IV fluids in hospice

[lsyorke, RN]

Quick question, are there any circumstances that a hospice would continue IV fluids? I was always under the impression that IV fluids are not part of the hospice concept.

[txspadequeenRN, BSN, RN]

I have had many patients have IV fluids now all of this is demanded by the family...denial denial denial. Alot of families think that if you shovel food down their throat or make them drink they will "pull out" and be there old self again.

Normally hospice would stop all IV fluid and go to comfort measures only. The one things that grips me more than the IV fluid thing is when families have their loved one on hospice and refuse to sign a DNR........

Quick question, are there any circumstances that a hospice would continue IV fluids? I was always under the impression that IV fluids are not part of the hospice concept.

[lsyorke, RN]

That's what I was thinking. I'm in total agreement with you. Terry Shiavo must have made this harder for hospice nurses.

[LJLeach]

The only time I've had a Hospice patient that received IV fluids was one that was admitted with ideopathic diarrhea. The doctor left to the Hospice nurse the responsibility of telling the patient that the only thing keeping him alive was the IV fluids...not a fun chore. (I hate it when doctors drop the ball on their responsibilities.) Within a couple of days he decided to stop them.

Since then, I've been told by each Hospice I've worked at (east coast and here in Phx) that IV fluids are not part of Hospice care. I've not used them since.

[caroladybelle, BSN, RN]

If they are being used as a comfort measure, hospices may use them.

[req_read]

There are times when IV fluids would be a bona fide comfort measure… but those instances are rare.

In most cases any significant amount of IV fluid will make the patient less comfortable; i.e. pulmonary congestion and edema. This needs to be explained to families. If they insist on denial, then pile on the guilt. The idea is to make the patient comfortable... and the family to understand.

[doodlemom]

We've had many that have come home from the hospital with IV fluids. We then try to do teaching with families about the detrimental effects. Most times the teaching is effective but some times it is not.