this hit too close to home...

Nurses General Nursing

Published

and i am still trembling...

and learned something very scary about myself today.

my mil died in 9/09.

dad, who lives in a ltc facility, has naturally been profoundly depressed, and only wants to spend his days in bed.

so my husband comes home yesterday, telling me that dad is going to be eval'd for hospice next week.

now, i know he has not been losing weight, and to my knowledge, has not had any new/serious dx.

my sister-in-law, who is poa, announced she is having the folks who cared for mom, eval dad as well.

i keep on asking "why? why?"

i also ask, "is he on antidepressants? has he had a psych consult?"

hubby doesn't know...

BUT calmly states they will give him morphine til he dies.

the family is on board with this, since they want to see dad with mom, once again.

by this time i am yelling," but that is MURDER!!!"

and knowing there are hospice agencies that are highly unscrupulous, i am in genuine panic.

i insist on talking to the cn at the ltc facility, but hubby is skeptical, since i have made a few, very vocal stinks over the years that have upset the family.

one time when mom was in a 'leading' hospital, she got a massive stage iv decub that resulted in her needing myoplasty.

i had called up the cno at this hospital and threatened to sue their sorry a$$es off.

sister-in-law/poa was very upset with me, since she was "good friends" with lots of these folks at the hospital.:rolleyes:

when mom was receiving hospice services, she was being very poorly managed and i didn't hesitate to let the nurse know.

as a result, i ended up taking over most of her care. (she would only take meds for me)

hubby reluctantly calls the ltc facility, with me on the other line.

he asks the questions that i have, w/the cn ending up addressing my concerns.

yes, dad has been on antidepressants, has gotten numerous psych consults, but evidentally, has been aspirating on foods, even after diet being changed to puree.

so today they are getting all the directives in order (dnr, dnh, no-fdg tube), and will have hospice eval next week.

siblings have been going in and basically, force-fdg his meals, which have resulted in sev'l hospitalizations r/t asp pneumonia.

what bothers me the most, is today i totally know i would have called authorities, IF he had received hospice illegitimately.

i was so distraught, i pm'd an admin on here, eliciting guidance/feedback.

and i am still shaking, knowing that ultimately in my heart, this would have been highly illegal and i couldn't let dad die unless there was a physiological basis.

so now, i know dad will soon be with mom once again.

and i know that my 23 yr marriage will not end, since i didn't have to notify those in authority.

thank you, dear God.

it really is terrifying to know that i'd be capable of doing what is right, even knowing the devastating consequences...

and am so very grateful, it didn't come to that.

thank you for listening.

leslie

Specializes in Peds Homecare.

Leslie, sweet Leslie, I don't know if you remember me or not. I wrote to all of you when my sister, Claudia, was on lifesupport. Through my tears, I typed to all of you, I could barely see the keyboard. When they took the life support off, I couldn't go be there, I had found my brickwall, and I couldn't get past it. I knew the next step when Claudia, kept breathing. I told you I just couldn't sit there and hold her hand, while they gave her morphine. I couldn't tell her it was alright to go because I didn't want her to go.

" leslie :-D allnurses Guide

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Feb 13, 2008, 10:25 PM

Re: My sister is on life support

may God hold you close as your sister embraces eternal peace...

i'm so, so sorry.

gentle hugs to you...

leslie "

I promised you all after my sister died I'd always be there for anyone of you, because of all the kindness, hugs, and prayers. I'm here for you Leslie, I know just how hard all of this is, for 2 years ago, I walked a mile in your shoes. Prayers, hugs, and thoughts of all of your family. May God hold you all in the palms of his hands.:heartbeat

Specializes in Developmental and Peds with disabilities.

first of all, God bless you and may he watch over you and hear your prayers during this time of need. May I suggest something? In the state where I live you can go through the Department of Health (or maybe it's DSS) and become a personal caregiver to your FIL and be paid for the work. I'm not sure how that would work if you are a nurse, but it's an option. Even if you could go sit with him for a few hours a day and listen to him talk or just hold his hand. It's been my experience that when someone is so depressed, they lose the will to live. I'm sure you MIL would not want him to lose his will to live and if it were me I would want my husband to rejoice the fact that I was away from this wretched world, but that's just how I would feel. Maybe even try to pull together a meeting, kind of like a care plan meeting with all the people in the family and the doctors and psychiatrist to discuss all the options. But as you know, in the end it is ultimately HIS decision that you must respect, whether you agree or not. Ah, the ethical dilemmas we as caring nurses must face. God bless you and good luck

Specializes in Cardiac Care.

Dear Leslie, you know, I hope, that I think you're an amazing woman, an outstanding nurse and one of the bravest people I've had the privelege to know. Your in-laws are grieving, but they are most fortunate to have you there with them. You have strength and courage of conviction that I can only imagine. Bless you for doing what you know is right. Much love to you.

