about boundaries. Also, most patterns are set up from a lifetime and can't be changed, so I define my goal with my patients and usually they don't include feeling guilty over family dynamics that I can't control. Great luck to you all.

[Hellllllo Nurse]

I worked inpt hospice for 4 years. You will see families at their best and at their worst.

I've had quite a few like you've described. The families are often tough to deal with, the pts are the easy ones!

I found one thing that helps w/ these kinds of people is to NOT get defensive. It seems to make them go that much more into attack/critisize mode.

Smile, remain friendly. Don't speak to these family members when you don't have to, it tends to give them ammo.

It's the feelings of guilt for not being their for their loved one, or feelings of helplessness, lack of control coming out.

It's not you, it's them. Remembering that helps.

[waves]

i guess i really believe in the general mission of hospice; and that does keep me going back. i do know that in general it is not the worst possible situation. it could definitely be worse. i just don't know if my head is ready for 10 years of this. is hospice something that nurses rotate in and out of...for a break?

[cargal]

I was removed as case manager from the pt whose husband expected hospice to "come in and take over everything". He told my supervisor it was because I wouldn't commit to a four hour time period 2x a week. He told me he needed hospice there at the same time every day because he ran his own business and he needed to take his handicapped son to work and back . I hooked him up with the volunteer co-ordinator and gently suggested some outside help. This has been very demoralizing to me.

[waves]

cargal-well doesn't that beat all? a sucker punch. hope your supervisor treats it as a people fit issue. ideally there should be someone that will fit each situation. even if the next case manager tells him the same thing, in the same way he may react completely in a different way. it's almost primal scents or something that set some people off. don't take it personally, maybe you'll be the saviour in another tough case!