Need some advice for very sick home care pt

[Goldentea]

Hi everyone,

Maybe someone can give me some advice. I have a pt that is 103 years old and has severe chf and copd that is currently under home care. MD wants pt to be under hospice but family refuses and when I wanted to refer a social worker for them to talk about long term planning they also refused. This pt is also a DNR. What do I do in this situation? What if pt expires at home under home care..which is seen as really bad. Thanks!

[caliotter3]

If they expire, they expire, people that are 103 do that. There is nothing you can do if the family refuses hospice. Follow the Plan of Care and document when you do teaching about the advantages of hospice. Frankly, I could see why the family would not want it if it means they will end up losing a continuous care set-up. But if they are in denial about where their loved one is on the life continuum, you might be able to get them to change if you continue efforts at education without badgering them. Good luck.

[ceebeejay]

Some people prefer to go in peace at home without interference. At her age and with her issues it's a non issue. Like the other member said document and go on.

[turningred15]

What does the patient want? You owe it to the patient to advocate in his/her best interest and to follow up with a social work referral if the patient does not know or understand hospice. Good luck!