artificial feeding-Terri Schiavo - page 30

I posted this here becaue I think this subject is something that we as nurses deal with on a regular basis.....Many many people state that they have a big problem with the feeding being stopped... Read More

  1. by   bugsbee
    Have you ever worked neuro I doubt it. She is not responding to anyone. We are paying for her care not her parents. And have you not wondered why she is in Hospice being cared for. What a shame to have the courts tied up on this. I sure would believe her husband over her parents. They are keeping her alive for their own selfish reasons only, and yes I do realize how hard it is to let go. But would you like to go public in her condition and take away all your rights of privacy?
  2. by   Spidey's mom
    Quote from Kyriaka
    _______________
    Retarded disabled people should be ashamed of themselves.

    Is it ok if that brought a little chuckle?

    steph
  3. by   Kabin
    I found a link that suggests Terri had a CAT scan, not MRI. Note the lack of cortex area from what is supposed to be Terri's brain scan:

    http://www.amptoons.com/blog/archive...chiavos-brain/
  4. by   Spidey's mom
    Quote from bugsbee
    Have you ever worked neuro I doubt it. She is not responding to anyone. We are paying for her care not her parents. And have you not wondered why she is in Hospice being cared for. What a shame to have the courts tied up on this. I sure would believe her husband over her parents. They are keeping her alive for their own selfish reasons only, and yes I do realize how hard it is to let go. But would you like to go public in her condition and take away all your rights of privacy?


    The Hospice issue is confusing - she isn't terminally ill.

    There are reports of her responding . . .

    Last Visit Narrative

    by Attorney Barbara Weller

    When Terri Schiavo's feeding tube was removed at 1:45 p.m. on March 18, 2005, I was one of the most surprised people on the planet. I had been visiting Terri throughout the morning with her family and her priest. As part of the legal team working throughout the previous days and nights to save Terri from a horrific fate, I was very hopeful. Although the state judicial system had obviously failed Terri by not protecting her life, I knew other forces were still at work. I fully expected the federal courts would step in to reverse this injustice, just as they might for a prisoner unjustly set for execution--although by much more humane means than Terri would be executed. Barring that, I was certain that sometime around noon, the Florida Department of Children and Family Services would come to the Woodside Hospice facility in Pinellas Park and take Terri into protective custody. Or that federal marshals would arrive from Washington D.C, where the Congress was working furiously to try to save Terri, and would stand guard at her door to prevent any medical personnel from entering her room to remove the tube that was providing her nutrition and hydration.

    Finally, I was sure if nothing else was working, that at 12:59,just before the hour scheduled for Terri's gruesome execution to begin, Florida Gov. Jeb Bush would at least issue a 60-day reprieve for the legislative bodies to complete the work they were attempting to do to save Terri's life and to make sure that no other vulnerable adults could be sentenced to starve to death in America. I had done the legal research weeks before and was fully convinced that Gov. Bush had the power, under our co-equal branches of government, to issue a reprieve in the face of a judicial death sentence intended to lead to the starvation and dehydration of an innocent woman when scores of doctors and neurologists were saying she could be helped.

    All morning long, as I was in the room with Terri and her family, we were telling her that help was on the way. Terri was in good spirits that morning. The mood in her room was jovial, particularly around noontime, as we knew Congressional attorneys were on the scene and many were working hard to save Terri's life. For most of that time, I was visiting and talking with Terri along with Terri's sister Suzanne Vitadamo, Suzanne's husband, and Terri's aunt, who was visiting from New York to help provide support for the family. A female Pinellas Park police office was stationed at the door outside Terri's room.

    Terri was sitting up in her lounge chair, dressed and looking alert and well. Her feeding tube had been plugged in around 11 a.m. and we all felt good that she was still being fed. Suzanne and I were talking, joking, and laughing with Terri, telling her she was going to go to Washington D.C. to testify before Congress, which meant that finally Terri's husband Michael would be required to fix her wheelchair. After that Suzanne could take Terri to the mall shopping and could wheel her outdoors every day to feel the wind and sunshine on her face, something she has not been able to do for more than five years.

