Just a Question

minette · Nov 16, 2003

It was always my understanding that people are to be helped but not forced. If she wanted to eat and needed assistance then you did the right thing. So many of the people in nursing homes get neglected during meals because of the time it takes.

So many times people feel if they are on hospice it doesn't matter, the hospice patient can get ignored and It does matter. She probably never gets fed. That is so sad.!

sunshineclarity · Nov 16, 2003

It is sad! No one ever feeds her, they just say oh,she is on hospice. But if you sit downa nd help her, then she eats! People where I work just never wat to take extra time! Errr, makes me mad!

Long Term Care Columnist / Guide · Nov 16, 2003

NO. Food is an enjoyable part of life for most people, even the dying, and you would have been negligent NOT to offer assistance with feeding. The other nurse apparently doesn't understand that hospice patients aren't dead yet---they should be offered food and drink just like everyone else. (And NO ONE is supposed to be "forced" to eat, regardless of their health status.)

I've seen people eat right up until a few hours before they passed on. You are to be commended for making this lady's meal as pleasant and nourishing as possible.

Here's a little story from my CNA training days: At the end of my first week on the floor, I was assigned to feed a 93-year-old hospice patient who was dying of renal failure. (He hadn't eaten much of anything for several days, but we were still offering meals.) I was also told to get him to eat at least half of his meat and vegetables before he was allowed to touch his chocolate cake.

It didn't take long to figure out that this gentleman wasn't going to eat his meat and vegetables, but he kept eyeing that cake as if it were the only thing on earth that looked good to him. This is where I'm glad I was old enough (35) to do some critical thinking, which went along the lines of "For God's sake, the man is 93 years old, he's dying, and I'M telling HIM he can't have his cake?!"

Well, that dear man ate every bite, and while I took a butt-chewing from the nurse for bringing out his tray full of food but minus the cake, it was worth it to see the bliss on his face and to hear his wife say "He hasn't enjoyed anything that much in a very long time".

He died that afternoon. And I like to think that he left this world happy, with the taste of chocolate cake still lingering on his lips like a memory. :)

minette · Nov 16, 2003

My mother in law was in a facility, lost 25 lbs in 2 months. She had alzheimers. The administrator suggested hospice. It so happened she went to the hospital, for something else. She gained 30 lbs within a month & one of the aides told my sister in law they didn't have time to feed her so she wasn't eating. Every time we went in we were told she was eating fine.

about 6 mts later she passed. Later in talking to one of the aides by a chance meeting we were told she had slept thru her meals daily and was fed when family came.

We asked why, they said it was a violation of her rights to force her to eat or pressure her to eat.

She wanted to die 3 yrs ago when her husband passed. She gave up. It was sad, but she is now out of her pain.

I feel so bad for all those older folks that are so alone. Aides, nurses, caregivers are so important, and so overlooked.

keep feeding her if you can, you're probably the only one that does!

sunshineclarity · Nov 16, 2003

Thanks for all the replys, I wish everyone at my work felt this way! Iwill keep on feeding her. I have another question too. This same residnt has a teddy bear that she always keeps in her lap and she calls it her baby. She really thinks it is her baby and she she doesn't have any other children (she does) only this "bear" baby. When feeding her I said, let's eat for the baby and that really helped her to eat to. Is that wrong to encourage to eat using the "baby"?

Long Term Care Columnist / Guide · Nov 16, 2003

No, it is not wrong. Over the years, I've found that a lot of what many of us were taught in nursing school about how we should always attempt to re-orient demented patients is just so much hooey.....it tends to agitate them more. It's almost always better just to enter THEIR reality and work with them inside that world, because that IS their reality. So if this lady wants to think of that bear as her baby, let her........it does no one any harm, and it probably comforts her tremendously.

aimeee, BSN, RN · Nov 17, 2003

Bless your heart, Sunshine, for taking the time to feed and to truly be concerned about the needs of this woman. What has been said is absolutely right. Hospice is about comfort and quality of life, which means being offered food, with perhaps a little gentle coaxing. If they take the food, great! If they don't, that's okay too. Sunshine, if you see that others are not taking the time to offer food to this woman and she enjoys it, you might tell her hospice nurse and perhaps they can get some volunteers to come during feeding time and help her.

Mjlrn97, I'm glad you gave that man his dessert. That was a wonderful final gift. And I tend to agree with you, that re-orientation only works with those with the very beginnings of dementia. For the severely demented it just disturbs them. It works much better to use their version of reality to guide them to the behavior you need from them.

minette · Nov 17, 2003

My dad is end stage Alzheimers and has a swallowing disorder. He talks off & on, and go's in & out day by day.

All of a sudden he will ask for soup or Icecream, or even a hamburger. I try to get him whatever I can as long as he can handle it. (of course everything is pureed.)

I love that big smile he sprouts when he is happy, it's a blessing.

Most of the time he can eat babyfood, but every now & then when he has a good day, we give him a shake by teaspoon.

This is such a delight to him. It's those small things that we take for granted that really make the difference to sick, and elderly people.

Good nurses, caregivers and all other health care providers are truley a blessing. It seems they go on and are never really appreciated. When people experience an illness or a illness of a loved one, it's a eye opening experience.

I for one am gratefull for all of those people who took the time to help and really care.

renerian, BSN, RN · Nov 18, 2003

I cannot say I have run into hospices that tell people you are not allowed to help them eat if they want to? Very sad.

renerian

RNonsense · Nov 18, 2003

There is a big difference between force feeding and helping. You did the right thing!

AndiMac · Nov 22, 2003

Hospice is DNRCC ... I don't believe starving someone is considered comfort.