We've had a woman in our facility who was in end-stage Alzheimer's and quickly declining over the past couple of weeks. She was refusing to even swallow, let puree food just fall out of her mouth, etc. So, we nurses thought hospice was the next call. Apparently it wasn't that important to the MD and NP covering this woman. The NP was in Friday afternoon to see some residents, and, according to the 7-3 nurse's note did not want to start hospice "secondary to it being the weekend. MD will follow up on Monday." WHAT? So, the 3-11 nurse was B.S. about the decision, called the covering MD and got an order for Morphine Sulfate. At 3:20am this morning I pronounced her deceased.
I am so angry and frustrated for this resident. She has no family, her HCP/POA (an old HHA of hers) didn't know where to send the body, and the body was still in the room at 7:50am. UGH. Even when I called my ADON she had no idea what to do. The day nurse said she would F/U around 8am.
It just disgusted me that no one CARED for this woman at all. No one thought of HER. Thank god for the 3-11 nurse, who actually pulled through for her.
You know what sometimes there is something to be said about dying in a familiar bed and not being moved around, I had a 102 yr old who was clearly dying and still somewhat oriented , we wanted to send her to a Hospice and she refused- saying she wants her last moments in a familiar setting, she died just a couple of hours after that conversation surrounded by caring nurses and CNA's who were as gentle as they could be for her. Also had noone to her name- lost her family in the Holocaust and never rebuilded- too painful she said to risk losing again.
Personally I think you & the PM nurse did a great job meeting the needs of your resident at the EOL. I'm a hospice case manager for our SNF's & Alz units in our area, one of the big issues for me is to educate the staff including MD's & Managers as to when it is appropriate to call in hospice. I have one facility that just loves us & wants to put their residents on service way before it is appropriate, so I do a lot of evals there.:)
I'm a hospice case manager for our SNF's & Alz units in our area, one of the big issues for me is to educate the staff including MD's & Managers as to when it is appropriate to call in hospice. I have one facility that just loves us & wants to put their residents on service way before it is appropriate, so I do a lot of evals there.:)
achot chavi
980 Posts
You know what sometimes there is something to be said about dying in a familiar bed and not being moved around, I had a 102 yr old who was clearly dying and still somewhat oriented , we wanted to send her to a Hospice and she refused- saying she wants her last moments in a familiar setting, she died just a couple of hours after that conversation surrounded by caring nurses and CNA's who were as gentle as they could be for her. Also had noone to her name- lost her family in the Holocaust and never rebuilded- too painful she said to risk losing again.
Sometimes we have to be the Hospice.