    At one point, I noticed Terri's window blinds were pulled down. I went to the window to raise them so Terri could look at the beautiful garden outside her window and see the sun after several days of rain. As sunlight came into the room, Terri's eyes widened and she was obviously very pleased. At another point, Suzanne and I told Terri she needed to suck in all the food she could because she might not be getting anything for a few days. During that time, Mary Schindler, Terri's mother, joined us for a bit, and we noticed there were bubbles in Terri's feeding tube. We joked that we didn't want her to begin burping, and called the nurses to fix the feeding tube, which they did. Terri's mother did not come back into the room. This was a very difficult day for Bob and Mary Schindler. I suspect they were less hopeful all along than I was, having lived through Terri's last two feeding tube removals.

    Suzanne and I continued to talk and joke with Terri for probably an hour or more. At one point Suzanne called Terri the bionic woman and I heard Terri laugh out loud heartily for the first time since I have been visiting with her. She laughed so hard that for the first time I noticed the dimples in her cheeks.

    The most dramatic event of this visit happened at one point when I was sitting on Terri's bed next to Suzanne. Terri was sitting in her lounge chair and her aunt was standing at the foot of the chair. I stood up and learned over Terri. I took her arms in both of my hands. I said to her, "Terri if you could only say 'I want to live' this whole thing could be over today." I begged her to try very hard to say, "I want to live." To my enormous shock and surprise, Terri's eyes opened wide, she looked me square in the face, and with a look of great concentration, she said, "Ahhhhhhh." Then, seeming to summon up all the strength she had, she virtually screamed, "Waaaaaaaa." She yelled so loudly that Michael Vitadamo, Suzanne's husband, and the female police officer who were then standing together outside Terri's door, clearly heard her. At that point, Terri had a look of anguish on her face that I had never seen before and she seemed to be struggling hard, but was unable to complete the sentence. She became very frustrated and began to cry. I was horrified that I was obviously causing Terri so much anguish. Suzanne and I began to stroke Terri's face and hair to comfort her. I told Terri I was very sorry. It had not been my intention to upset her so much. Suzanne and I assured Terri that her efforts were much appreciated and that she did not need to try to say anything more. I promised Terri I would tell the world that she had tried to say, "I want to live."

    Suzanne and I continued to visit and talk with Terri, along with other family members who came and went in the room, until about 2:00 p.m. when we were all told to leave after Judge Greer denied yet another motion for stay and ordered the removal of the feeding tube to proceed. As we left the room, the female police officer outside the door was valiantly attempting to keep from crying.

    Just as Terri's husband Michael has told the world he must keep an alleged promise to kill Terri, a promise remembered a million dollars and nearly a decade after the fact; I must keep my promise to Terri immediately. Time is running out for her. I went out to the banks of cameras outside the hospice facility and told the story immediately. Now I must also tell the story in writing for the world to hear. It may be the last effective thing I can do to try to keep Terri alive so she can get the testing, therapy, and rehabilitative help she so desperately needs before it is too late.

    About four in the afternoon, several hours after the feeding tube was removed, I returned to Terri's room. By that time she was alone except for a male police officer now standing inside the door. When I entered the room and began to speak to her, Terri started to cry and tried to speak to me immediately. It was one of the most helpless feelings I have ever had. Terri was looking very melancholy at that point and I had the sense she was very upset that we had told her things were going to get better, but instead, they were obviously getting worse. I had previously had the same feeling when my own daughter was a baby who was hospitalized and was crying and looking to me to rescue her from her hospital crib, something I could not do. While I was in the room with Terri for the next half hour or so, several other friends came to visit and I did a few press interviews sitting right next to Terri. I again raised her window shade, which had again been pulled down, so Terri could at least see the garden and the sunshine from her lounge chair. I also turned the radio on in her room before I left so that when she was alone, she would at least have some music for comfort.

    Just before I left the room, I leaned over Terri and spoke right into her ear. I told her I was very sorry I had not been able to stop the feeding tube from being taken out and I was very sorry I had to leave her alone. But I reminded her that Jesus would stay right by her side even when no one else was there with her. When I mentioned Jesus' Name, Terri again laughed out loud. She became very agitated and began loudly trying to speak to me again. As Terri continued to laugh and try to speak, I quietly prayed in her ear, kissed her, placed her in Jesus' care, and left the room.

