Resident with End-Stage COPD

[SuesquatchRN]

Horribly anxious. Increasingly dependent with ADLs and losing continence, which is new. Obsessed with her bowel movements - it's hard for her to defecate 2o exhaustion. Very frail, arthritis, already on axiolytics and we started her on Vicodin yesterday for severe back pain. She has been in bed moaning, "Oh, dear, oh dear" and, while I feel great sympathy, she is driving me nuts while breaking my heart.

Any suggestions? We have speech working with her on eating because she gobbles from fear of getting too tired to finish which, of courses, exhausts her.... it's a vicous circle.

[rotteluvr31, ADN, RN]

I saw the suppositories being used in hospice pts when they could no longer swallow their meds, but certainly needed them. That then seemed to advance to the gel, which is certainly less invasive, but still seems to be effective.

[Hospice Nurse LPN, BSN, RN]

CapeCodMermaid said:

Sounds like she might have terminal agitation....see if you can get an ABHR suppository or gel. Ativan, Benedryl, Haldol, and Reglan. I've seen it work wonders.

We use ABH supp @ times for terminal agitation--never with the Reglan. I'm going to suggest this to our MD. Thanks!