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Hospice Patient, a student's perspective

Posted

Specializes in Progressive, Intermediate Care, and Stepdown.

Last semester, I wrote an article about an experience I had with a hospice patient and it was my first experience with death. Needless to say, I had a similar experience today.

I just can't imagine getting used to death. As I walked in the room today, I could feel the sadness and pain. I could immediately see the pain in the daughter's eyes. She was so down. I really didn't know what to do. I suppose I reverted back to what I do with all patients. I cared. I was as compassionate as much as possible. I didn't talk much and was there for emotional support when the daughter needed to talk. I sat with the daughter for awhile. She was very tearful. She had a painful story.

The patient and her husband had been independent up until very recently. The two lived in the same home for 60 years! And, had been married longer. My patient was 94. Amazing! Recently, however, the patient was becoming more and more of a safety risk. And, the husband was having difficulties at home as well. The daughter as well as the family as whole decided to place the two in a long term care facility. After that, my patient and her husband has had an abrupt and steady decline. For simplicity, we'll call my patient,"Anne" and her husband, "Buddy." The nurses from the facility had called the family with terrible news. She had a stroke at facility and was sent to the hospital. Ever since Anne was admitted, she was making a progressive decline. Neurologically, she was unresponsive. She was taking a full leap into the dying process. Truly, a sad situation.

To make this much worse, Buddy had a massive health decline as well. He had a history of heart issues. Apparently, he was admitted, soon after, his wife's stroke. He was in the same hospital but a different unit. Furthermore, he was having significant confusion. During his admission, he fell out of bed despite measures to ensure his safety. This hospital tries to avoid falls yet they are extremely conservative on restraints (understandable considering the research) and wouldn't give him a sitter. I'm getting off track. He fell and along with his other issues, he was declining dramatically. The family wanted to break the news to him about Anne as he wasn't aware of his wife's condition yet.

Imagine this. Two spouses that were in different locations. Wife has a stroke. Less than a day later, the husband has CHF complications. I'll get to this idea in a moment. Anyway.

So this family has, likely, the two most important people in the family abruptly come into hospital. Amazingly sad. Shocking for the family. And, difficult for the student to broach and walk into. As I sat there, and listened to her story, I felt emotionally challenged. I really felt my tear ducts almost fill. I truly care for these people despite not having known them for, maybe, 30 second. I care for complete strangers because that's who I am. It's more than a job to me. I eventually physically assess the patient and provide comfort measures such as oral care, repositioning, morphine prn, and of course, a nice bed bath. The family left during the bath not concerned about the nudity, but by watching us bathe her mother in her frail condition. I understood.

Also, the daughter was deeply blaming herself for the whole situation. She felt that by putting her parents in a long term care facility that she caused her mother's stroke and her father's heart failure. As I sat there, I didn't know what to say. I had thoughts of, "Of course you didn't cause this, or we can never predict or foresee these occurrences, or the almighty answer to some psychosocial related nursing questions, tell me more about how you feel." Ultimately, I didn't say much. I was uncomfortable. I imagine that these last few moments are going to be burned in her memory. And, despite how I pride myself in patient communication, I say stupid stuff sometimes and I simply looked her in the eyes and let her speak with me as she wanted to. I didn't want to accidentally say something wrong or stupid, especially during this time in her life. Anyway.

I did say something that I haven't really discussed before with patients or the family. This hits on human spirituality. The daughter didn't understand why her parents had declined simultaneously. I have heard of this occurring before. Spouses, at this age or both with declining healths, die around the same time period. What made this more spiritually based, I believe, is that the husband had not been informed by any of the family or friends. He was completely unaware of his wife's condition. They did try to tell him but apparently, he was so confused, the message didn't appear to sink in. I believe this to be the spiritual side of our humanity. I'm not particularly religious but I can't say there is no God for certainty. And, after rigorously studying the human body, I can't believe that we simply evolved from some random creature, a previous neanderthal, or from the Big Bang. I feel like there were forces at work here beyond human comprehension. Maybe, the two sensed "is was time." And, I mentioned to the daughter that I've heard of such circumstances and she had as well. This was the first time that I had talked with family member about spirituality. It was difficult considering the circumstances.

