Hospice Care

[StarCat]

Rose mentioned hospice care on another thread. Rather than clutter and confuse that thread, I opted for a separate thread. My name is Patricia Morgan. I'm a licensed practical nurse in the state of Colorado. I've worked in the medical field since 1992. I've seen a lot of changes. Medical care has gradually become more person centered, and less outcome centered.

When I trained as a nursing assistant in 1992, we were taught how to syringe feed people who didn't want to eat. Today, that's a violation of patient rights, and can lead to assault charges. We also used to forcibly take people to the shower room for bathing. People who were reluctant to take their medication had it masked in pudding or applesauce. Families weren't consulted. The worst practice though, was the overuse of restraints. The restraints were more for staff convenience than for patient safety.

Death with dignity and end of life care were unpopular topics at best. We were supposed to be focused on keeping people alive. Supporting people to have a calm and comfortable death just wasn't what medicine was about. "First do no harm," was trumpeted. But how much harm were we causing people and their families by staving off the end product of life. Then cam advance directives and "Do Not Resuscitate" orders. If I remember correctly, these ideas had to be forcibly pushed through legislative bodies.

Now we have states moving toward allowing physician assisted suicide in cases of terminal illness. I agree with that idea. When my daughter's Aunt Carol died in 2001, she was medically indigent. Physician assisted suicide wasn't even on the horizon, and hospice care wasn't even available to her and her family. Ovarian cancer is one of the more painful ways to die. And since she was allergic to morphine and medically indigent, Carol didn't even have the option of adequate pain control.

Hospice care puts the end of life decisions back in control of the patient and family. Which is where it belongs.

Cat

[re-rose]

Yes, Cat, I was a volunteer in the local hospital hospice back then and remember that it was considered to be a novel idea. Now it hospice care is a medicare benefit, and 'for profit' providers are proliferating profusely. (sorry, got on an alliterative run and couldn't stop!)

rose

[StarCat]

By the time TTB passed, death with dignity had begun to be an option. It probably helped, that he wasn't living in a major city at the time. The death of a loved one is normally traumatic for the family. How much more traumatic would it have been for the family if over zealous doctors had gotten in the middle of things? I had an RN tell me at one point, that disturbing an elderly woman for daily weights while she was in the hospital, had to be done, despite the family's objections. She reported me to the unit manager when I refused, per the family's refusal. The unit manager set her straight. We're daily weights really going to help a terminally ill 90 something woman? Probably not.

Cat

[LuisP]

Rose mentioned hospice care on another thread. Rather than clutter and confuse that thread, I opted for a separate thread. My name is Patricia Morgan. I'm a licensed practical nurse in the state of Colorado. I've worked in the medical field since 1992. I've seen a lot of changes. Medical care has gradually become more person centered, and less outcome centered.

When I trained as a nursing assistant in 1992, we were taught how to syringe feed people who didn't want to eat. Today, that's a violation of patient rights, and can lead to assault charges. We also used to forcibly take people to the shower room for bathing. People who were reluctant to take their medication had it masked in pudding or applesauce. Families weren't consulted. The worst practice though, was the overuse of restraints. The restraints were more for staff convenience than for patient safety.

Death with dignity and end of life care were unpopular topics at best. We were supposed to be focused on keeping people alive. Supporting people to have a calm and comfortable death just wasn't what medicine was about. "First do no harm," was trumpeted. But how much harm were we causing people and their families by staving off the end product of life. Then cam advance directives and "Do Not Resuscitate" orders. If I remember correctly, these ideas had to be forcibly pushed through legislative bodies.

Now we have states moving toward allowing physician assisted suicide in cases of terminal illness. I agree with that idea. When my daughter's Aunt Carol died in 2001, she was medically indigent. Physician assisted suicide wasn't even on the horizon, and hospice care wasn't even available to her and her family. Ovarian cancer is one of the more painful ways to die. And since she was allergic to morphine and medically indigent, Carol didn't even have the option of adequate pain control.

Hospice care puts the end of life decisions back in control of the patient and family. Which is where it belongs.

Cat

Very, very troubling post.


I cannot read it indifferently. As in, remain.

Today, Disease and Death are taboos. Everyone is young, healthy and with white teeth. When you get old, you retire and go live in a condo in Florida or wherever it is old people "vanish" to. Our children and youngsters do not go to bed deaths and even less funerals because it is "traumatic" and may post stress them to eternity.

"Focus" ...

Again that word.

Where should Our "focus" be ?

How to praise Life without knowing - knowing ! - that Death and Disease are part of it and nothing to be ashamed of or shunned from, but exactly the opposite ? How to Love - truly love . without knowing that whom we so chersih will not be here forever ? how to Respect old age and all that it means if one Equals it . is "forced" to equal it - with silliness derived from loss of faculties and capabilities instead of exemples of endurance from pre-paved roads ?

How to treat Disease and ease Death when treatment no longer assure Life as "we" understand it ?

That's when Focus is all about.
Never lose sight of "focus".

And focus, to me, is Life.

Never Death.

Yes, when Medicine and Care no longer mean nothing but artificial life and prolonged suffering, I agree it is not Medicine but Chemistry, and it is not Care but Torture.

And that's when Love will make a call.
Has to.
If we Love.

But never - ever ! - the Law, the Rules, the Directives ... or the lack of Love !

Beause we must always keep "focus".

Which is Life.
And Love.

I remember my Grandfather.
And his daughter's - my Mother - Love.

Who said "No more".

She would never follow "directives".
Just her Love.

All this to say,
If we loved more, we would not need anything else.

Think of Sparta, that loveless sociey.
They "exposed" their elderly on a cold mountain top and left them there with only a blanket.
This "directive" went on for centuries, for that's what "Florida" meant to Spartans .... or maybe just "death with dignity"

Until one day.

When a father looked at his son and said -"Keep the blanket. You will be needing it".

He said it from Love.
And changed Sparta, forever, from that day onwards.



Focus ....