Artificial feeding-Terri Schiavo

FranEMTnurse, CNA, LPN, EMT-I · Mar 26, 2005

I feel the same way. Why else would he put himself through all of this? He could have washed his hands of Terri long ago and nobody would've faulted him for that. I admire him for sticking to his guns and seeing to it that Terri's wishes are respected until the end. It has been a long and tortuous road to take.
I refuse to judge him in a negative light for resuming his life outside the walls of the nursing home. I used to work in a NH caring for brain and spinal cord injured young and middle aged adults. It was not unusual at all for the healthy spouse to have girlfrinds/boyfriends while maintaining their marriage. They would still come and visit their partner, take care of them and take them out for day trips or weekend visits.....but they also went forward with their own lives. They are not evil sinners....they are people doing the best they can in a horrible situation. It's easy for those of us not in these predicaments to sit back and claim superior morals. :stone

And may she finally rest in peace. Goes to show how important making a living will, and appointing a power of attorney is. I have done both, and have given copies to my doc, and my daughters. They even had a newscast about the importance of it is, and one website was offering to help anyone who wants a copy of the one where the website is located. They have been flooded with requests this week.

camay1221_RN · Mar 26, 2005

What thought have the Schindlers' given to who will care for Terri when they are no longer able to?

leslie :-D · Mar 26, 2005

is it true that when a person is dying of dehydration, he or she can not feel the hunger or thirst but patient becomes unconscious and die peacefully?

as a hospice nurse, my observations are that as the body is shutting down, such basic needs for food and water are greatly diminished. furthermore, when your body is in a dehydrated state, your brain releases endorphins which serve to act as a natural analgesic and has a positive effect on the condition of the patient.

when their oral mucosa becomes dried/parched and i am giving mouth care, i don't see them sucking on the toothette/swab or wet washclosh....which to me indicates they are not thirsty.

one time i had this male pt that was put on hospice and he wasn't being fed, still alert. when i gave him mouthcare, he sucked on it as if he couldn't get enough. so i put him in a high fowler's position and gave him a little ice cream. this pt was not ready to stop eating/drinking. i was furious and went to my don with my findings. trays started being served to him; i fed him but a few weeks later i noticed him shutting down. and it was then that he no longer sucked on a toothette or washcloth......

so to answer your question, i believe it to be no, they do not feel hunger or thirst. and yes, most die very peacefully.

leslie

Home Health Columnist / Guide · Mar 26, 2005

concur with earle 100%--same experience seen in my 20 years in homecare:as the body is shutting down, such basic needs for food and water are greatly diminished, desire to eat/drink is not there. oral care sucking good indicator if patient desires to drink.

my hospice program used a book gone from my sight -- the dying experience by barbara karnes that beautifully explained this issue. http://www.bkbooks.com/booklets.html

many of us have expressed the need for improved communication regarding end of life wishes and care-- found these links interesting.

communicating end-of-life wishes

an rwjf-funded study provides advice on better preparing the people designated to represent our interests at the end of life.

gentle passages care, inc. is a nonprofit, non-denominational

service organization founded by judith l. buchman, executive director. judy has supported, assisted and encouraged hundreds of patients and their families during the dying process. one of the many goals is to:

to assist the family in celebrating the patient's life and to ensure that the patient's journey ends in peace and with dignity. http://www.gentlepassages.org/

wishing much strength and energy to the staff at the hospice prograrm caring for terri. cannot begin to fathom what working under such scrutiny must be like, but sending then a heartfelt {{{{{{{{{{{{hug.}}}}}}}}}}}}}}

danu3 · Mar 26, 2005

one time i had this male pt that was put on hospice and he wasn't being fed, still alert. when i gave him mouthcare, he sucked on it as if he couldn't get enough. so i put him in a high fowler's position and gave him a little ice cream. this pt was not ready to stop eating/drinking. i was furious and went to my DON with my findings. trays started being served to him; i fed him but a few weeks later i noticed him shutting down. and it was then that he no longer sucked on a toothette or washcloth......
so to answer your question, i believe it to be no, they do not feel hunger or thirst. and yes, most die very peacefully.
leslie

This reminded me of my mom when she died. The last week or so of her life, she basically stopped eating and drinking on her own. When I tried to feed her or give her a drink, she would take a token bite or a token drink and will refuse to open her mouth after that. About 10 minutes before she died, she was moving around a little bit in bed, didn't say anything, just moved around with some renew energy which I haven't see for a while. So I gave her a little bit of the dinner which she didn't eat a bit earlier and she ate a little bit of it. I gave her some jello which she like and she ate a little bit of it. I gave her some 7up which she like and she drink a little bit of it. She then calmed down and then about 10 minutes later, she passed in front of me to my surprised. It is as if she somehow knows and decided to enjoy a bit of food and a bit of drink before she goes.

