A central picc line and a mid-line

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    I was just informed that my father can not be fed no longer through his feeding tude so his doctors want to send him to hospice. Can a central line be administered for him to recieve his nutrients? What are the other ways that a line be placed for person to recieve nutrients other than a gastronomy feeding tubes. Please advise before they give up on my father when all his organs are still functioning and so is he.
    Signed by a:
    A fighting daughter.. :
    Last edit by joniquenme on Aug 14, '05
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  4. 0
    Quote from joniquenme
    I was just informed that my father can not be fed no longer through his feeding tude so his doctors want to send him to hospice. Can a central line be administered for him to recieve his nutrients? What are the other ways that a line be placed for person to recieve nutrients other than a gastronomy feeding tubes. Please advise before they give u on my father when all his organs are still functioning and so is he.
    First question, why is he on hospice care?

    Second question, why can he no longer be fed via his feeding tobe?

    TPN (nutrients via central line) is generally only appropriate for temporary use. It is frequently not considered appropriate to be used in a patient in a patient that is going to return to normal functioning. It is also dangerous as it greatly increases the chance of sepsis.

    In addition, in the vast majority of causes, the patient must be on frequent blood draws. The electrolytes are closely monitored and the formula of the TPN must be altered daily to correct for any labs out of normal range. This is frequently not within the purview or capacity of most hospice situations.

    As a general rule, a patient is not on hospice care unless they have a prognosis of less than six monthes to live. I must presume that your family member must have an incurable condition. And if "all of the organs" were working properly, he would not be on hospice and there would not be a problem using the feeding tube.

    People have the mistaken idea that the patient suffers a great deal if they are not continually fed. And they request feeding tubes or TPN for their loved ones who may not desire these things. In truth, many of this interventions are quite useless, and actually cause extensive discomfort to the patient. The TPN frequently causes fluid overload, causing pain and breathing impairment. It can also cause pleural effusion/ascites, necessitating thoracentesis/paracentesis. Then the patient must endure diuresis. They go through the cycles over and over again. And it interferes with the natural death and dying process, actual causing more suffering.

    And if your father expressed a desire for these interventions, the MD would probably find a way to utilize them if they were remotely appropriate. However, possibly in private, the patient may have expressed his feelings and the MD is honoring them by not initiating these interventions. And the patient's wishes always are paramount over anyone else's.

    My regrets on your situation. I hold you in my prayers.
    Last edit by caroladybelle on Aug 14, '05
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    My dad had cancer on his jaw bone, they broke his bone and placed a hallo type under his chin to hold it in place, thereafter complications began. He was sent home 2 wks after 1st surgery, but only to learn that dad was getting infected in the mouth so he was admitted back to ICSU for a week1/2. Then they placed a trech in his throat, the gastro feediing tube and performed another procedure to remove all infections out in jaw again.
    From that point, daddy start improving and was moved to regular floor and over to nursing home section to be there for 20 days then released to go home. On yesterday, the doctors called and said that he's not getting enough nutrients and was given him a couple of weeks to live and will be going to hospice in a couple of days. This is all at VA hospital.
    Now this evening while visiting him, they were given him potassium and on of the nurses asked me, it will be better if your father had a central line.
    Please educate me to his, am I missing something here?
    Why are they in a hurray to send him to hospice when he has so much life in him and alertness and I am fighting to learn....
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    A central line is easier on the veins if needing potassium by IV fluids in higher amounts. If he is no longer ecieving enough nutrients by his G-tube, then he is going to have issues absorbing it in any form.

    But as per the TOS of this forum, we are unable to offer medical advice. For anything further, you are going to need to speak with someone familiar with his care.


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