Palliative Care - question

[mrsdannydyer]

Hi i hope someone can help me with this question.

Thepatient is elderly and frail. She has advanced heart disease and is bed ridden for most of the time. She is very weak and is nearing the end of life. She takes your hand and asks you is she dying. How would this be answered?

[Straydandelion]

That is a tough question and I am interested to hear what others have to say. I have not had a patient ask me that, but my mom with Alzheimer's has, yet is not as weak as the patient you described. Knowing her I give a little chuckle and tell her "we all are" and she seems to feel much better starting to laugh with me. Not knowing the patient however would be much harder. I would think that IF the patient had family, it might be good to talk with them about it.

[dosamigos76, RN]

Without knowing the person, it is difficult to answer. You can usually ask why they are asking the question and what do they think? If they are the type of person that is direct, I would answer them honestly about their condition and not draw any conclusions. But I am a hospice nurse and have found that the patient almost always knows. It could be that they want to talk about dying or their concerns and by addressing them you are giving them that opportunity.

Best of luck to you!!!

[BBFRN, BSN, PhD]

Thread moved to Hospice Nursing forum to encourage more responses.

[Whispera, MSN, RN]

I'd respond by asking the patient what she thinks, and go from there. Maybe she just needs to talk about her feelings about everything, dying or not, and she feels you are a caring person who might be strong shoulders and listening ears...

[tewdles, RN]

whispera hit the nail on the head...if the patient is at all able to answer, ask her what she thinks. If she doesn't want to answer that then be HONEST with her. It is not a failure of some sort to die...it is inevitable...we all do it...some of us get to have a measure of control over the process. Listen to her, encourage her, honor her, and be honest with her in a compassionate way.

[Whispera, MSN, RN]

I'd add to what tewdles says, that if you are telling the patient that she is dying, do it in such a way as to NOT eliminate hope, such as "it seems, from all you're going through that that's what is happening." seems, not is for sure...

[Lovenox1]

:heartbeat Many times people are worried and want to talk. People may have "unfinished" business, and really would like to see things in perspective. But it sounds like she wants to talk. By understanding that "stepping over" will happen and you can help her, by finding out what her fears are, {it could be her last good byes, or even who would take care of her pets,}....it would be nice if she has family, or some kind of spiritual support. Many times people drift in and out of sleep preparing to step over...I had a wonderful little book from hospice, "Gone from my sight". The dying experience by Barbara Karnes....best wishes...I hope I helped you a little..:redbeathe

[Lovenox1]

:heartbeat Also she maybe scared to be alone, when she passes, it means so much for someone to be near when they pass, holding their hand letting them know that someone will be with them for their next journey, that is why dying at home with family around is so special....:redbeathe