Specializes in Peds/outpatient FP,derm,allergy/private duty.

I'm trying to navigate some unknown scary waters also with my parents and extended family,too-- and I'm finding out how I really feel about things in the process-- you jumped up to ferociously defend your FIL surprising even yourself, it sounds like. Now you know, in truth you are your FIL's daughter, and he is your dad. I don't think you need mentally consider at all the "in law" part. My step dad died last year, and I too was almost stunned by some of my reactions-- because he has a daughter and 2 sons of his own.

I'm so glad you were able to get enough answers (at least for today;) ) and you can now use a more low-key approach to going behind everything they do and protecting your dad. That's why I would do! Bless you, Leslie, for doing the right thing. I imagine the next few months are going to be tough ones for your husband, and you. :redpinkhe

Thanks for sharing, Leslie. As my hubby said to me this week, "What's right isn't always what's easy." I'm sorry that you had to go through that, but it's nice to know that there are others out there who will do what's right, even if the consequences are heavy. Had a bad experience this week about what's right vs. what's easy, and felt pretty alone, so reading your post helped. Thank you.

Leslie, I am not understanding some of this, I am sure it will come in time when I know more about end of life care, but I just wanted to lend some support and tell you I am very sorry for what you are going through and will be praying for you and your family :)

pm me anytime, and i'll try and help to answer your questions.

thank you, sweetie.

My mother is ESRF. She is on daily dialysis. We had this discussion several weeks ago with her. We let her know in no uncertain terms, that when she has had enough, she can stop dialysis. She knows that death will come shortly after. I am greatful that we have a physician compassionate enough to have given her this option.

it sounds like you all are very lucky to have ea other.

i too, am an advocate of a pt's autonomy.

but i have to stay within the legal confines as well.

prayers for peace and strength for your mom, lisa.

I'm trying to navigate some unknown scary waters also with my parents and extended family,too-- and I'm finding out how I really feel about things in the process-- you jumped up to ferociously defend your FIL surprising even yourself, it sounds like. Now you know, in truth you are your FIL's daughter, and he is your dad. I don't think you need mentally consider at all the "in law" part. My step dad died last year, and I too was almost stunned by some of my reactions-- because he has a daughter and 2 sons of his own.

yes, i can tell you my reactions scare me.

most times i am pretty low key, so when these 'emotions' surface, it's like 'whoa, who said that'?:)

today is dad's birthday, obviously his last one.

everyone will be there, and i will take my usual place by his side and read him his cards.

for sure, it will be a bittersweet time.

again, thank you ALL for such love and support.

it's interesting in that hubby has been even more incredibly loving to me.

he admitted that he saw 'something' in my eyes yesterday, and he knew that if he didn't get on board with me, he was going to lose me...and saw the light/truth.

it just reinforces that grieving folks are not thinking straight...

and sometimes it takes a stinging dopeslap to orient back to reality.

will return later on.

leslie:redpinkhe

Les just thinking of you and your family :

just thought i'd update you- dad died today at 3:30pm...

peacefully, surrounded by all his children.

up until yesterday, i had been spending the nocs with dad, while the days were filled with a constant flow of visitors.

it was my choice to do it this way, since i got quality 1:1 time with him, and my in-laws were all too happy that dad had a 'sitter' with him.

the nsg staff was superior, and there were no problems with overmedicating.

all interventions were appropriate, with all nurses showing excellent judgment and sensitivity.

while everyone is devastated, we are also comforted knowing that mom and dad are finally back together again.

rest in peace, dad.

and give mom a loving hug from all your kids.

you'll never be separated again.

leslie:redpinkhe

Specializes in Advanced Practice, surgery.

Leslie I am so very sorry for your loss.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

My heart goes out to you...what a difficult time you are having. But you are one of the strongest people on this site and I know you will, in the end, be ok. I am so sorry for your loss. I have no words that will make it better, but I am thinking of you. (((Leslie)))

Specializes in PICU, NICU, L&D, Public Health, Hospice.

Peace to you leslie...

Your experience points out a couple of really important things....

1)hospice nurses are not made of stone, we experience all the things lay persons do...

2)hospice is consistently about giving people comfort at the end of their lives...not about medicating them until death occurs...

3)our greatest support comes from our family...

4)spiritual faith can and should be a source of comfort and peace for patients and families dealing with the realities of death...

Take some time...care for yourself and your DH...spill your love over onto your patients when you get back to work.

I hope that your hospice employer has greater compassion for bereaved hospice professionals than my previous employer did.

Specializes in MICU/SICU.

Hugs to you, leslie

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