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Old 09-07-2018, 01:25 PM
 
Location: Oort cloud
84 posts, read 48,787 times
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I worked as a nurse for several years in a nursing home so perhaps I can give a different perspective.

Some of our patients were on hospice care through other companies which shall not be named. They were Still our patients one of our facility physicians still cared for them however they had an extra layer of care through the hospice nurses and physicians.

Hospice care could be requested by family or recommended by staff. An evaluator will come out gather paperwork meet with the family meet with the managers meet with staff.. They would figure out where the patient is where the patient was whatís going on with the patient and what are the familyís expectations and wants. There within determine if they qualify or not.
One or more hospice nurse from each company would come and perform weekly visits on the hospice patients under that companies care. That week they would ask the staff if there was any patients we had concerns about that they wanted us to look at but they also had a certain schedule with how they routinely saw patients.

Some patients remaining on hospice for months even almost years with very little intervention from them others were routinely visited. Some even head massage therapist then other ancillary services they would come visit them.

Once under hospice The facility staff had access to the hospice care telephone line where we could report changes. Any report would generate a hospice nurse to come out within 2 to 4 hours or less depending on distance in current workload This nurse would assess the patient gather details contact the covering hospice physician and family and update the plan of care.
Significant decline or change in condition called For 24 hour care by the hospice RN and LPNs. Each company had their own gimmick nameThat they used to refer to 24 hour care.Honestly all other factors being equal we considerered the initiation of of 24 hour care to be an unofficial death sentence. Yes many of the patients were suffering and needed to be eased. However many of the nurses aggressively pushed to have the morphine and Ativan increased. First itís every six hours as needed and then the dosage gets increased. Then the patient is ďin so much pain ď even though breathing is regular pulse is regular body is relaxed etc. theyíre constantly calling up the hospice physicians getting updated orders. Then itís every four hours as needed. Then itís every four hours on schedule then the dosage get some increased in the dosage guess increasedWithin a few days the patient is completely zonked out and ends up expiring. Whether thatís a good or bad thing is not my determination to make.

Personally I would recommend hospice but family must know what theyíre getting themselves into and remain involved. Some of the companies were known to have a much better response time and much better care provided the not the others.
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Old 09-08-2018, 10:04 AM
 
Location: SWFL
21,429 posts, read 18,139,040 times
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I think the hospice nurses try to give the patients a quiet, peaceful end, al a Dr. Kevorkian. I would want that. I think it should be that way. There is no need for a person to pass in pain if they are under care.
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Old 09-08-2018, 11:25 PM
 
Location: El paso,tx
1,487 posts, read 572,187 times
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I've told my DH that if i am terminally ill, and in pain, give me drugs, and if i become semi comatose, give me lits of drugs...I want my death hastened un that case.
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Old 09-26-2018, 07:03 AM
 
Location: Planet Woof
2,950 posts, read 3,188,994 times
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I recently lost my spouse after 4 months in hospice. My only contribution to this discussion is to say that once the body enters into the dying process and organs begin to shut down, there is far more pain and discomfort and emotional trauma than one could ever envision for their loved one. Toward the very end the use of opoids to ease pain may not even touch it. I am a firm believer that a person should not have to go through this if there is a way out that alleviates this suffering. Thank God for the nurses and doctors that twilighted my loved over to peace and freedom at the end. May none of us ever have to go through this ourselves but hope that you have choices if it comes to it.
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Old 10-01-2018, 10:21 PM
 
Location: Mid-Atlantic
22,695 posts, read 21,741,083 times
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Quote:
Originally Posted by HappyDogToday View Post
I recently lost my spouse after 4 months in hospice. My only contribution to this discussion is to say that once the body enters into the dying process and organs begin to shut down, there is far more pain and discomfort and emotional trauma than one could ever envision for their loved one. Toward the very end the use of opoids to ease pain may not even touch it. I am a firm believer that a person should not have to go through this if there is a way out that alleviates this suffering. Thank God for the nurses and doctors that twilighted my loved over to peace and freedom at the end. May none of us ever have to go through this ourselves but hope that you have choices if it comes to it.
I almost died after an accident when I was in my teens. I was fine at first when I was dying, bleeding to death. That didn't hurt at all. My brain did what it was supposed to do and protected me.

I've broken toes, fingers, my left elbow, right humerus, and nose--three times! What can I say? I'm a very clumsy person.
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Old 10-03-2018, 11:58 PM
 
Location: Mid-Atlantic
22,695 posts, read 21,741,083 times
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Quote:
Originally Posted by Gerania View Post
I almost died after an accident when I was in my teens. I was fine at first when I was dying, bleeding to death. That didn't hurt at all. My brain did what it was supposed to do and protected me.

I've broken toes, fingers, my left elbow, right humerus, and nose--three times! What can I say? I'm a very clumsy person.
I meant to add that those injuries hurt quite a bit.
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Old 10-04-2018, 07:22 AM
 
Location: Midvale, Idaho
1,428 posts, read 2,252,516 times
Reputation: 1826
Quote:
Originally Posted by HappyDogToday View Post
I recently lost my spouse after 4 months in hospice. My only contribution to this discussion is to say that once the body enters into the dying process and organs begin to shut down, there is far more pain and discomfort and emotional trauma than one could ever envision for their loved one. Toward the very end the use of opoids to ease pain may not even touch it. I am a firm believer that a person should not have to go through this if there is a way out that alleviates this suffering. Thank God for the nurses and doctors that twilighted my loved over to peace and freedom at the end. May none of us ever have to go through this ourselves but hope that you have choices if it comes to it.
My husband was totally lucid when he died. He had no drugs on board other than his usual acid blocker and vitamins. He had pain meds if he asked for them and I asked him several times and he said he was not in pain. He said his back ached a little the pancreas cancer had gone to his lungs and spine. It had been removed from his pancreas in a whipple surgery and did not re-occur there. We were talking and he was gone that fast. I totally agree though if they are in pain they should have pain meds available.
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Old 10-04-2018, 07:44 AM
 
318 posts, read 74,416 times
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Quote:
Originally Posted by tamiznluv View Post
I think the hospice nurses try to give the patients a quiet, peaceful end, a la Dr. Kevorkian. I would want that. I think it should be that way. There is no need for a person to pass in pain if they are under care.
Big difference- I believe Kevorkian actively shortened the lives of his patients, which is a moral issue for many people. Hospice is not meant to take any actions to shorten the lives of patients- just to make their natural end as peaceful and painless as possible.
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Old 10-04-2018, 12:53 PM
 
Location: SWFL
21,429 posts, read 18,139,040 times
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Quote:
Originally Posted by athena53 View Post
Big difference- I believe Kevorkian actively shortened the lives of his patients, which is a moral issue for many people. Hospice is not meant to take any actions to shorten the lives of patients- just to make their natural end as peaceful and painless as possible.
True, about Kevorkian. Yes, I realize hospice does not actively kill people. I tend to babble when I get emotional about something.

Just like on the abortion issue, until my daughter had to have a medically induced one, I was all for it. Now, IDK how I feel. I think it is between a woman and GOD.

I am leaning towards that way with self-medicating to induce death now too after seeing my husband down to 80lbs and still not swallowing his pills. I pray I can be brave enough when the time comes if I am as sick as he was.
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Old 10-04-2018, 08:32 PM
 
Location: Planet Woof
2,950 posts, read 3,188,994 times
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There are some states, and countries, where assisted suicide is legal. It should everywhere, IMO.

I mean if we can offer our pets euthanasia, we should be able also to have that choice.
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