    Terri is alone now. As I write this last visit narrative, it is five in the morning of March 19. Terri has been without food and water for nearly 17 hours. I'm sure she is beginning at least become thirsty, if not hungry. And I am left to wonder how many other people care.

    http://cogforlife.org/schiavoweller.htm
  5. by   Spidey's mom
    From 2003 . . .

    http://www.cnsnews.com/ViewCulture.a...20030903b.html




    Disabled Woman Would Cry 'Help Me,' Caregivers Claim
    By Jeff Johnson
    CNSNews.com Congressional Bureau Chief
    September 03, 2003

    (Editor's note: This report contains quoted language and descriptions of alleged multiple instances of denied medical care that some readers may find offensive.)

    (CNSNews.com) - A federal judge Tuesday refused to stop a Florida court from ordering the removal of a disabled woman's feeding tube at the request of her husband. However, the judge gave the woman's parents ten days to amend their lawsuit against the husband, the hospital caring for the woman and the hospice where she is being kept in anticipation of her death by starvation or dehydration. The lawsuit also named the husband's attorney as a "non-party co-conspirator" to the alleged violations.

    Robert and Mary Schindler filed an emergency complaint Saturday with the U.S. District Court for the Middle District of Florida in Tampa in an effort to block their daughter's husband and legal guardian, Michael Schiavo, from moving forward with plans to remove his wife's feeding tube. Thirty-nine year old Terri Schindler Schiavo suffered a brain injury in 1990 under questionable circumstances. That injury, complicated by a lack of therapy for more than a decade, has required that she be given nutrition and hydration through a gastrostomy or "feeding tube." . . . . . .
  6. by   James Huffman
    Quote from bugsbee
    She is not responding to anyone. We are paying for her care not her parents. And have you not wondered why she is in Hospice being cared for. What a shame to have the courts tied up on this. I sure would believe her husband over her parents. They are keeping her alive for their own selfish reasons only, and yes I do realize how hard it is to let go. But would you like to go public in her condition and take away all your rights of privacy?
    1. She is most definitely responsive; the videos indicate that. Saying otherwise is simply ignoring the evidence.

    2. "We" are paying for a lot of stuff. I'm not exactly sure why the costs spent on Ms. Schiavo's care is suddenly such a big deal when it is next to nothing in the big scheme of government spending.

    3. Yes, I have wondered why a woman who is not dying is in a hospice. I thought that's what hospices are for.

    4. This is an important case; that's one of many reasons the courts are involved in it.

    5. We can believe whom we want to believe. But Michael Schiavo, I continue to remind people says the following:

    "When is she going to die?"

    "Has she died yet?"

    "When is that ***** gonna die?"

    "Can't you do anything to accelerate her death - won't she ever die?"

    and her nurse pointed out that "When she wouldn't die, Michael would be furious."

    I am disinclined to believe that someone who makes such statements is someone worthy of believing.

    6. Since I'm not privy to the mind of the Schindler family, I won't presume to guess that they are being "selfish." Maybe they love their daughter, and don't want her to die. Why is that such a problem?

    Jim Huffman, RN
  7. by   Haunted
    Quote from Tweety
    I've expressed my opinion on the subject in the current event boards many times. I support the husband in his desires to carry out his wife's wishes and I'll leave it at that.

    To the original question, as it pertains to my nursing practice, I support spouses and families with nonjudgement no matter what they do in cases like this. I taken care of patients on both sides of this issue, those in a permanent vegetative state that are kept alive with all kinds of heroics and those who have been allowed to finish the process of dying that their initial illness/injury started, which I think of a tremendous act of love and courage, not murder. This included the case of a 19 year old head injured boy who would have lived for 40 years on a tube feeding, but his parents cut it off and he died of dehydration.

    I think any "Terri's Laws" that would present this option for families is dangerous territory.

    Off topic. Terri's husband was on the radio the other day saying he got offered lots of money to keep her alive and drop his efforts. I wonder if this is true.

    Absolutely TRUE! A business man in So Cal offered him something like 10 million bucks to release guardianship to her parents.

