August 12, 2009

Very Disturbing

The scandal of hospice care.

Update: See Elena's comment for a different view.


Elena LaVictoire said...

Yea...but normally the dying person doesn't eat a lot anyway. My mom had trays put before her three times a day and could only manage a few nibbles. We upped her pain medication because she was in such severe pain and it did make her more unresponsive, but the alternative was more pain for her.

If it were 100 years ago she would have been in excruciating pain most of the time and still wouldn't have eaten much.

I'm sorry for that blogger's pain but I wonder if he has thought it all the way through.

TS said...

Very good point Elena.

William Luse said...

Thought what all the way through? The details in the fellow's comment are too sparse to make a judgement one way or the other. He seems to think his grandfather was being dehydrated to death, but whether through deprivation of orally given food and drink or through an IV drip he doesn't say. If he couldn't take anything orally, he should have had the drip, which is palliative care that should never be denied to any patient.

Elena LaVictoire said...

You can give a drip if you can find a good vein, and if the vein holds up and if the skin doesn't breakdown, and once the kidneys start to shut down which is normal in the dying process you start to have fluid build up and bloating which is just more discomfort for the person who is dying.

At some point, as hard as it was for me to face with my mother, there comes a point where the body is just going to shut down and it just won't respond to the normal care (even IV nutrition, hydration, wound care etc.).

Kevin J. Jones said...

Elena's initial thought had occurred to me too.

The perilous thing is that a corrupt hospice system would have many of the appearances of a caring one. Perhaps only the death rate would indicate which is which.

Roz said...

I agree with Kevin - a lot depends on the hospice itself. It's true that the funds from insurance or medicare are "capitated" or fixed, but a good hospice will plan for good care for the longer-lived patient as well as provide for what is appropriate for those who survive only a short time.

At a certain point in my husband's dying process, nutrition and even hydration would have caused disruption to his body which was no longer able to process them and cause more pain. But in the case of the original writer, brown urine would suggest that the kidneys had not shut down, so the care offered would probably deserve a second look.

I tend to urge everyone in hearing to become educated and sophisticated about medical care and the care system, not only in the case of hospice but whenever anyone is hospitalized for any reason. The more I learned, the better I was able to team up with the medical people to provide better care.