Help me--with dieing neighbor

Specialties Hospice

Published

Hi!!

I'm an ICU/telemtry RN. My grandma died with the aide of an hospice nurse. I totally adored the care she gave my grandma and assisted my parents through grandma's death. I deal with death often at work but it's different when it's direct family.

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I have a neighbor I've known 30 years who's very close to us. (more so to my parents to the point of being "family") My mom's neighbor had breast cancer, that went to bone, liver and etc. She's lived 4 years longer than the Dr's have given her.

Unfortunately her condition is declining. She has a lot of ascites. The Dr. gives her 2 months to live. My neighbor's have no family that they talk with. They have friends in another state and my parents. The husband to my neighbor will be lost without his wife. He's demanded the best care for his wife and has gotten it.

She's still actively getting Chemo. From what my parents can tell he'll do anything to keep her alive. If her condition is to worsen she's to go directly to my hospital. I'm scared no advance directives are filled out and instead of her going to our oncology unit she'll be visiting me in ICU. I've seen so many cases of a patient with full blown cancer tubed and with lines every where. I truly want to prevent this for her.

My mom said after holidays my dad will have a heart to heart talk with his neighbor. What should he say?

Any input will be great! Thanks in advance

For people who are very reluctant to address the issue of advance directives because it is unpleasant to think about or who feel its a kind of a jinx to deal with it ahead of time, I sometimes tell them that advance directives give them an opportunity to exert control over their last days. If you want to peacefully slip from this world into the next, in your own home, surrounded by your loved ones, then you need to take control and set your wishes down on paper. YOU can write the last chapter of your story, not some stranger in the hospital.

A paracentesis may give her some more comfort. Do what you can to keep her at home the hospice team will do a great there in her home.

A paracentesis may give her some more comfort. Do what you can to keep her at home the hospice team will do a great there in her home.

it sounds like the husband isn't thinking anywhere near hospice services. on the contrary, the parents are under the impression that he would hospitalize her again. this poor man sounds grief-stricken, albeit in grave denial.

perhaps this lady's oncologist or doctor should have a heart to heart talk with her husband, and gently direct him towards obtaining hospice services.

leslie

perhaps this lady's oncologist or doctor should have a heart to heart talk with her husband, and gently direct him towards obtaining hospice services.

Unfortunately there are too few oncologists who do well with handling this part of their profession. Oncology clinics should be providing grief counseling to their patients but there are few who do. Most simply continue to do "what the patient wants" as if their patients could possibly make informed decisions without the medical knowledge the oncologist has and in the midst of agonizing fear and grief.

Since this woman has done so well in outliving her original prognosis, her husband is less likely to believe the oncologist now when he gives her 2 months.

What I usually see is that oncologist's prognoses are usally optomistic by about double.

i stand corrected aimee....you're so right about oncs. i've certainly dealt w/enough of them.:stone but i have dealt w/a couple who knew when enough was enough. i do think however, that if the pcp did see this lady, s/he would be more apt to make the referral for hospice. as the op wrote, the decline is now apparent. let's pray for their comfort and peace of mind.

leslie

What are the patient's wishes? Does she want aggressive treatment right up to the end?

It is a sad fact that there are some people who will choose futile care, no matter how gently/positively hospice care is presented. Ultimately, we can't choose how someone else dies. Perhaps the pt. and her husband have religious/spiritual beliefs that make hospice care not an option for them. And even if it's not that, and more just personal beliefs that prevent them from seeking hospice care, it's their decision.

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