Don't you hate secrets?

  1. 0
    I worked in ICU for 15 years and my biggest pet peeve was when families kept secrets or "lets not tell mom about her diagnosis/prognosis". And now in Hospice I've had 2 different families not tell the children. I just hate that!! No amount of teaching seems to help.
  2. 13 Comments so far...

  3. 3
    I agree that this is very frustrating!

    Too often, the patient that the family doesn't want to tell about their terminal disease, knows that they are dying but have no family permission to speak about it.

    Very sad.
  4. 3
    In LTC people were SO relieved when I broached the subject of death. They knew and were so pleased to have "permission" to ask about what was happening.
  5. 4
    Quote from tewdles
    I agree that this is very frustrating!

    Too often, the patient that the family doesn't want to tell about their terminal disease, knows that they are dying but have no family permission to speak about it.

    Very sad.
    admittedly, my brain has been challenging me these past months, but i am having a hard time understanding your question.
    are you saying that although the pt knows/senses s/he's dying, the family needs to give pt permission to talk about it?

    fwiw, if i sense a pt really wants to be told the truth, i tell them whether family wants it or not.
    i would never do so if i felt pt wanted to continue life in denial.

    leslie
  6. 4
    Yeah, that is what I was saying, Leslie. People who know, but their families are emotionally paralyzed by their anticipatory grief and fears...so they never allow, much less encourage those important end of life conversations.

    I agree with you, I have a relationship with the patient and I will NOT lie to them. I have, many times, had to educate family members who persist in secrecy that their loved one KNOWS that they are dying. Sometimes it changes everything, too many times it changes nothing and the patient dies with only the hospice workers to listen to their dying thoughts.
  7. 4
    Quote from tewdles
    too many times it changes nothing and the patient dies with only the hospice workers to listen to their dying thoughts.
    omg, that is incredibly frustrating.
    i've had (too) many pts linger...FEARING to go because family was hysterical, and wouldn't give permission to let him die.
    (my compassion would go right out the door, r/t family making the pt's dying, anything but peaceful)
    i would just sit on bed w/pt, quietly assuring him/her, that it's perfectly ok to leave and move on...
    and that i'll make sure your loved ones are ok.
    another frustration is families that are so out of control, that it takes me away from pt, trying to appease family.

    i'm just having one of those venting type of days....just blow me off.

    leslie
  8. 5
    Probably the angriest I have made families is when I have talked openly about death and dying in front of their loved one who is dying. However, I feel it is my responsibility to be honest with my patients. As I have become more experienced with hospice, I find myself being more open to things, so I generally allow the family what they want, with the understanding that I will not lie if the patient asks questions about what is happening.
    annacnatorn, tewdles, SuesquatchRN, and 2 others like this.
  9. 3
    I remember the whispering and the talking outside the patient's room, and they think that the patient doesn't notice all this? I agree the patient knows they are dying. And how sad that they can't talk about it and the family keeping all these secrets from them.

    So how about Kids? Do you think its unhealthy for families to shelter kids from knowing that Grandma is dying? My own father-in-law died in June and we were totally open and honest with my two kids (ages 10 and 12) they visited Grandpa, saw him just 2 hours before he died. And I really don't think it harmed them at all. I have a family that I'm caring for now, and they won't tell the kids anything. Isn't that so sad? They 13 year old reported that he couldn't sleep all night and had an upset stomach to his grandma. Don't you think he knows and senses that things aren't right?

    This same family has also decided that none of the kids will attend the funeral.
  10. 3
    Quote from tewdles
    I agree that this is very frustrating!

    Too often, the patient that the family doesn't want to tell about their terminal disease, knows that they are dying but have no family permission to speak about it.

    Very sad.
    That makes me so sad. The pt wants to talk, but is afraid to upset the family. Sometimes, no amount of education helps.

    Quote from ErinS
    Probably the angriest I have made families is when I have talked openly about death and dying in front of their loved one who is dying. However, I feel it is my responsibility to be honest with my patients. As I have become more experienced with hospice, I find myself being more open to things, so I generally allow the family what they want, with the understanding that I will not lie if the patient asks questions about what is happening.

    You sound like me, ErinS. I always tell my pts and families that I will not lie to them. The truth may be painful, but its so much better than keeping secrets and telling lies.


    Quote from Vtachy1
    This same family has also decided that none of the kids will attend the funeral.
    What are they going to tell the kids when they ask where grandma/grandpa is? I see therapy in those childrens future.
    annacnatorn, tewdles, and SuesquatchRN like this.
  11. 4
    Well, I have learned that sometimes denial is the only defense mechanism people have. I am going to have to learn to help them to acceptance, but without ripping away their only coping skill. Toughie.


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