Help!! Any Advice appreciated!

indigo girl · May 13, 2006

Who is making decisions for him? Is he doing it or his wife or other family member? Do they want hospice? Doctors usually will isten to what the patient or care provider wants especially if they insist that they want the person to die with dignity and in comfort. It is the right of any patient to do so. If sounds as if the doctor has not come to terms with the terminal status of the patient but the family has. In that case, the family must be the advocate and say "enough". The fight is over. The caregiver should insist on hospice, and if the doctor will not agree, fire him. So the question is, is he really terminal? And, of course, pain should ALWAYS be treated.

veronica butterfly, ADN, RN · May 13, 2006

Can you call a local hospice agency and get their advice?

indigo girl · May 13, 2006

Oh sorry, I see his caregiver is the one refusing hospice. That may be why the doctor is having a difficult time. So, if the caregive can't let go, then it is much, much harder. I've seen this alot. Sometimes, you can talk to a family member who is close to the caregiver and may be willing to be an advocate.

And, clearly an advocate is what is needed for this patient. If you can't have hospice, you can at least speak to them about alleviating pain. I'm sure his PCP does not want him to suffer and neither does his doctor. Tell his PCP how we assess pain.

luvmy2angels · May 13, 2006

Can you call a local hospice agency and get their advice?

Yes, they said they can't come in to see him unless they have a Dr order since they would need to be in contact with a family Dr regarding meds.

luvmy2angels · May 13, 2006

Who is making decisions for him? Is he doing it or his wife or other family member? Do they want hospice? Doctors usually will isten to what the patient or care provider wants especially if they insist that they want the person to die with dignity and in comfort. It is the right of any patient to do so. If sounds as if the doctor has not come to terms with the terminal status of the patient but the family has. In that case, the family must be the advocate and say "enough". The fight is over. The caregiver should insist on hospice, and if the doctor will not agree, fire him. So the question is, is he really terminal? And, of course, pain should ALWAYS be treated.

He is in his right mind and has made the decision that he wants no further treatment. He and my grandma have both told the Dr they want Hospice as well as my aunt and the Dr is just being a total jerk about it. I had thought about telling them to find another Dr and one that will allow hospice to come in. It sucks to see him suffer so bad. I LOVE hospice and know they would do all they can to keep him comfortable. I think I may bring up finding another Dr to her tomorrow.

leslie :-D · May 13, 2006

does your grandfather's doctor agree that he's dying?

if he is actively dying, a close family member should speak with this doctor (if your grandfather won't or can't) and remind him that he's abandoning his pt in his time of need.

the medical director of the hospice agcy i worked at, did indeed, occasionally take on a pt. if the pcp did nothing.

call a reputable hospice agcy and ask to speak w/the medical director.

in the meantime, see if your grandfather's doctor will prescribe some generous analgesia until hospice services are in place.

with peace,

leslie

TazziRN, RN · May 13, 2006

If your grandfather wants hospice or is at least willing to check it out, you (he) can ask for a second opinion from another physician. Or you can switch physicians outright to someone who will care for him the way he should be cared for at this point.

Dang, there's no smiley for hugs......

luvmy2angels · May 13, 2006

If your grandfather wants hospice or is at least willing to check it out, you (he) can ask for a second opinion from another physician. Or you can switch physicians outright to someone who will care for him the way he should be cared for at this point.
Dang, there's no smiley for hugs......

I agree, we are getting ready to leave to go see him this morning (he lives about 2 and a half hours away), I am going to bring this topic up though. I hope we can work something out so he and my grandma can get some help!! Thanks everyone for your replies!!!

Marie_LPN, RN, LPN, RN · May 13, 2006

Getting another doctor. Souns like that one doesn't have his priorities in line.

PANurseRN1 · May 13, 2006

I would call the local hospice, tell them that he wants hospice. They can at least do an informational visit. At that time, they may be able to make arrangements for another physician. In certain cases, when I worked in hospice and a doc was being difficult, the medical director assumed responsibility for the pt.

He does have to have a qualifying illness with a life expectancy of 6 mo or less. In the meantime, I would be all over that doc about getting him some pain relief, and remind him of his ethical and legal obligations to do so, and the consequences of refusing.

PANurseRN1 · May 13, 2006

If the PCP is all caught up in tryng to cure him, is he by any chance an oncologist or other specialist? If your GF also has a family doc, one option would be to go back to the family doc, state his wishes, and initiate hospice through the family doc. This happens a lot in hospice care.

There's more than one way to skin a cat.