Don't you hate secrets?

tewdles, RN · Sep 29, 2011

I agree that this is very frustrating!

Too often, the patient that the family doesn't want to tell about their terminal disease, knows that they are dying but have no family permission to speak about it.

Very sad.

SuesquatchRN, BSN, RN · Sep 29, 2011

In LTC people were SO relieved when I broached the subject of death. They knew and were so pleased to have "permission" to ask about what was happening.

leslie :-D · Sep 29, 2011

I agree that this is very frustrating!
Too often, the patient that the family doesn't want to tell about their terminal disease, knows that they are dying but have no family permission to speak about it.
Very sad.

admittedly, my brain has been challenging me these past months, but i am having a hard time understanding your question.

are you saying that although the pt knows/senses s/he's dying, the family needs to give pt permission to talk about it?

fwiw, if i sense a pt really wants to be told the truth, i tell them whether family wants it or not.

i would never do so if i felt pt wanted to continue life in denial.

leslie

tewdles, RN · Sep 29, 2011

Yeah, that is what I was saying, Leslie. People who know, but their families are emotionally paralyzed by their anticipatory grief and fears...so they never allow, much less encourage those important end of life conversations.

I agree with you, I have a relationship with the patient and I will NOT lie to them. I have, many times, had to educate family members who persist in secrecy that their loved one KNOWS that they are dying. Sometimes it changes everything, too many times it changes nothing and the patient dies with only the hospice workers to listen to their dying thoughts.

leslie :-D · Sep 29, 2011

too many times it changes nothing and the patient dies with only the hospice workers to listen to their dying thoughts.

omg, that is incredibly frustrating.

i've had (too) many pts linger...FEARING to go because family was hysterical, and wouldn't give permission to let him die.

(my compassion would go right out the door, r/t family making the pt's dying, anything but peaceful)

i would just sit on bed w/pt, quietly assuring him/her, that it's perfectly ok to leave and move on...

and that i'll make sure your loved ones are ok.

another frustration is families that are so out of control, that it takes me away from pt, trying to appease family.

i'm just having one of those venting type of days....just blow me off.:)

leslie

ErinS, BSN, RN · Sep 29, 2011

Probably the angriest I have made families is when I have talked openly about death and dying in front of their loved one who is dying. However, I feel it is my responsibility to be honest with my patients. As I have become more experienced with hospice, I find myself being more open to things, so I generally allow the family what they want, with the understanding that I will not lie if the patient asks questions about what is happening.

Vtachy1 · Sep 30, 2011

I remember the whispering and the talking outside the patient's room, and they think that the patient doesn't notice all this? I agree the patient knows they are dying. And how sad that they can't talk about it and the family keeping all these secrets from them.

So how about Kids? Do you think its unhealthy for families to shelter kids from knowing that Grandma is dying? My own father-in-law died in June and we were totally open and honest with my two kids (ages 10 and 12) they visited Grandpa, saw him just 2 hours before he died. And I really don't think it harmed them at all. I have a family that I'm caring for now, and they won't tell the kids anything. Isn't that so sad? They 13 year old reported that he couldn't sleep all night and had an upset stomach to his grandma. Don't you think he knows and senses that things aren't right?

This same family has also decided that none of the kids will attend the funeral.

Hospice Nurse LPN, BSN, RN · Sep 30, 2011

I agree that this is very frustrating!
Too often, the patient that the family doesn't want to tell about their terminal disease, knows that they are dying but have no family permission to speak about it.
Very sad.

That makes me so sad. The pt wants to talk, but is afraid to upset the family. Sometimes, no amount of education helps.

Probably the angriest I have made families is when I have talked openly about death and dying in front of their loved one who is dying. However, I feel it is my responsibility to be honest with my patients. As I have become more experienced with hospice, I find myself being more open to things, so I generally allow the family what they want, with the understanding that I will not lie if the patient asks questions about what is happening.

You sound like me, ErinS. I always tell my pts and families that I will not lie to them. The truth may be painful, but its so much better than keeping secrets and telling lies.

This same family has also decided that none of the kids will attend the funeral.

What are they going to tell the kids when they ask where grandma/grandpa is? I see therapy in those childrens future.

SuesquatchRN, BSN, RN · Sep 30, 2011

Well, I have learned that sometimes denial is the only defense mechanism people have. I am going to have to learn to help them to acceptance, but without ripping away their only coping skill. Toughie.

Ginapixi, BSN, RN · Oct 3, 2011

Well, I have learned that sometimes denial is the only defense mechanism people have. I am going to have to learn to help them to acceptance, but without ripping away their only coping skill. Toughie.

that is so true! i tend to forget that when i am caught in the midst of whispering and closed doors!

some families are semi open, others make me want to scream- until i step back and realize THIS IS how they deal with the tragedy they are facing;

then again, when i look at the "world" around me, it is no different! there is always the secrecy thing going on in the office; i addressed management before by voicing: this is how all the rumors get started; no one knows for sure and every one speculates and talks about it and before you know it.......

at least the families are going through a tragic, life changing event; yes it is frustrating, but be gentle! we are all only human! to us death and dying is our daily bread, to the families it is often brand new and shocking, the carpet was just pulled out from under them

annacnatorn · Oct 5, 2011

YES..FRUSTRATING INDEED....I despise it when informed by IDT members or Family members "dont mention they are on hospice"...WTH? really?

Our jobs are hard enough with out having this type of stipulation put on us.

I explain..Your time is limited with "loved one"...you need to say all you want to say to your family before you pass and allow your family time to come to grips with your passing. You have quality time, not quantity time left. You must make the best of it.

To the Family: Further explain...quality time vs. quantity time. You must be allow yourself to grieve and say and do what you need to do, because when your "loved one" passes you will not have another chance. Last breath, last chance.

I also don't like it when certain family members say "don't allow that person in here..I don't want to see them" when they are not the ones dying. Recently, a dear friend passed away and this very issue arose, I needed to intervene, you need to allow this person to come, you go to the room, this person needs to see this person. Fast forward to Funeral: said person is literally having a break down because they did not get to spend the time with their loved one that they needed to come to grips with it.

Hospice..only done by those with heart!