-Dan

FranEMTnurse, CNA, LPN, EMT-I · Mar 26, 2005

as a hospice nurse, my observations are that as the body is shutting down, such basic needs for food and water are greatly diminished. furthermore, when your body is in a dehydrated state, your brain releases endorphins which serve to act as a natural analgesic and has a positive effect on the condition of the patient.
when their oral mucosa becomes dried/parched and i am giving mouth care, i don't see them sucking on the toothette/swab or wet washclosh....which to me indicates they are not thirsty.
one time i had this male pt that was put on hospice and he wasn't being fed, still alert. when i gave him mouthcare, he sucked on it as if he couldn't get enough. so i put him in a high fowler's position and gave him a little ice cream. this pt was not ready to stop eating/drinking. i was furious and went to my DON with my findings. trays started being served to him; i fed him but a few weeks later i noticed him shutting down. and it was then that he no longer sucked on a toothette or washcloth......
so to answer your question, i believe it to be no, they do not feel hunger or thirst. and yes, most die very peacefully.
leslie

Excellent post, Leslie. You would know.

danu3 · Mar 26, 2005

Here are a few links to a few brief comments on this case from the National Hospice and Palliative Care Organization.

http://www.nhpco.org/i4a/pages/Index.cfm?pageid=4525

http://www.nhpco.org/i4a/pages/Index.cfm?pageid=4522

http://www.nhpco.org/i4a/pages/Index.cfm?pageid=4521

What I do like about the above brief comments is the absent of any condemning attitudes of one side or another.

-Dan

mysticalwaters1 · Mar 26, 2005

my father had to make a decision for my mother like this. her k was high and i don't know what happened. she was on dialysis had crohn's disease had no more intestine left just multitude of complex issues basically everything failing her.

we took her to mt siani where she got significantly better. anyway she was home doing well and suddenly just became unresponsive and instantly started doing death gasps. i have no idea what happened except that her k was high i found out later and had problems with different dialysis shunts. it seems some electrolyte imbalance. the paramedics revived her physically but by then i don't think she had enough oxygen and was brain damaged.

now my father loved my mother to death. she was also only 43 years old. the doctors did an eeg and other examinations and deemed her brain dead. i knew that was it. and my dad agreed to a dnr status. we visited her in icu and she was doing reflexing "death gasps." so the day my dad issued the dnr her heart gaveway. i know i'm blabbing away here but i feel for anyone in these situations and everyone is so diffent and complicated. i usually see spouses making these decisions or if the parents are involved it's collective agreement. the entire senario is horrible. honestly if my grandmother was closer she has now grasp about medical issues or rather she can't make decisions i could see her fighting my father to do this. i'm not saying that terri's parents don't understand her medical situation just from my personal experiece can see how something could have turned very ugly.

i can see the points on either side with terri's case. i just feel right now people are throwing mud with issues they don't really understand and am rather amazed at some press going on. i took care of a similar pt. now we still don't know all the circumstances with terri's family. i have seen however a similar pt i consistantly take care of who has severe brain damage and both legs and arms permanently contracted. she opens her eyes and closes them but does not follow you or show any sign that she's aware of her suroundings. her poor mother feels one day her daughter will come out of this. it's very sad because she is not. i'm not talking about someone in a comma i'm talking about someone severely brain damaged and not going to get any better. the other thing is that i feel the mother is almost obsessed with her daughter. it's some coping strategy to get everyone on her side to believe in her daughter to have hope she will pull through. it almost verges as fanatical and it's really scary. she dictates every aspect of her daughter's day and keeps putting the tv by her face during the day to entertain her which is fine but i'm just saying it' s overboard. one time she was hospitalized then her daughter was and she was bringing in other pts in to see her "precious angel" while her daughter had vre. she should not have been on the same floor.

hope is a good thing but i feel obsessing is not and sometimes i do get that vibe with terri's parents. that's just a vibe i'm getting but then again they're desperate to say or do anything to keep their daughter alive and as i've said we don't know the entire story either. what a sad situation. it's just sad that after this specific situation came out people don't seem to understand these decisions go on all the time and i feel many without a big legal or family fight. i don't know why this case has been so huge. i'm sorry it seems too politacally motivated and sorry but if it is that's disgusting exploiting a family situation to do so however it seems that same family may have done it as well but this is someone's life.

