jpeak

(I posted this comment to the wrong thread yesterday. Will try again. Thank you.) Re: Why Can't She Stay Here? Getting Kicked Out of Inpatient Hospice I work in a free-standing hospice inpatient unit. We provide respite, general inpatient, and residential levels of care. I just finished an independent study module on Ethics of Family Communication. It talked about when fear is an emotion, our thinking reverts to flight, fight or freeze. Full cognitive ability is not utilized to process information. Many times our families of hospice patients experience that. Fear that their loved one is actively dying. Fear of a new diagnosis that has limited days. Fear of having to provide care that they don't know how to do. Fear of making things worse and not comforting. I like your approach of open hands, open mind, open heart and open questions. Helping the families to acknowledge their fears can release that flight, fight or freeze response and open the "hearing" to information presented. I always hesitate to tell families of inpatient hospice patients "they will go home when they are better". In the families understanding...they will never be better...their loved one has a hospice diagnosis. I try to stress "when symptoms are under control" and then define what that looks like. Even then they may be in the fear-thinking mode and not understand me. Gentleness, time, and reinforcement then becomes the focus. Reviewing the written information given at admission also helps the family to see in black and white what those guidelines for inpatient level of care are and supports that we are not just making things up as we go or trying to make things difficult for them. How to reduce the fear of caregiving? Gentle demonstration of care elements. Little tips of turning, bed changing, or feeding. We as nurses may have been doing these things for years and it is second nature to us. The families need that instruction to develop confidence in their ability to provide compassionate care. In the end...that family may be so proud of what they were able to do for their loved one in the home environment. Fears relieved. Thank you for addressing this difficult issue.

I work in a free-standing hospice inpatient unit. We provide respite, general inpatient, and residential levels of care. I just finished an independent study module on Ethics of Family Communication. It talked about when fear is an emotion, our thinking reverts to flight, fight or freeze. Full cognitive ability is not utilized to process information. Many times our families of hospice patients experience that. Fear that their loved one is actively dying. Fear of a new diagnosis that has limited days. Fear of having to provide care that they don't know how to do. Fear of making things worse and not comforting. I like your approach of open hands, open mind, open heart and open questions. Helping the families to acknowledge their fears can release that flight, fight or freeze response and open the "hearing" to information presented. I always hesitate to tell families of inpatient hospice patients "they will go home when they are better". In the families understanding...they will never be better...their loved one has a hospice diagnosis. I try to stress "when symptoms are under control" and then define what that looks like. Even then they may be in the fear-thinking mode and not understand me. Gentleness, time, and reinforcement then becomes the focus. Reviewing the written information given at admission also helps the family to see in black and white what those guidelines for inpatient level of care are and supports that we are not just making things up as we go or trying to make things difficult for them. How to reduce the fear of caregiving? Gentle demonstration of care elements. Little tips of turning, bed changing, or feeding. We as nurses may have been doing these things for years and it is second nature to us. The families need that instruction to develop confidence in their ability to provide compassionate care. In the end...that family may be so proud of what they were able to do for their loved one in the home environment. Fears relieved. Thank you for addressing this difficult issue.