unrealistic family of dying resident

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I don't mean to complain but I need to get this off my chest. There is a couple of families at my work that just can't let mom or dad just go, die. One in particular. He is a cardiologist, mom is dying, he never visits her really anyways. Now that mom is very close to death her wants everything done for her. Our unit MD even says that if we stop with the 2-3 antibiotics she would die. She moans everytime you touch her, but her son insists that we can put her on morphine. how do you deal with family members like this. I feel that our unit Dr. doesn't want to affend the cardiologist, so I don't think he is really advocating for the poor res. Any suggestions

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Specializes in LTC, Hospice, Case Management.
She moans everytime you touch her, but her son insists that we can put her on morphine.

What is the problem with this? Pain management is a good thing.

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Maybe a typo?

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People who are in emotional pain struggle to control the situation whether or not they can.

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Specializes in Palliative Care, NICU/NNP.

I would get her on a very low level morphine drip and death will come--not from the morphine but because this is the end of her life. The antibiotics are complicating things.

Does she have a DPOAHC (advanced directive) in her chart? If she has one I'd be sure to read it if she can't respond. There must be someone that could talk turkey to the son.

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Specializes in Gerontology, Med surg, Home Health.

Ginger-Most SNF's at least around here do not do morphine drips. We are all hesitant to do IV narcotics. Some of us use CADD pumps for subq morphine but those are not the most comfortable for the patient. I've found the best is liquid morphine - Roxanol...It would seem that for this patient, pain control is the most important thing you can do for her. Her son,even though he is a doc, is still her SON....you know that son/mother relationship....HE needs emotional support as much as your resident needs pain control.

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I have experienced the same thing because I work in LTC. You get so frustrated when it is someone who has not come in the whole time they were well and now they are dictating how things are going and act so very concerned. BUT, you have to remember many people have a hard time dealing with seeing their loved one in a nursing home. My husband could not go and see his grandma hardly at all. He could not stand to see the grandma that he remembered being in her condition. And then when the time of their death is upon them, a lot of guilt steps in because they realize that they should have been there all along. This man needs a lot of support because however much we feel that he just stuck her in there and did not come and see her, his MOTHER is still dying. That is what we have to remember in times like this. I agree with capecod that some Roxanol would be appropriate to keep her comfortable. No one should be in pain when they are dying. We still need to be able to give good care and keep them comfortable.

Leslie

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deleted

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Specializes in Case Management.
She moans everytime you touch her, but her son insists that we can put her on morphine. how do you deal with family members like this.

I would give her the morphine.:stone

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Specializes in ED, ICU, Heme/Onc.

Pain meds can even be given in a suppository form. She obviously needs them, and hospice needs to be consulted. Even with the antibiotics on board, it sounds like the patient is not going to live much longer. I do not think that you need family consent for a hospice consult.

Blee

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I would pretty much guess it is out of guilt from not visiting her much.....and it's very sad! My uncle dies this past October...and my aunt never visited him for more than 1/2 hour at a time each day.....that was it......and she is still going through the should of , could of, would of's.......and it is most likely out of guilt.... It's so sad. It sounds like she is suffering and I can definetly understand your frustration!! I agree ...she should be made comfortable so she can die peacefully. But he is her son & he is the one who has to live with his decision.....not anyone else. All you can do is be supportive even if you don't agree with his views or what he wants done. Maybe he feels if he has everything done then he'll feel guilt free. Maybe someone just has to be very blunt with him.......I wouldn't walk on eggshells just because he is a doctor....he** no!!!!!

Well please post what happens.......try to not let it get to you!:o

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Pain meds can even be given in a suppository form. She obviously needs them, and hospice needs to be consulted. Even with the antibiotics on board, it sounds like the patient is not going to live much longer. I do not think that you need family consent for a hospice consult.

Blee

At our facility we have to give the family the option for Hospice and if the choose to take it, we tell them what ones come into our facility and they choose what one they want to use. We are not allowed to use hospice without their consent. If you are Hospice, you have to pay for the room and board.

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