Advice please

[Been there,done that, ASN, RN]

Family member has metastatic ovarian cancer. Currently has hypercalcemia and malignant ascites. I am far away, but I got "home care" on board, instead of a rehab facility. Her mentation varies, she is refusing morphine, for her own reasons . Her pain is 7/10. I suggested a pain team consult.

Please tell me what I am missing.

[Katillac, RN]

I'll say this as gently as I can. . . what you're missing is that you can't case manage from a distance, especially with a complicated case where pain meds are being refused. It is of course against TOS to give medical advice, but a Google search on malignant ascites with ovarian cancer will show that the prognosis is poor. Mentation changes support the poor prognosis. It would seem she might be appropriate for hospice services, which instead of home care will actually focus on helping manage her symptoms.

Good luck, I know the heartache of feeling helpless, miles away, and feeling the situation is being mismanaged.

[dianah, ASN]

Agree with Katillac, care is very difficult to manage from a distance.

Your frustration is palpable.

Seems you need a family member or a case manager nearby the patient.

And possibly a meeting with the care team, to explore goals and determine trajectories.

We wish you and your family member well.

Closing this now.