:crying2:

Robinr1958 · Mar 26, 2005

As an ICU nurse for more than 20 years, I have been witness to countless cases as heart-breaking as Terri's. I feel the pain of both sides of her family. I have discussed my wishes with not only my husband but also my daughter and the rest of my family and they know exactly how I feel. I believe that there are truly worse things than death. I cannot imagine wanting to continue to exist if I were probably permanently going to be unable to communicate my needs to my caregivers. I can't imagine not being able to communicate to someone that I needed to scratch an itch or push my hair out of my face if it is tickling me or adjust the position of one of my limbs when it becomes uncomfortable...and even worse than that...to not even be aware that I had those needs...especially if, in all likelihood, I would not ever be able to improve.

If what happened to Terri had happened even 50 years ago, first of all, she would not be here at all as CPR as we know it wasn't developed until 1960. And truly adequate tube feeding formulas weren't begun to be very well developed until the early space program when alternate means of adequate nutrition were needed for the astronauts. Perhaps this is an example of what Albert Einstein meant when he said "It has become appallingly obvious that our technology has exceeded our humanity."

I do believe that this case and the publicity it has earned is going to have a positive outcome...not necessarily for Terri's family...either side... but for everyone who will, because of this case, talk to their families about what their wishes are if they are in a similar situation and write a living will.

Robin

James Huffman · Mar 26, 2005

From WorldNetDaily, 3/25

"Michael Schiavo lawyer

gave to judge's campaign

George Felos made contribution to Greer day after key ruling by court in Terri's case

The judge who tried the Terri Schiavo case and most recently rejected Gov. Jeb Bush's request to intervene, received a campaign contribution from the lawyer pressing for the brain-injured woman's death, raising questions of a conflict of interest.

According to Florida's Department of State, Pinellas County Circuit Court Judge George W. Greer received a contribution of $250 for his 2004 re-election campaign from Felos & Felos, the law firm of George Felos.

Felos, known as a "right-to-die" advocate, represents Terri Schiavo's estranged husband, Michael Schiavo, who won a court order from Greer to have the woman's life-sustaining feeding tube removed one week ago.

The contribution's apparent conflict of interest was raised by an Internet site investigating the Schiavo case, the Empire Journal, and by Rev. D. James Kennedy's group Center for Reclaiming America.

The contribution from Felos came May 7, 2004, one day after Pinellas County Circuit Court Judge Douglas Baird ruled "Terri's Law" unconstitutional. The Florida Legislature's measure was designed to enable Gov. Bush to intervene in the previous instance in which Terri Schiavo's feeding tube was removed.

The contribution from Felos was the only one made that day, indicating it was not part of a fund-raising effort.

The Empire Journal also reported contributions to Greer were made by three other lawyers who represented Michael Schiavo at various stages in the case.

Deborah Bushnell, Gwyneth Stanley and Stephen G. Nilsson each contributed at least $250 to Greer's re-election campaign, as did court-appointed attorneys representing the husband's interest, Pacarek & Herman and Richard Peorifice.

WND attempted to reach the Florida Judicial Qualifications Commission, the independent body that investigates complaints against state judges, but there was no response.

Felos' office in Dunedin, Fla., also could not be reached.

The Empire Journal notes that in Florida, a judge is not required to recuse himself if he receives a contribution from an attorney in a case over which he presides.

Nevertheless, a contribution can establish the appearance of impropriety, and the state's code of judicial conduct requires a judge to remove himself in such a case.

Ronald D. Rotunda, professor of law at George Mason University, told the Empire Journal he sees such contributions as problematic.

He cites a 2002 poll of the American Bar Association concluding 84 percent of all Americans are concerned that the impartiality of judges is compromised by their need to raise campaign contributions.

Rotunda said judicial campaign contributions constitute or appear to constitute a tacit quid pro quo in which the judge favors or tilts towards the contributor-litigant."

James Huffman · Mar 26, 2005

From FoxNews.com, on Thursday:

"The state court request by Gov. Bush and the state's social services agency to take custody of Schiavo may have been the Schindlers' final option. The request cited new allegations of neglect and challenged Schiavo's diagnosis as being in a persistent vegetative state.

The long-shot custody request by Bush was made before Judge Greer, the same judge who has presided over the case for several years and issued the ruling last month that allowed the feeding tube to be removed.

Greer on Thursday also denied a request by the Florida Department of Children and Families to unseal probate records, including financial information, in the guardianship case to determine if Schiavo has been abused or exploited. DCF argued it needed that information for their current investigation.

DCF filed a motion last month to intervene in the case, saying it was investigating 30 allegations of abuse, neglect and exploitation of the brain-damaged woman and that her husband Michael was the suspect. The agency asked for a 60-day stay of removal of the tube but Greer denied the stay and refused them the right to intervene in the case."

allnurses Guide · Mar 26, 2005

What thought have the Schindlers' given to who will care for Terri when they are no longer able to?

Terri has siblings and many other relatives.

steph