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Discussion

What to do when you don't know what else to do???

I've cared for a hospice patient for almost 3 mos now. Dementia is a factor & the family stays 24/7 & constantly wants meds meds meds. Patient hasn't eaten in over a month except bird bites. I can get water & juice in the patient most times. However- hospice ordered laxatives & suppositories ( dulcolax) . There's yet to be anything in the rectal area in past 2 weeks. Abdomen is soft & no pains. Not distended at all. However, would you give a suppository that can cause cramps etc to one like this with basically no food intake? I don't feel comfortable doing it. It's gotten extremely hard to even get regular SL meds in this patient . If the patient even speaks the family runs to hint me down in rooms etc saying their loved one is " in distress" when I'm fact they aren't. I'm just at a fork in the road here.

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    Nothing in, nothing out. What's the point of lax/suppositories? Seems cruel to me.

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    I think it would be a good idea to ask the hospice nurse to educate the family about EOL nutrition (or lack thereof) and the body's processes of shutting down. Families often need to hear it from someone besides the facility nurses, for some reason "outsiders" have more credibility. I've dealt with this situation in one form or another many, many times, and found most outside agencies were more than happy to intervene. Good luck to you.

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    A rectal check can confirm if a suppository is necessary.

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    I like VivaLasViejas' reply best. Confer with the MD and hospice and see if this practice can be discontinued and then they can confer with the patient's family. Sometimes, it's best to hear it from them. (hospice/MD).

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