Studies: Some Nursing Home Elderly Get Futile Care

"I've seen some extreme cases in this area because when the elder can no longer voice desires, some family member will take over and suddenly decide that 97-year-old grandad who's in renal failure w/ severe dementia, really needs to be "saved" and allows intubation and tube feedings for the poor fellow whose last wish was to have his DNR honored.

It's really all about the money, folks."

It's not always about money. Sometimes it's about guilt and pressure. You want to make sure you did everything or are expected by other family members to do 'everything' otherwise you would be accused of not 'caring'.

oh my gosh I am so with you people--- 20 years in LTC- and why do some nurses never listen to the nurse aides? Why do LTC companies insist on making the outside of the building beautiful and keep us understaffed and then scream at us for too many falls??? Cut the nursing staff and then get mad because of poor documentation which means bad data in bad data out=NO MONEY It is not rocket science if you have "MR JONES" getting up every 5 minutes attempting to ambulate (of course after he has been toileted) and you have to stop and go answer his pendant alarm, how in the heck can you get your charting done?? And the quack docs putting them on benadryl for sleep and klonopin for dementia( what are they thinking) If you dare ask to review meds they ask you where you went to medical school. Something has to give. I so dearly love our sweet residents, but something has to change feels like you asked to do your job with your hands tied behind your back somedays. Being a nurse aide is tough that is precisely why I went to nursing school!!! Have you hugged a nurse assistant today??? God forbid listen to one when they say Ms. Smith does not look so hot. --- any suggestions on how we get nurses to listen to nurse aides and doctors to listen to nurses??

Wow..that is beyond sad. It's a "smart" nurse who listens to the aides?? I thought that was part of every nurses job...considering the nurses aides have more patient contact than anyone. I would hope that ALL nurses are listening very attentively to their aides.

They're not. Some do, many don't.

Ughhhh! Luckily, I haven't had to deal with disrespectful nurses much. If I come to the charge nurse with an issue, it's pretty much always been resolved in a timely manner.

As a CNA, I have personally saved a nurses job... and had that nurse been anything but respectful towards me during our employment together, I am not sure that I would have been so forgiving of her mistake. Also, I did work under a LPN for awhile who was very rude and treated (in my opinion) her patients very disrespectfully. When I finish nursing school, I will be her boss. Be careful how you treat your CNA's. Glad this point was brought up..

We all have to start somewhere.

I think there's a special place in heaven for CNA's who work in long-term care facilities.

Thank heavens for a good CNA/HHA.....many is the time I've been thankful to work with some excellent ones. They make patient care so much better.

I love the HHAs on my team. They collaborate well when it comes to supplies and they are a valuable tool in my educational goals for families. Their skin assessment skills are priceless. My heads up on the terminal transition frequently comes from the HHA. They are sometimes more aware of some of the psychosocial disfunction in families.

My Daddy died in March, yeah I still call him daddy, he was 83 years old.

He was diagnosed with Alzheimers disease in 2000, but it progressed very very slowly until 2007. He had 6 strokes and became violent, so we placed him in a skilled nursing facility.

He always said "when it is my time to go, let me go. I lived my life, I had my fun, I am ready when the good lord is willing". He started going downhill, and eventually he had difficulty moving and walking, he was in a bed a lot, but kept in good spirits. Above all else he remembered his daughters, my sister and I, the whole time.

My daddy developed pnuemonia, and we opted for comfort measures, O2, etc.. No antibiotics.

He died a week later, early in the morning, 5:00 am.

My sister, POA, missed the phone call that he was having Cheyne stokes respirations, he passed away before we could whisper in his ear that we loved him...and we were so blessed to have him as a father..even through the tough times.

Through ALL of that, I hope somewhere that he is proud of us for ensuring that his wishes were met. I like to think that he knew we loved him, and that he died in peace. The most difficult thing for me was not letting go.. It was wondering IF I was living up to what he wanted, if he was proud.

If my dad had antibiotics, and was on a tube, he may have lived, but for what? Another fall onto the floor, bed ridden to the point that no amount of care could prevent bed sores? We knew that treatment was futile, we knew what he wanted, and it was not easy, but we HONORED his last wishes.. and I hope he is proud.

As a nursing student, I am so greatful for the SNF, their caregivers were like a second family, and we thanked everyone there for taking care of my daddy.

Perhaps the hesitancy to address these issues by nursing staff has something to do with management's constant working toward customer satisfaction. There have been some downright ridiculous stories about nurses correctly caring for patients per unit protocol, yet they are disciplined if a family member complains (enforcing visiting hours comes to mind.) If the ICU is not backing it's staff when they decide a patient needs a nap they won't back a nurse that tries to talk about end of life care, and the family takes offense.