    My humble opinion, give this woman 30 days of PT, OT, SLP etc. Give her every opportunity ONCE AND FOR ALL in a neutral facility with no intervention on the parent's or husbands part. After 30 days, have her evaluated by a neutral, court appointed physician to determine the viability of continued therapy. If yes, have her declared a ward of the state and resume treatment, if no, resume the starvation. What say you all?
  8. by   BRANDY LPN
    Quote from Haunted
    Absolutely TRUE! A business man in So Cal offered him something like 10 million bucks to release guardianship to her parents.

    My humble opinion, give this woman 30 days of PT, OT, SLP etc. Give her every opportunity ONCE AND FOR ALL in a neutral facility with no intervention on the parent's or husbands part. After 30 days, have her evaluated by a neutral, court appointed physician to determine the viability of continued therapy. If yes, have her declared a ward of the state and resume treatment, if no, resume the starvation. What say you all?
    That is my thoughts too, why not court order a swallow study, a PET scan, an MRI and then give her a year of aggressive therapy and re-evaluate. 30 days would not be enough time IMHO to prove anything. Then IF she did not respond to therapy her parents would KNOW for certain that everything that can be done has been done and hopefully then they would be able to let go. If it was my child I would want definate proof that there was no hope before allowing them to die.
  9. by   Tweety
    Quote from Haunted
    Absolutely TRUE! A business man in So Cal offered him something like 10 million bucks to release guardianship to her parents.

    My humble opinion, give this woman 30 days of PT, OT, SLP etc. Give her every opportunity ONCE AND FOR ALL in a neutral facility with no intervention on the parent's or husbands part. After 30 days, have her evaluated by a neutral, court appointed physician to determine the viability of continued therapy. If yes, have her declared a ward of the state and resume treatment, if no, resume the starvation. What say you all?
    I don't see the harm in that. I wonder after 14 years though what her rehab potential is, but certainly wouldn't hurt to find out once and for all as you have one camp saying she's been this way for 14 years and isn't going to change, and another camp saying she's rehabable.

    Here's an article: http://www.sptimes.com/2005/03/22/Ta...yond_the.shtml

    The Florida Legislature saw a half-dozen video snippets of Terri Schiavo in 2003 and hastily passed an unconstitutional law that kept her alive for more than a year.

    Last week, Bill Frist, majority leader of the U.S. Senate and a doctor, reviewed the video images, pronounced her conscious and decried her "starvation." Then, he and his congressional colleagues also passed a "save Terri" law.

    Through it all, well-meaning people all over the country have called Schiavo's husband a murderer and compared Pinellas-Pasco Circuit Judge George Greer to Adolf Hitler.

    Why do these video images hold such power?

    For starters, the six brief scenes posted on www.terrisfight.org were chosen by her parents and their supporters to make the strongest possible case that Terri Schiavo - damaged though her brain might be - is still a conscious being.

    Secondly, there is simply no denying that a few of the images are disturbing - even after years of medical testimony and court decisions have concluded she has no real consciousness and never will.

    Go to the Web site and watch Schiavo arch her eyebrows after being told to open her eyes. Maybe this is a reflexive action, as some doctors say, but it's easy to see why lay people might be moved.

    In late 2003, I reviewed all four hours of videotape from Terri Schiavo's court-ordered medical evaluations, not just the four minutes and 20 seconds that are posted on the "terrisfight" Web site, and wrote a story about it. The complete videos - the latest ones - are part of the court file.

    With the Web site still stirring a nation, the question remains: Do these brief images represent her condition or are they a result of creative editing? Are her reactions purposeful or as unthinking as a sea anemone that contracts upon touch?

    The full four-hour version was taped in 2002 under the supervision of doctors. On it, Schiavo's parents, Robert and Mary Schindler, repeatedly coax their daughter to perform. It was their chance to show Judge Greer firsthand that Schiavo still had spirit. The video is poignant and, at times, painful.

    Mary Schindler bends to her daughter's face to chat and coo. On two occasions, Schiavo's eyes seem to focus and her mouth seems to broaden. Could that be a smile?

    When her mother plays some loud, tinkling music, Schiavo's moans grow louder while her face remains relaxed. Is she enjoying the sound?

    Her eyes follow a balloon on three separate occasions, surprising even a doctor selected by her husband, Michael Schiavo.

    But more often than not, the parents' and doctors' ministrations elicit no apparent reaction - at least not to someone unfamiliar with the nuances of her expressions. She mostly lies in bed with stiff limbs, loose jaw and unfocused eyes - no matter how hard her parents try.

