Care for surviving family

[drem7116]

Im a very new nurse and have encountered my first end of life care on a patient. She was recently diagnosed with the big C and rapidly deteriorated. The family was very unprepared for this and the past few days I have tried my best to care for them as much as my patient. Unfortunately, my hospital doesnt offer any services for the surviving family. My patient was diagnosed only one month ago and received an extreamly poor prognosis (weeks to months). The family is having a very hard time making decisions and coming to terms with the prognosis. I had requested clergy come to see the patient, however I feel there can be more. (Aside from keeping my patient comfortable). What I am inquiring about is a support group of some type for the surviving family that would come to the hospital or speak to the family to assist and assure the family they are making the best decisions. I have advocated for my patient as best i can, unfortunatly due to insurance issues hospice care/services "isnt applicable" in this situation. Is there any nonprofit service that can come and even just be an ear or shoulder for my patients family? I know I am the nurse and I am her advocate and I have tried, but as a new nurse I feel my voice alone is inadequate/insufficient enough due to my inexperiance. I have spoken to the case managment team and I was made aware that they are there to assist with matters of the patient, not their son (ps the only surviving family member). I know I am new, but in my mind the son is my patient as well and he needs just as much care. Without infringing on HIPPA to much i am located in the NY area. Thank you in advance for any suggestions/recommendations

[chopwood carrywater]

If your hospital has a hospice or palliative care department, I would begin by talking with them or having them contact the family.

Does this hospital have a hospice organization that they refer pt's and families to?

[chopwood carrywater]

Also, it will help you and your pts if you can call cancer, cancer. It's awkward at first, and I don't mean to say you should blithely bludgeon people with technical terms and truths, but an honest, caring conversation is such good and often rare medicine these days.

[ShesanRN]

You may also consider contacting the American Cancer Society to see if they have recommendations for your situation/area.

Also, it will help you and your pts if you can call cancer, cancer. It's awkward at first, and I don't mean to say you should blithely bludgeon people with technical terms and truths, but an honest, caring conversation is such good and often rare medicine these days.

Somtimes even being willing to use the word "cancer," is a needed step in caring for a family in this situation. It feels like dropping a bomb into the room, but if your tone and mannerisms are gentle and respectful, the injection of reality can be therapeutic in its own right.

I have also cared for families, though, where we don't even refer to ourselves as "hospice," because the patient just can not deal; use your best critical judgment

[chopwood carrywater]

You may also consider contacting the American Cancer Society to see if they have recommendations for your situation/area.

Somtimes even being willing to use the word "cancer," is a needed step in caring for a family in this situation. It feels like dropping a bomb into the room, but if your tone and mannerisms are gentle and respectful, the injection of reality can be therapeutic in its own right.

I have also cared for families, though, where we don't even refer to ourselves as "hospice," because the patient just can not deal; use your best critical judgment

All true.

[toomuchbaloney]

I see that the patient's insurance may not have a hospice benefit. Contact your local not for profit hospice agency ANYWAY, many of them have the ability to provide "charity care" for folks who want it but cannot afford the care. The hospice may be willing to include the family in the afterdeath programming and services at no charge.

[lifelearningrn, BSN, RN]

It's my understanding that most hospice companies have funds set up for patients who aren't covered by their insurance policy and do not qualify for assistance through medicaid. I don't know if that is why hospice isn't applicable to your patient, I'm thinking your hospital wants to treat her in house for the cancer, even with her terminal diagnosis, so that likely why she's not qualifying for hospice services. Is there another reason why they are keeping her in the hospital and not referring the family to hospice?

[TammyG]

It's my understanding that most hospice companies have funds set up for patients who aren't covered by their insurance policy and do not qualify for assistance through medicaid. I don't know if that is why hospice isn't applicable to your patient, I'm thinking your hospital wants to treat her in house for the cancer, even with her terminal diagnosis, so that likely why she's not qualifying for hospice services. Is there another reason why they are keeping her in the hospital and not referring the family to hospice?

It could be that the patient is too sick to leave the hospital, and the hospice does not have GIP beds there. A palliative care consult would be very helpful. The other suggestion to Life With Cancer is also good. Certainly the social worker at the hospital should be able to step in.