You have never steared me wrong!

[Antikigirl, ASN, RN]

Okay...well I am being silly, and keeping something in that is really getting to me. I guess I am using work as a way to fill my time and efforts because..heck..truth be told that is something I can actually see, feel, smell, and do here at home....

But alas...this one it eating me up!

My grandmother, nice lady but can be one of those old fashioned holding on to the past social bit bitties! She was dx with labial cancer...and it has mets to the lungs, and brain. She is on hospice...but is typical in the way she tries to socially please them and look like a proper and elite social lady. She is the last of when my family was honored and part of the community...very well known in her day.

Okay...well she is refusing to take her pain meds because she can't be socially correct on them, and is afraid of getting addicted. yeah I know...but she is really sticking to her guns and not listening. Uhgggg! I have to respect that because that is what SHE wants (dispite knowing full well the ramifications..she is very aware and alert...just not very medically savy and ingnores it...the medical community in her oppinion didn't save her husband 50 years ago from Cancer...so she thinks...well...we are doofuses who don't know our orifice from our heads still!).

My poor mom, and my poor aunt are trying so hard and asking me...the only medic in the family what to do, and all I can tell them is what they already know, and what they have already told her. The hospice team doesn't seem to be clueing into what is going on totally with her, and at the same time..what the heck can they do....can't force it on her!

Uhgggggggg...I am really stuck, and I am also not on the HIPAA list to be delving into the situation..which I believe is fair for her...rotten for me..LOL! But I am RN...use to rotten situations...

I am being supportive and acting more as a councelor for my mom and aunt which honestly seems to help quite a lot! (whew!!!!!!!!).

But does someone have some pearls of wisdom to help me in this "in the middle and no way to do much about it" deal? LOL! It is starting to effect my home life..which is already effected by such a heavy workload that I don't get to see my family hardly as is (one day a week if I have a weekend off only..that happens every other weekend unless I am called in).

Thanks..and thanks for listening to me vent. I am not in bad shape..but asking has always helped me here...and I know I am far far far from alone on this one!

Huggles!

[TazziRN, RN]

Even though you are not privvy to information about your GM, that doesn't mean you can't discuss the issue with her doctor if you want. He can't talk to you, but he can listen. Tell him what she's thinking and ask if there's any way he might be able to come up with an alternative for her.

[IMustBeCrazy]

Even though you are not privvy to information about your GM, that doesn't mean you can't discuss the issue with her doctor if you want. He can't talk to you, but he can listen. Tell him what she's thinking and ask if there's any way he might be able to come up with an alternative for her.

:yeahthat:

Exactly. In Psych these situations come up ALL the time. We generally get the extremely demented or psychotic pt that is paranoid and says "no way no how" can family get info from the doc. However it doesn't stop savvy families from saying "I know you can't share info with me due to HIPAA, but I just thought you'd want to know that Gramma C has her TV covered in aluminum foil and walks around her home naked while talking to invisible 'aliens'." Many times just knowing a bit of history can help the MD form a new care plan or at least a different one to one approach with the pt.

[Multicollinearity, BSN, RN]

So true. I called my father's PCP once to report some of my Dad's serious symptoms that Dad wouldn't tell the doc about. His doc called me back and even let a bit of info 'slip' to let me know what to do in the future. You never know how much the doc will tell you about your relative. They can always listen to the info though.

[Daytonite, BSN, RN]

I just went through two years of treatment of cancer of the breast and then mets to the lung with my mother. It never failed to upset me at how she would refuse pain medication and then when we went to a doctor's appointment she would tell the doctor she needed "a little something for pain". The hospice nurses told me that this was very common. The best I was able to figure out is that my mom lived through the depression years when people were glad for what little they did have. Complaining just wasn't something they did. After the depression, everything else was gravy on their plates.

At the very end, my mom did ask very frequently for pain medication and for something to help ease her breathing. When your grandma is ready she'll ask for help, or she will become so confused she won't know what's being done for her anyway. As long as she doesn't seem to be in any excruciating pain then I would say let her be herself. To impose what others want for her would not be giving her the dignity and respect she has earned.

[gentle]

I just went through two years of treatment of cancer of the breast and then mets to the lung with my mother. It never failed to upset me at how she would refuse pain medication and then when we went to a doctor's appointment she would tell the doctor she needed "a little something for pain". The hospice nurses told me that this was very common. The best I was able to figure out is that my mom lived through the depression years when people were glad for what little they did have. Complaining just wasn't something they did. After the depression, everything else was gravy on their plates.

At the very end, my mom did ask very frequently for pain medication and for something to help ease her breathing. When your grandma is ready she'll ask for help, or she will become so confused she won't know what's being done for her anyway. As long as she doesn't seem to be in any excruciating pain then I would say let her be herself. To impose what others want for her would not be giving her the dignity and respect she has earned.

agreed.

If the hospice staff are already aware of your grandmamas situation, then the best thing you can do is to respect her wishes as this in itself is an opportunity to show your love for her.

One thing, i might try is to see if she would be willing to occassionally compromise. For example, ask to see if she would be willing to take a T#3 before naptime and at night-time. i mention T#3 because some elderly patients are more willing to take medicine that has tylenol versus morphine due to stigmas held during their lifetime.

perhaps you are already doing this and I missed it in your post. I do get the impression you might have tried many different things already.

[NRSKarenRN, BSN, RN]

Some who won't accept a pain pill will accept a pain patch..... cause it lasts 3 days and steady stream...can apply without thinking about it.

Or she will outright refuse until pain becomes unbearable. Her choice.

Few educated "moments" re how those hospice nurses at allnurses were telling you that patients with controlled pain live better, longer lives.....no ceiling to amount of pain medication one can have..... less than 0.5% patients with cancer taking pain meds become addicted (Margo McCaffery MSN, pain expert)....not all pain meds are narcotics, sometimes tylenol is all one needs. along with anti inflamatory meds like advil/steroid etc.....around the clock schedule pain medications make people more comfortable with even pain control and have improved daily function and quality of life...................