    "It's Mommy. Look this way," Mrs. Schindler urges to no avail. "Can you say, "No, no, no' like you did before? No, no, no?"

    "Terri, Terri, Terri. Can you look over here, sweetheart?"

    At one point, Robert Schindler gets gruff while trying to get his daughter to follow a Disney-character balloon. "Come here, Terri, no more fooling around. No more fooling around with your Dad."

    He pokes her in the forehead to make sure she's awake. "No more fooling around with your Dad. Listen to me. You see the balloon? You see Mickey?"

    Later, he apologizes. "I'm not going to lecture you anymore. I was scolded. No more lectures. You do as you please."

    Neither Schindler's gruff admonition nor soothing apology seem to draw any reaction from his daughter.

    Two doctors chosen by the Schindlers testified that the medical evaluations and video images show that she retains some level of consciousness. Two doctors picked by Michael Schiavo and one doctor appointed by Greer said her reactions are reflexive and involuntary - like a sunflower following the sun across the sky.

    CAT scans show significant damage in her brain, they said.

    Yes, a Web site image shows what could be a smile when her mother talks to her. But at other moments, not shown on the Web site, Schiavo makes similar expressions to no apparent stimulus. That doesn't square with smiling at Mom, some of the doctors said.

    The majority of doctors, Greer and appellate judges concluded that Schiavo meets the definition of "persistent vegetative state," required under Florida law for feeding tubes or other life prolonging procedures to be removed. To meet that standard, the statutes say, people cannot exhibit any voluntary action or cognition "of any kind."

    The single most dramatic moment on the video occurs when William Hammesfahr, a Clearwater neurologist picked by the Schindlers, asks Schiavo to open her eyes.

    At first, her eyelids barely flutter. She slowly turns her head toward Hammesfahr, gradually opening her eyes. Then her eyebrows lift into an exaggerated arch - the kind of face a cartoonist might draw to show astonishment.

    It's the only time in four hours that she makes that expression, which would appear to rule out coincidence. A lay person could easily conclude that some part of her, somewhere, responded to language and followed a command.

    "Good job!" Hammesfahr exults. "Good job, young lady!"

    But she never pulls it off again, or anything remotely like it. For nearly an hour, her parents and the doctor tell her to open her eyes, close her eyes, look this way, look that way, with little apparent response.

    New Jersey resident Linda Lariviere said she has an idea why Schiavo only opened her eyes once. Doctors diagnosed her husband as living in a vegetative state - until she showed them videos of him "crying appropriately to music and emotionally evocative statements," she wrote to the Times in 2003. Doctors then upgraded his diagnosis to "minimally conscious," a standard that would not allow removal of a feeding tube in Florida.

    Schiavo "can't perform consistently, the way a normal person would," Lariviere wrote. "The command or request has to be processed first. Maybe it makes it to completion, enabling Terri to respond, while other times it doesn't.

    "Responding is real hard work for Terri and very fatiguing. Of course there would be long periods of taping with no obvious cognition going on. She is severely brain injured."

    [Last modified March 22, 2005, 06:59:05]
    Last edit by Tweety on Mar 22, '05
  10. by   KRVRN
    Well, hospice should be involved now... now she is terminal.
  11. by   Kyriaka
    Quote from stevielynn
    Is it ok if that brought a little chuckle?

    steph
    _________
    Yeah. Its ok.
  12. by   Kyriaka
    Quote from KRVRN
    Well, hospice should be involved now... now she is terminal.
    _____________
    You got that right!
  13. by   barefootlady
    The debate is over, the feeding tube will remain out. There was a constitutional issue here that was settled. That being said, I hope we all say a prayer for her parents today and everyday, it is never easy to lose a child, but this will be very, very difficult for them to endure.
    I find it strange that celebrities have made statements regarding how horrible her death would be without really understanding what it would really entail. I have lost respect for some of the publicity seekers who spoke without knowing the facts of how she will probably expire.
    Remember, I have kept my opinion to myself, it would surprise some you to know it, but I do have sympathy and concern for all involved.
    I do hope the spouse and parents can have private, meaningful visits with her before she slips away, I doubt the press will allow this though, and will wait like the vultures they are for one more headline.

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