Such a sad situation....

[AtlantaRN, RN]

Patient with chf, on dialysis, he has frequent falls (family wouldn't even consider a hospital bed). They refused aide

visits, dear wife is at her wits end (saving grace is his son who rearranges his schedule to give mom some respite).

each week dear wife is just exhausted and asking when he might pass. I've suggested stopping dialysis, which they are not ready to do.

He took a fall this am, fractured pelvis and shoulder, cardiologist said he is not a surgical candidate, (he wouldn't survive it);

after all is said and done; the family would consider our IPU but ONLY if patient could continue receiving dialysis 3x/week. It

is just so sad. Why put someone through all of this? They are the dearest, kindest people.

Thank you for listening.

atlantarn

[leslie :-D]

what does your pt want?

if he didn't have these fxs, i could appreciate him continuing w/dialysis.

(not saying i agree with it, but accept it)

it's the hardest part of hospice, when no one's on the same page...

leslie

[texastaz]

Yes that is hard. I have had wives like that before in denial and I assume it makes it more difficult for the patient. I know that patient more than likely has over heard thier spouse asking how much longer. I feel for you because you said they are such nice people. Bless you for your courage. :redbeathe

[AtlantaRN, RN]

patient wants surgery to repair shoulder, but cardiologist said he would die on the table. Patient wants to live, hence the dialysis 3 x/week. Son said since we couldn't provide dialysis at our IPU 3x/week, they would seek "rehabilitation" and go back on home health. It's just such a sad situation. Wife is at the end of her rope. She cries because she is so tired (he is essentially a total care patient) and when he is asleep during the day, her bliss is her yard and garden--so she exhausts herself out in the yard working--then the patient is up all night asking for breakfast every 2 hours, so wife gets NO sleep. Through the last few months, I've suggested respite (friday through monday morning, so he wouldn't miss any dialysis), and she just won't hear of it. She does take great care of him, but I worry about her health.

linda

[shrinky]

:redpinkheIf she loses him, then she will have empty days. The sad thing is that she may die before him at the pace she is keeping. It happened to one of our caregivers , our volunteer found the patient's wife dead when she arrived to visit. His daughters would not/could not care for him so we had to hurry to find a place for him as he was bedbound and unable to care for himself. Some people are also stuck in the rescue/martyr/victim triangle and have a difficult time breaking the chain. We had one wife who was like that and could not decide on Hospice but would call us to come talk to her about Hospice so she could vent and feel better for a while. He passed in the hospital and we found out that she had told us many untruths about her home situation. The sad thing is that your patient may not be receiving the care he needs due to her agenda. Bless you and bless him. You have done all you can but we can't fix everything for everyone.

[AtlantaRN, RN]

he died this morning while hospitalized. It was truly a blessing.

linda

[quinnie50]

linda...i truly believe that everything happens for a reason...may your patient rest in peace....it is so hard to make the decision to stop dialysis...my mother was in a similar situation 7 years ago and fell at the dialysis center and broke her hip...she coded on the operating table and was put on a ventilator....after 6 months of suffering and having a horrible quality of life she decided to stop dialysis....most of my older relatives felt that my mother was commiting suicide...can you imagine? now they understand where she was coming from as they all are approaching the end of their lives...you seem like a very compassionate nurse...may God bless you:redbeathe