recently a favorite pt of mine passed away a week after i transferred her to hospice care. i spent some time before that easing the daughter into accepting that her mom was dying.
i have another pt with liver ca who knows she's terminal but refused hospice because she was in denial about just how close the terminality is. earlier this week she was crying and saying "i'm so tired, i can't take this anymore." i think she will be going to hospice tomorrow.
yet another pt with ca has had increasing confusion over the last couple of weeks....she literally went from alert and oriented to periodically confused within a week, and in the week since then has become completely confused. her daughter has been calling me often, and today her mom was taken to the er when she collapsed at home. ct (which was clear last week, for some unknown reason) now shows a large lesion in the left hemisphere. mri will be done in the morning but it's pretty certain she has met.
i have mixed feelings about all this. from all my years in the er i'm used to sudden deaths, and helping families cope with the immediate aftermath. i'm not used to helping pts and their families deal with impending death, and it's taking a lot out of me. it's gotten to the point where the hospice coordinator and i have each others' cell numbers programmed in.
