Husband Doesn't Get It...

[AtlantaRN]

New hospice patient discharged saturday from hospital, terminal ca with mets; can't make it to her md appointment today. Tried to set up a visit 9:30 this morning; hubby said "no, she has a md appt at 1:30, so we won't be back til after 5; give us a call then". Just got a call from MSW saying she spoke with hubby who said wife is more weak and won't make it to md appt today; so I called back; he said wife "just had a nausea pill and is lying down." he also said that kids and grandkids were "over all weekend, too loud and rambunctious for us all weekend." verbalized it was really too much on the patient.

Says give her 2 hours, call back at 3:30, if she is awake you can "make your visit then." Then he said "I thought they were going to give her 2 more rounds of chemo, but I guess they cant because she didn't go to her appointment today. Now when she was admitted on Saturday, we went all through the supportive care, no more treatment for cancer, just supportive/symptom control. Both she and her husband verbalized an understanding of this, at that time. I reiterated that Hospice is for "symptom control, to help her stay home as she wishes."

Another thing, we have this 8X11.5" sign that we place on the front of the hospice packet, and the front of the refrigerator for easy view, to call the HOSPICE FIRST for any problems. I reminded him that any nausea medication, etc would have been covered under the hospice benefit...

Anywhoo, now I'm wondering how much information he has retained. I know he is really worried about her, but I don't think he gets the purpose of hospice at this point. I went over everything, and gave him copies of everything.

We'll go more over everything today, should he let me come and see her...

What else can I do for them?

thanks for your input.

linda

[AtlantaRN, RN]

nope, he would LOVE to have them there...but they just want to pop in and leave.....

another nurse did the visit yesterday, i'm home with stomach flu...

[leslie :-D]

if the pt can't remain at home w/o causing injury to herself, then i would gently pursue a snf.

sounds like dad is feeling rather helpless.

leslie

[AtlantaRN, RN]

husband wants patient at home, patient wants to be at home. Daughter who took LOA doesn't want to do ANYTHING for the patient or the primary caregiver...she wants the AUTHORITY, but NO responsibility...

Husband, who is stepdad to the 2 daughters are completely physically ABLE to help the husband...but they don't do a THING to help him. We go through expectations, and what is REQUIRED to help patient to stay at home. But still, Daughters will call me the day of visit and say "call and let us know when you will be there so we can be there." I drive 35 miles one way, they are 1 mile away, and I'll get there 30-45 minutes before they do!!!!!

Patient is mostly in bed this last week, but it's just so sad. Daughters may show up for the visit, but they certainly aren't "present." Patients hubby is doing everything. Nurses aide goes out every day and stays 2-2.5 hours, i'm going out twice a week.

Patient and husband don't want inpatient care...I don't know how to get through to the daughters. They are grown adults. One is the power of attorney for healthcare, but again, she wants the authority, but not the responsibility.

One daughter called me yesterday to say "she has a headache, i'm calling 911 because she may be having a stroke." Now, this little patient is lucky to have a 90/40 BP; there was NO WAY she was having a stroke. They told me earlier in the day when I called the husband that she was drowzy most of the day and had only had 1 piece of toast....could it be that she may be "HUNGRY???" Encouraged her to have a couple pieces of crackers before trying to give her her percocet for her headache (patient is known to have headaches).

I just get frustrated with the daughters.

[Liddle Noodnik]

husband wants patient at home, patient wants to be at home. Daughter who took LOA doesn't want to do ANYTHING for the patient or the primary caregiver...she wants the AUTHORITY, but NO responsibility...

Husband, who is stepdad to the 2 daughters are completely physically ABLE to help the husband...but they don't do a THING to help him...

I just get frustrated with the daughters.

So if you treat this as if there WERE no daughters - would the pt be allowed to stay home? And if so, what services would you be able to provide? You almost have to play it like that since you can't count on them to do ANYthing.

As in the old adage, expect nothing and be delighted if you DO get something.

Stinks but it seems there is nothing you can do to change their behavior!

[AtlantaRN, RN]

patient is having a better day today. Talked to hubby about inpatient care...he is not interested--she is not interested. We have a contract with a local nursing home. She is more debilitated every day, he is doing his best, but like you said with no help from the daughters--it's like they don't exist.

linda

[Liddle Noodnik]

patient is having a better day today. Talked to hubby about inpatient care...he is not interested--she is not interested. We have a contract with a local nursing home. She is more debilitated every day, he is doing his best, but like you said with no help from the daughters--it's like they don't exist.

linda

Are you feeling any better Linda?

I think, based on what you're saying, that you guys (you, wife, hubby) will just have to do the best you can to keep her comfortable and safe. As long as you document that hubby knows the risks of her falling if she stays home - what else can you do? You have to respect their wishes. Even if it was your own mom and dad I don't think you could force her to go into a home (then again, if you WERE their daughter, it sounds like you would BE there to help!)

[ktwlpn, LPN]

I was just wondering how things are going with these people-their story touched me...I hope they are all more accepting of her diagnosis and her and hubby's wishes to stay at home and the daughters have gotten their heads out of their butts and are DOING something instead of just talking.