I have been a public health nurse and nurse educator for 11 years. I currently live across the street from my uncle who cares for his wife full time. She has early onset dementia and is in the end stages. She is non-communicative, is bedridden, incontinent, and just recently has changed in her ability to even chew the food that she is fed. She has skin breakdown in several pressure areas, and requires suctioning. My uncle does everything for her; Dresses, bathes, feeds, transfers, etc. As far as transferring goes, he lifts her as dead weight. I have somewhat of an ethical dilemma and I'm not sure how to approach it. I know, in my nursing judgement, that B.A. is not getting the care that she needs, and this should be reported. However, I am very close to this uncle and I also know that her husband loves her very much. He has voiced that he absolutely does not want to place her in a skilled facility. How can I approach this subject with him, without offending him, or hurting his feelings? How can I convince him of placing her in hospice care without threatening him?
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I have been a public health nurse and nurse educator for 11 years. I currently live across the street from my uncle who cares for his wife full time. She has early onset dementia and is in the end stages. She is non-communicative, is bedridden, incontinent, and just recently has changed in her ability to even chew the food that she is fed. She has skin breakdown in several pressure areas, and requires suctioning. My uncle does everything for her; Dresses, bathes, feeds, transfers, etc. As far as transferring goes, he lifts her as dead weight. I have somewhat of an ethical dilemma and I'm not sure how to approach it. I know, in my nursing judgement, that B.A. is not getting the care that she needs, and this should be reported. However, I am very close to this uncle and I also know that her husband loves her very much. He has voiced that he absolutely does not want to place her in a skilled facility. How can I approach this subject with him, without offending him, or hurting his feelings? How can I convince him of placing her in hospice care without threatening him?