Please Advise ASAP Confidential please - page 2
I received this note yesterday.Please advise ASAP. Urgent. My...... has lung cancer and has been at... Hospice for the past week. We are not completely happy with the service, but are not sure if... Read More
Nov 27, '11 by Daisy_08, BSN, RNIt sounds like the family is not being educated on what is happening. They should seek clarity from the staff.
However my knee jerk reaction is no, that does not sound right. My pts can eat if they want, or not. Eventually they will stop being hungery and not want to eat becsue simply put thier body is shutting down and now longer needs the energy food provides. That can be very hard on the family, and they need a lot of reasurence. Some people don't understand why we dont force feed. Maybe that is the situation. The letter didn't say the pt was asking for food, it could be the family wanting to feed the pt and the pt is not able to eat. Either way, the family needs more education.
Sorry to your friend
Nov 28, '11 by Capco56All very good replies. Rule of thumb, if he is alert and oriented enough and barring any swallowing difficulties or aspiration precautions, there is no reason he can't have a hot fudge sundae for breakfast if he wants. Hospice=Comfort Care. Whatever is needed to provide comfort is what should be done.
A lot depends on where he is in the dying process. A little known fact among familes and patients is that when a person is actively dying, unlike you and I, a little dehydration is actually beneficial because it releases "feel good" endorphines that help with pain control and a sense of well being...kind of like "runners high". And, as another post said, the body does not know what to do with this extra food given to the patient if the organs are shutting down. This is all part of the family education that hospice nurses should be providing. Instruction to not feed a patient without explanation is just not acceptable. When I explain this rationale to my families, it gives then much comfort that they are not "starving" their loved ones to death.
In answer to the sedation issue, it is sometimes very difficult to maintain that balance between pain/breathing control and alertness. Very often, families will opt for the sedation over seeing their loved ones struggling. Bottom line, if you are not getting this type of education from the hospice nurses, it is time to find a new agency.