mother in law on vent

NCgirl · Nov 6, 2004

Your story touches my heart, it is this type of situation exactly that always got to me when I was a CVRU nurse. Did your MIL have a living will? Is your Husband the family member allowed to make decisions? I guess what this comes down to is the age old debate of quantity vs. quality of life. Do you truly believe this is what she would have wanted? Or, if she's conscious, just ask her. Above all, try to make decisions that are what SHE wants, not what the family members want. God bless her and your family!

mollie · Nov 6, 2004

my mil has no living will. There are 5 siblings who believe in life at all costs.. but "you" pay the cost! What are the stats on recovery from this? My mil is conscious, miserable but unable to make a decision. Do you know any sites I can go to to find out detalied info? Thank you!

NCgirl · Nov 6, 2004

I'm sorry, but I do not know any specific web sites. My suggestion to you is this: ask her three primary physicians that if it was THEIR mother, and they knew she didn't truly want to live like that, would they let it all continue with true hopes she'd make a meaningful recovery. As far as the siblings who believe in life at all costs--I pray that they will make choices that honor their mother's wishes, and not their own selfish needs to keep their mom here with them. I know that is SO much easier said than done, but I pray that they will have peace in making such difficult decisions.

Trauma Columnist · Nov 6, 2004

Please contact your MIL's case manager in the current hospital and get a family session scheduled with the primary docs caring for her. If she is alert and oriented, though non verbal - ask her how she feels about this continued care. I wish you the best.

snowfreeze, BSN, RN · Nov 6, 2004

Hello, I work in a facility that probably would take your mother-in-law. Talk to the doctor assigned to your mother-in-law and talk to the social worker and let the nursing staff know your wishes.

You may e-mail me if you like

[email protected]

leslie :-D · Nov 6, 2004

Please contact your MIL's case manager in the current hospital and get a family session scheduled with the primary docs caring for her. If she is alert and oriented, though non verbal - ask her how she feels about this continued care. I wish you the best.

i agree with trauma 100%!!

you say your mil is conscious/alert....there must be a way that she can communicate HER desires..

a meeting is in order asap.

and much luck to you and yours.

leslie

apaisRN, RN, CRNA · Nov 6, 2004

I work in MICU and see many of these failure-to-weans, many of whom should never have had surgery to start with.

If she was asymptomatic, who pushed for surgery?

An ethics consult might be in order, especially if the patient can communicate that she doesn't want all this.

Rachel2004RN · Nov 6, 2004

My mother in law is on a vent and has a feeding tube after quad. bypass and aortic valve replacement. She is 84 years old. She has been on the vent for 2 and 1/2 months and is now being moved from ICU to a vent weaning hospital. She also has mrsa. I am a home health nurse and unfamiliar with all of this. I don't know the right questions to ask or what the expected outcomes are, although I have a general idea. My husband and I were totally against her having all this, because she was asymptomatic and had a great quality of life. What is wrong with just dying peacefully in your sleep? anyway, I would appreciate any help. Thanks

I am a new RN working on a floor that takes patients like your MIL. We get lots of admits from ICU's, many come to us to be weaned off the vent as they become more stable respiratory-wise. Weaning is a gradual process and isn't always successful. There are patients who have been on this floor for a very long time who have failed to wean repeatedly. There are others who wean without difficulty, and still others who are able to wean eventually but may experience setbacks along the way.

I agree with the other posters who suggested a family meeting with the case manager and the rest of the health care team, including respiratory therapy, to find out the plan and the progress. Since she is alert and oriented definitely get her input on her desires for her care---and get it in writing. Also, depending on her progress, part of the discussions may include where to go after the vent-weaning hospital, if she is indeed able to be weaned off the vent. A different floor within the hospital? The same floor? Long term care? Home with visiting nurse services? Home with 24 hour care? Was she healthy before this surgery (relatively)? It's hard to tell you what exactly to expect, since I don't know her and it's hard to predict how people will come along, but I wish you well and hope for the best for her.

Antikigirl, ASN, RN · Nov 7, 2004

My best to you and yours during this time. I work in assisted living, but lately there has been far more people brought in for end of life care or come back from very similar experiences as your MIL. It is rough on everyone.

I find that good communication, and someone that will shed reality on the situation for EVERYONE is in order. Speaking to the case manager is a very good start, and having ALL family come for a visit so they can see that their choises have real impact.

I have so many family members go into the idea of "do everything" only to come in and see mom with tubes coming out of everywhere and they just don't know how to cope with their choice vs the reality. They just wish to help, and sometimes seeing their loved one with all the bells and whistles on them is just too hard to bear and they are in limbo between what they feel is right, and the sights they see...very hard time for folks! And even harder for medics to come to terms and explain things without bias of some sort (so typically questions go unanswered...plus you know you will get that one question "what would you have done" or "what would you have suggested" which is always hard to answer without bias or skirting the whole matter!!!!).

I could also suggest the help of your local religious organization (actually hers) if this fits your MIL lifestyle. They can be a really good source of info and support at times like these!

mollie · Nov 7, 2004

Thank you all for all of the input, it is really all very helpful and provides me with useful information to present to the family. God bless you guys!