- 0Jul 9, '12 by coogaboogaI've been reading a few posts on iv therapy with patients on hospice and I'm a bit confused.,,,why? Our company considers it "aggressive" but too me it's not so much aggressive as it is another thing for families to focus on aside from just comfort... And does it really help?
Enlighten me and share cases where this is considered appropriate :-)
- 1Jul 10, '12 by leslie :-Dgenerally speaking, it is NOT a comfort measure at all.
the body is shutting down, including circulation.
fluids will either shunt to vital organs, where fluid isn't desirable...
or the fluid will pool and build up.
either way, it causes many more undesirable effects and makes dying that much more distressful.
family members need to be educated as to what happens when the body shuts down...
and how to enhance the natural dying process, in order to benefit the pt.
eta: i just saw where you asked when it is appropriate.
if a pt is dehydrated but otherwise relatively *strong*, not close to imminent death, then it can be helpful in some cases.
generally though, ivf is the exception and not the rule.Last edit by leslie :-D on Jul 10, '12
- 0Jul 11, '12 by amoLuciaQuote from coogaboogaPlease don't take it personally, nobody meant to be a smart-mouth. But every now and then something just catches us all off guard and this one was one of those times. It's worth a giggle because there have been some hot & heavy threads here lately!Funny, I had no idea that I developed such an awesome debate issue ;-)
Please, take my title to another thread. I'm sure it would be helpful there too :-D
As to your question, many do consider IV fluids a bit aggressive for palliative care. Even in LTC in-pt. There will be extenuating circumstances at times and it's a delicate balance among all parties concerned re education, pt rights, outcome of positives vs negatives, etc. I've kind of always seen it to be that whoever is the POA (or whoever pays the bill) tends to win the argument.
And there is professional literature out there that discusses the public's beliefs about thirst and dehydration that run the contrary to some research as being necessary and/or PAINFUL (which is what families fear).
- 1Jul 12, '12 by gorgenurseI agree that IV fluids are excessive in these situations. Sometimes I think it is more of a comfort measure for the families. I cannot tell you how many family members I have heard say that NOT doing iv fluids means we are letting the person starve or dehydrate to death. NO, they are already dying! But the families do not see it this way.
By the way, it seems I am one of the only one's who immediately got iv fluids from IVF, I guess I am just one track hospice minded right now! =)