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.

morphine, cancer, metastasis, I believe.

: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...

Can we clone him? please!

There will never be a cure for stupid.

There may not be a cure, but there is a "fix", but it isn't allowed by law....

Ethics committee should look into this

What ethics committee?

What ethics committee?

lol, something hospitals have and LTC doesnt.......

i think the guardian aspect is one that may need to be looked into.

Same family members who don't want granny on any "street drugs" aka morpine and ativan because they don't want her addicted and/or because they cause granny to do nothing but sleep, are the same ones screaming bloody murder when Granny is obviously in terminal anxiety, resp rates off the charts, gurgling away with secretions and in obvious distress! Now they want me to "help her, make her comfortable"..uhh ok, with what, no morphine and no ativan, you suppose maybe an APAP suppository might help?! AGGRRRRRGGGG!! I was helping her! She was peaceful and appeared comfortable with the morphine and ativan, YOU caused her distress and obvious discomfort and pain when you wigged out that granny was on "street drugs"!

I feel for you Suzie Q, I really do! I can't tell you how many times I've felt like I was torturing a poor soul doing nothing more than trying to escape its dying and no longer needed shell. Its 6 of one, 1/2 dozen of the other. There are those families who want everything medically possible done to keep granny alive and there are those who want no further treatment but won't allow us to properly medicate granny as she is actively dying!

Family are not the only ones in denial. I once had a terminally ill patient who was receiving pain medications. It took awhile but she finally got the right dosages and was no longer in pain. Imagine my surprise when I returned from my 2 days off and found her in pain again. I couldn't believe it. I checked her chart and found out that a nurse had called the doctor to decrease her pain medications. The nurse charted that the pain med was preventing the patient from participating in " the LTC's social activities.":mad: The family came in and was furious. I called and got the pain meds reordered immediately.

Can you get adult protective services involved?

Can you get adult protective services involved?

No one is going to remove the POA as POA. Not happening.

Specializes in Gerontology, Med surg, Home Health.

Two incidents stand out in my mind:

Elderly man admitted to my unit. He was hours away from death...bleeding from every orifice. Doc ordered labs and IVs. His wife of 60+ years begged me to just let him be. I called the doc, told her the wife's wishes and get screamed at for 15 minutes...who did I think I was...SHE is the doctor, I the mere nurse. I let her rant on and on and told her we were going to honor his wife's wishes and if she wanted to come in and start the IV that was up to her. The poor man died less than 4 hours later, relatively peacefully with his wife at his side. She wrote me a 5 page thank you letter 2 days later. When I can't remember why I do this, I read that letter.

Other resident, same facility. 95 year old woman totally A+0. Diagnosed with cancer. Doctor recommended chemo therapy. She politely declined. Family was fine with that, doc was fine with that. A priest came in, found out she said she wasn't going to have chemo therapy and started screaming at her that it was tantamount to suicide and she was going to burn in hell. I called his superior I gave my opinion of how the priest had acted. The priest get sent to South America to preach to the natives and the woman was able to get her affairs in order and spend some time with her family. She died peacefully.

WE have to continue to be advocates for our residents. We are forming an Ethics Committee at my facility.

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