I have no particular questions or concerns. I feel like it was appropriate of me to mention that it's possible that long time spouses "decide" when to die together. They wanted to be married on this earth as well as be together in the beyond.

Take my experience for what it's worth. I just nice to talk about because it can be emotionally challenging. It really was today.

This is a very interesting subject. While I'm only a pre nursing student, I've heard of instances such as this. More so, however, I hear that when a spouse dies, the husband or wife declines within that year. What those two patients went through seems like a miracle or something. Neither of them had to deal with a year long decline of missing his/her spouse. Its amazing how the body seems to "know" when to die; even if it takes them awhile.

(What I've said is only what I've heard. I have yet to witness this in person.)

KelRN215, BSN, RN

Specializes in Pedi. Has 10 years experience.

Death is a part of life. You will get used to it. I can't think of any area of nursing you'd work in where you wouldn't encounter death. I, for one, think this is a beautiful story. Though Buddy doesn't "know" Anne's condition, being that he became ill and was sent to the hospital shortly after she was, I'm guessing that on some level he knows that Anne is declining and he is choosing to go with her.

It is true that people who've been together that long often move on from this life together. My great-grandparents died within a week or 2 of each other. I had a great aunt who was the picture of health when her husband of 50+ years died. She died 9 months later.

These people have been married for over 60 years and have obviously had a good life- if they lived independently to their mid-90s. No one wants to lose their parents at any age, so it's natural to feel sympathy for the daughter, knowing that she's about to lose both of her parents. I would, however, consider her lucky to have had both her parents for that long.

As a disclaimer, I will tell you that I work in pediatrics and the youngest patient I have seen die was only a few months old so I'm used to helping parents let go of their children, not the other way around. Because of that, I have a hard time getting too excited about an old person dying. Of course it's sad for their family, but at least you can look back and say they've lived good, full lives.

guest042302019, BSN, RN

Specializes in Progressive, Intermediate Care, and Stepdown.

Death is a part of life. You will get used to it. I can't think of any area of nursing you'd work in where you wouldn't encounter death. I, for one, think this is a beautiful story. Though Buddy doesn't "know" Anne's condition, being that he became ill and was sent to the hospital shortly after she was, I'm guessing that on some level he knows that Anne is declining and he is choosing to go with her.

It is true that people who've been together that long often move on from this life together. My great-grandparents died within a week or 2 of each other. I had a great aunt who was the picture of health when her husband of 50+ years died. She died 9 months later.

These people have been married for over 60 years and have obviously had a good life- if they lived independently to their mid-90s. No one wants to lose their parents at any age, so it's natural to feel sympathy for the daughter, knowing that she's about to lose both of her parents. I would, however, consider her lucky to have had both her parents for that long.

As a disclaimer, I will tell you that I work in pediatrics and the youngest patient I have seen die was only a few months old so I'm used to helping parents let go of their children, not the other way around. Because of that, I have a hard time getting too excited about an old person dying. Of course it's sad for their family, but at least you can look back and say they've lived good, full lives.

I agree with you. They did live a long and fulfilling life. I found the whole situation amazing in that the parents will likely die within days of each other. The father had the last rights and the mother will have them soon. This felt good to talk about. I'd like to think that I eventually become somewhat "used" to death. Not to not care or be compassionate, but to be able to emotionally handle the situation and to come home with a clear head. I'm not quite there yet. I think that's why I write these. To show other students what it's like and to therapeutically help myself. Thanks again for your thoughts.

guest042302019, BSN, RN

Specializes in Progressive, Intermediate Care, and Stepdown.

This is a very interesting subject. While I'm only a pre nursing student, I've heard of instances such as this. More so, however, I hear that when a spouse dies, the husband or wife declines within that year. What those two patients went through seems like a miracle or something. Neither of them had to deal with a year long decline of missing his/her spouse. Its amazing how the body seems to "know" when to die; even if it takes them awhile.

(What I've said is only what I've heard. I have yet to witness this in person.)

I'm glad you found it interesting and you'll likely experience something like this soon enough as a nursing student or as a licensed nurse. I truly feel honored to be with a family when taking care of a member who is dying. My mother remembers a hospice nurse that took care of her grandmother when she was twelve. As a student and as a future nurse, I hope to make a positive impression when the family recalls this memory.