Denial

Specialties Geriatric

Published

Same one I've had trouble with.

Loved one in end-stage cx. Mets everywhere. Intubated a few weeks ago. Finally a DNR. Not eating, not voiding.

POA had us stop the MSO4 because that's why the loved one isn't eating.

Specializes in LTC, Hospice, Case Management.
Is that something that can be detailed in a living will? i know I need to put my desires in writing, my husband will totally not get it. Good luck with this case. We have a resident with very debilitating MS, they were just able to extubate her , again, spouse just cannot let her go... so sad.

Unfortunately, you can put it in writing all you want, but if your loved ones won't back it up..it won't matter one bit. Facility/Dr will nearly always follow family demands despite what is written in a living will.

My husband would also probably have a very tough time following my written living will. I plan to make my daughter my legal health care rep as soon as she is of legal age. She's grown up the daughter of a nurse & just "gets it" after all these years.

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This is not what the loved one wanted. And the POA was not at all involved with the LO until death came lurking.

It has been explained and we have educated and had meetings with everyone and the hospital got involved - POA refuses to let go.

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Specializes in adult ICU.

This is so common across all levels of care. In my ICU we regularly have 1-2 patients that are in "critical" but "stable" condition (if that makes any sense, it should make sense to you ICU nurses) that we have basically brought back from the brink of death - then once they are lucid, they start expressing their desire to die. After 3-4-5-6 weeks and a trach/PEG the family always seems to think that they are doing "so well" and they just need "rehab" -- all the while, the poor patient gets owly, angry, withdrawn, depressed, hateful -- you get the picture. Participating in acute rehab with no will to live doesn't work. Families often just don't get it. Myself and coworkers have even gotten blamed for "planting" thoughts of death in patients heads.

The worst one I ever saw was a terminally ill man that the wife refused to give a DNR/DNI order on because she was sitting at home collecting his disability checks. We kept him alive, rotting from the inside out (he had been admitted with 15-20 pressure sores from home because she didn't take care of him.) Just AWFUL.

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Specializes in LTC, Hospice, Case Management.
The worst one I ever saw was a terminally ill man that the wife refused to give a DNR/DNI order on because she was sitting at home collecting his disability checks. We kept him alive, rotting from the inside out (he had been admitted with 15-20 pressure sores from home because she didn't take care of him.) Just AWFUL.

This should be a criminal offense..

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Specializes in LTC, Hospice, Case Management.

Every medical study ever conducted has concluded that 100 percent of all Americans will eventually die. This comes as no great surprise, but the amount of money being spent at the very end of people's lives probably will.

Last year, Medicare paid $55 billion just for doctor and hospital bills during the last two months of patients' lives. That's more than the budget for the Department of Homeland Security, or the Department of Education. And it has been estimated that 20 to 30 percent of these medical expenses may have had no meaningful impact. Most of the bills are paid for by the federal government with few or no questions asked.

See: End of Life Care: The cost of dying under the news threads

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Oh, you're preaching to the choir, NN. I sometimes actually feel dirty about doing what I do. When the suits are in trying to rehab 90 yo LOLs after hip replacement with so much dementia they can't walk because the oayment schedules and priorities of Medicare are so snafued - gah.

I have one of those, grandma. Not a weight-bearing surface left.

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Specializes in LTC, Psych, Hospice.
Same one I've had trouble with.

Loved one in end-stage cx. Mets everywhere. Intubated a few weeks ago. Finally a DNR. Not eating, not voiding.

POA had us stop the MSO4 because that's why the loved one isn't eating.

Oh hun! My heart is breaking reading this. I will pray for you and this family. One of my home pts wife finally "got it" today. It made me smile to know that she is now going to be able to let her husband go peacefully and without pain. She had been withholding breakthrough pain meds because she wanted him awake. Poor thing was in so much pain. It took another 2 hour visit today, but she promised to give him his meds on schedule. I'm thankful because I'm off for a week and that is one pt I won't be thinking of while I'm trying to relax.

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Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.

There will never be a cure for stupid.

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Same one I've had trouble with.

Loved one in end-stage cx. Mets everywhere. Intubated a few weeks ago. Finally a DNR. Not eating, not voiding.

POA had us stop the MSO4 because that's why the loved one isn't eating.

Ethics committee should look into this

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Specializes in ICU, Telemetry.

:hug:

Been there, got way too many of those tshirts hanging in the closet. If it's possible, and there's anyone in the place with guts, see about getting a court appointed guardian. We had to after a family wouldn't take "grandma" off the vent when she was brain dead with just enough "umph" to keep the heart beating. Feet turned black, rotting away from end stage everything. The facility finally called the court came in because nurses were quitting to avoid torturing this poor woman. Court appointed a guardian, and the guardian (who was a hospice trained doc, bless'm), walked in, looked over the patient and chart, and told the family, "She died the day she had the last stroke" and ordered the patient be made a DNR and extubated. She stopped breathing, brady'd down and died within minutes. Family goes ballistic, starts screaming we've murdered grandma and they're going to sue, the doc says the first call he gets regarding a suit, he's having them all arrested for elder abuse. Family slunk away -- but not before they asked how long they had before they had to tell medicare to stop her check.

Freakin' vultures...

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Same one I've had trouble with.

Loved one in end-stage . Mets everywhere. Intubated a few weeks ago. Finally a DNR. Not eating, not voiding.

POA had us stop the MSO4 because that's why the loved one isn't eating.

Could someone pls translate MSO4, cx, and Mets ?

Thanks

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Specializes in PACU, CARDIAC ICU, TRAUMA, SICU, LTC.

Has there been any involvement/help from pastoral services? Just a thought/suggestion...

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