Nursing home phenomenon/ What's this?

[Juliet310]

Hello All,

I am very curious what politics are involved in the current trend to have residents in

LTC facilities that are bed bound and requiring various artificial means for life? I visited

my grandmother in an Alzheimer's unit as a child towards her later stages when it became

hard to care for her, but I do not remember this large of a community. ( I know I was a

child so that has to account for alot ) . But, the argument still is many more people are

alive this way then 30 years ago, and 50 years ago. I was discussing with a classmate today and we agreed with these points, but I want to learn more and wondered if anyone

can recommend some books about this.

-It is costing California SOOO much money

-I wonder if these patients were informed about their rights to not have artificial means

before.

-Is there a lack of information available to the population about our human rights/medical rights and lack of education regarding our options

-If that is the case, what is being done to inform the public?

-What segment of the population is more informed, at what age, and what is the problem getting the information to segments of the population that are not as aware,

language, socioeconomic factors, ect.

-These facilities provide many jobs for LVN, what is the loss and gain of taxpayers of this?

-What arguments are ethical to propose, what are not? How does religion play a role?

How does government play a role?

[Red Kryptonite]

I am not sure what the Catholic church says exactly either, but I know their belief with regards to physician assisted suicide.

Any and all forms of suicide and direct euthanasia are against Church teaching, but as you said you know that. To address the rest of your question here is the most relevant section of the Catechism of the Catholic Church:

http://www.vatican.va/archive/ENG0015/__P7Z.HTM:

2278 Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of "over-zealous" treatment.

Here one does not will to cause death; one's inability to impede it is merely accepted.

The decisions should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected.

2279 Even if death is thought imminent, the ordinary care owed to a sick person cannot be legitimately interrupted.

The use of painkillers to alleviate the sufferings of the dying, even at the risk of shortening their days, can be morally in conformity with human dignity if death is not willed as either an end or a means, but only foreseen and tolerated as inevitable.

Palliative care is a special form of disinterested charity. As such it should be encouraged.

See also about artificial nutrition and hydration: Responses to Certain Questions Concerning Artificial Nutrition and Hydration

I'm a fellow Catholic and knew where to find this info quickly, and so thought I'd post it here to help. Hopefully it can help in the conversation with your Dad. The Vatican website is actually a great resource, searchable and easy to use. Some of the documents are ginormous, but they definitely don't keep this info where people can't find it. HTH.

[BuckyBadgerRN, ASN, RN]

Were would you expect the clients you describe to receive care if not in a SNF?

[casi, ASN, RN]

I was hoping to work with seniors, but the conditions in this LTC/ SNF is deplorable. I can't understand my purpose there except to learn , I feel like the patient's

life is gone.

What are you seeing that you consider deplorable? Maybe we can give you a better view of what is going on.

I've found that in most placed I've worked we've worked really hard to educate our families and resident's on EOL issues. For the most part most of the resident's I've worked with have had DNR/DNI orders and orders for no tube feeding and in some cases IVs. When you are at a LTC as a student ask about and look for patient POLSTs. Just because these people don't want CPR done, doesn't mean we don't treat them. Grandma can have a CVA or a MI and we are still going to send her to the hospital. Grandpa could come down with pneumonia and we are still going to give him antibiotics if his POLST states it's okay we maybe will have to do IM or IV antibiotics. If grandma or grandpa has something that it looks like they aren't going to recover from or will greatly impact their qaulity of life we'll be talking to the family about palliative and hospice care and changing orders to do not hospitalize.

[spiderslap]

Isnt it sick? I question this stuff everyday. Big business has money to make, families feel too guilty to accept the truth and move towards hospice, patients put all their trust into the doctors' decisions, ignoring the fact that they make money to prescribe and treat rather than do whats best for the patient's well being. Simply voicing your opinion and allowing people to know that you feel that there is something very wrong with this picture will help to bring about a new paradigm for end of life care. Its easy to write an order for more meds, tubes, treatments, but watching a person slowly die(slower than nature would ever allow) and being forced to surrender basic abilities like speaking, swallowing, or moving, is traumatic for nurses and the patient's family. And of course, the amount of our tax dollars spent paying private businesses to pretend that this is humane is beyond ridiculous.

[spiderslap]

I agree. Its easy to dump your family member off somewhere and demand "everything be done" to keep them alive, especially when you dont see them often enough to realize how much suffering and misery they go through. It goes against nature. People seem to forget that we will all die. Its a normal part of life.