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Need caregiver advice for esophageal cancer

Hospice   (583 Views 4 Comments)
by jjaye jjaye, BSN (New) New

816 Profile Views; 12 Posts

Hello all you awsum hospice nurses. I am an RN in the ER and took this week off as my dad was said to have a week left to live according to his hospice nurse. I need some advice if possible as I am having a hard time thinking critically or clinically bout my dad. (Terrible I know) ok, here goes

He was diagnosed in Aug stage four with mets to liver and lungs. Previously he had a stroke in 2016 and had been bed bound ever since. 

I feel he is a day or two from going. Whenever he wakes (which is further and fewer in between today) he whispers drink. I sit him up and he is able to suck from the straw once and then falls back asleep still with straw in his mouth. Then he has these awful groan/hiccup/painful sounding noise, and that's it. 

He totally cognitive at this point and I dont want to deny him water. He ate last about 8 days ago. The tumor was large and towards the bottom of the esophagus.

Do I keep letting him drink while he can (I am afraid of aspiration) . I am using the mouth sponges and doing oral care, but he still manages to utter the word water. It is the only thing he is saying as of today. 

I hope this is enough info. Thank you for any insights. I want him comfortable as possible and I dont want to cause anymore pain

...and yes he is on hospice but 3 different nurses have been in this week and I got three different answers.. so I am just feeling lost. I know all this is so hard to predict but maybe somebody has some experience and insight to offer.  These hospice nurses actually talk about each other to my mother. 🤦‍♀️.

 

Thank you again I will be eagerly awaiting your replies. 

Jill, RN, BSN

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nrcnurse has 13 years experience and specializes in hospice.

197 Posts; 6,668 Profile Views

It is fine for him to drink as long as he can swallow.  Oral care is also really important, so keep that up!  You might want to keep his head slightly elevated to help the fluid go in the proper direction.

It is really hard to be a nurse when it comes to your family and end-of-life.  I was very grateful for my hospice team when my parents where on service.  In case no one has told you, you are a great kid and your dad is fortunate to have you with him. 

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12 Posts; 816 Profile Views

Thank you,  I appreciate your comment.

Another question, he is not verbally responding but can squeeze my hand for yes or no. When he was verbal he very rarely took the ativan prescribed for him, sometimes at night he would ask for it. Last night he was restless so I told him I would give him some ativan. He wouldnt open his mouth for the syringe and when I told him to squeeze my hand if he wanted it, he didnt. I really feel it will comfort him but cant force it (its sublingual) but I feel as a nurse I should make him take it, as a dgtr I cant. Hospice nurse said to give it at least every 6 if not 4 hrs... what would you do ?

😓

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Silverdragon102 has 31 years experience as a BSN and specializes in Medical and general practice now LTC.

7 Followers; 1 Article; 38,922 Posts; 143,304 Profile Views

As per the Terms of Service of the site we can not offer medical advice. I am sorry you are going through this but can you not speak to his pcp?

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