Does patient need to know the diagnosis?

Specialties Hospice

Published

hello

i work in nursing home and i have a hospice patient who doesnt know that she have a terminal illness and that she is very sick. does this patient deserve to need to know what her diagnosis is? do i need to tell her what her diagnosis is? i'm afraid that if she finds out about this, she will give up and her condition will deteriorate fast. i appreciate any advice. thanks

Hmm, every case is unique. It helps to ask open ended questions and to be simply truthfull in an unobtrusive way. For example, when I have such a case I say sometimes, "I'm sorry that you are so sick, it must be really hard." The response given from the patient will help you to know in what direction to lead the conversation.

Ambil

I fully agree with ambil, whereas we generally beleive that patients deserve the truth, we have to accept that everyone copes differently, the approach suggested comes straight from the pages of validation therapy, it also works with disorientated elderly good luck to all

Julian

Specializes in LTC, Psych, Hospice.

I bet she knows. If she were to ask me about her dx I would tell her as I feel the patient has a right to know. They may have some business (mental) to work on--closure.

I'll never understand why some families want to withhold info.

I kind of have personal experence with this. My grandfather was diagnosed with leukemia we decided not to tell him because we felt like he would give up. At the time of hi diagnoses he was 86 and had already gone through prostate cancer and treatment, the doctors felt his body was not strong enough to go through any type of treatment. We feel like we made the best descion for him at that time.

To me it sounds that first of all we have to find an answer to another question - does the patient want to know? and if s/he does, how much? Of course, the answer to these qs have to be addressed by somebody confident with communicating bad news, and should not be done directly, I mean, straight to the point.

Every human being has the right to know what's going on with their bodies and how this can affect their lives. However, forcing information on patients who prefer to be in denial is not less than an abuse.

:)

To me it sounds that first of all we have to find an answer to another question - does the patient want to know? and if s/he does, how much?

You are so right. I learned this lesson from a patient whose daughters kept insisting that we couldn't tell her her dx or px, and that she would not want to know. They wouldn't let me in to her room until we came to an agreement about it. I finally had a conversation with the lady (sanctioned by the daughters) and I asked whether she wanted to know about her condition and sure enough, she said "No". She said she wanted her daughters to deal with it and leave her out of it. It was a real eye opener for me, and I now believe that everyone has the right to know what/how much they choose. Of course, I know that she knew. She just made the choice not to deal with it.

hn

i find it hard to know that a patients diagnosis and limited prognsis, but they do not. i can understnad that the results come in and we a re waiting for the pt doctor to inofrm and the familly want to be present, this is short tem. harder still if an older person has this withheld alltogether at the familly request, i've worked with nurses who feel that they wouldn't disclose but if asked wouldn't deny that they are ill but would refer back to the medics. terminal pts often know their very ill, perhaps even unconsious bdy language by nursing staff

Specializes in Hospice, Med Surg, Long Term.

6-26-2007

Number One - Is patient capable of understanding the diagnosis and prognosis?

Number Two - Does patient want to know? How honest does the patient want you to be?

This is what I would consider in making this decision. Yes the patient & family have a right to know, so they may make an informed decision about the care they are going to receive from Hospice. The criteria to be met to qualify for Hospice is to have a prognosis of 6 months or less to live. If the patient doesn't want to know or talk about it, he/she has the right to stick their head in the sand, but the primary caregiver and the person signing for admission must know both Diagnosis and Prognosis.

Ana

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