Viewing a single comment thread. View all comments

subcuriousgeorge t1_j4v50w1 wrote

Really can't stand that article title as a hospice worker. That is not end-of-life care. It's last ditch treatment. What I do is end-of-life care and is actually beneficial and far from useless. I wish more people would honestly get on hospice sooner so we can help patients and families prepare themselves more for death.

152

shnnn73 t1_j4v9bbj wrote

ICU RN…. We also wish people would go on hospice sooner! Unfortunately, it almost always comes down to patient and family decisions. Some families have a very difficult time accepting end of life news.

A patient can be 95 with a very low quality of life and families will insist on keeping them alive as along as possible.

80

0skullkrusha0 t1_j4vfm00 wrote

My post above describes exactly that. I’m an ICU RN as well and I shudder at every 90+ patient I get when it’s clear they’ve been declining for a very long time and they are “full codes.” And the family just can’t shut up about how Mom or Dad is gonna be right as rain in no time. Or acting as if a potassium/BUN/Cr level normalizing is gonna be the moment they’re back to their old selves. Like at what point will they realize that old age is the one illness none of us can survive?

58

puppyinashoe t1_j4wbrh7 wrote

Yes I’m an ICU nurse and this is the most difficult part of our jobs. I love my job but I hate working an assignment where I am truly just torturing an intubated 90 year old who has no hope of meaningful recovery and is spending their last days, their last memories, with me turning them q2 and assaulting their mouth with q4 oral care. We just extubated a 90 year old who lasted 5 days on the floor and is now back after aspirating and coding. She’s re-intubated and the daughter is STILL saying if she was successfully extubated once it can happen again. But only lasting 5 days before having to be reintubated d/t a lack of airway protection doesn’t seem successful in my mind.

31

swellswirly t1_j4wepn4 wrote

My 89 YO dad had CLL and injured his spleen in a fall. He ended up at a trauma center where we had an extensive conversation with the doctor about his end of life wishes. After a few days he ended getting sepsis, became too weak to swallow, and we declined a feeding tube for him. They had a palliative team who kept him medicated until he peacefully died. There is no way he wanted to be kept alive in that state, at a certain point we all die.

25

bonniesue1948 t1_j4vtjd3 wrote

A relative was under hospice care and collapsed at a doctor’s office. He ended up in the ER. There was an argument going on between us and the ER staff when the hospice nurse arrived. She sprinkled her magic fairy dust over all of us, stopped them from intubating him, got him pain relief, and into a comfy room where he passed away peacefully a few hours later. To us, hospice was the best care possible.

38

Vultureinvelvet t1_j4wn9yq wrote

Hospitalist here. Agree.

Wish more people would decide on hospice sooner so they can get home and be with their family for as long as possible. Sometimes if they wait they miss the golden opportunity to get home and end up dying in the hospital, either as a medical patient or a hospice patient.

18

kaymoney16 t1_j4yfm17 wrote

I call it “Kitchen sink medicine” as an ICU Pharm

4

plinocmene t1_j4w7062 wrote

What is there to prepare for and what are the consequences of not preparing?

I rather die fighting to live no matter how low the odds are. I may know that in all likelihood I will still die or that barring a miracle I will die but I'd rather take even the smallest chance if it's available.

−10

shnnn73 t1_j4w8rb9 wrote

Decide what you consider “living”. For me and my family, living in a long term care with a tracheostomy and feeding tube unable to get out of bed and 100% dependent on caregivers is not actually “living”. It’s a very prolonged death that’s also very physically uncomfortable.

It is a very large, very grey area.

35

plinocmene t1_j4wa77j wrote

If I can think, or even just dream I want to be alive. I have a very vivid imagination and can entertain myself.

I'm not saying that other people's preferences are invalid, but people speak as if my preference to try everything is somehow invalid. There is this implicit assumption in today's culture that if you value anything other than net pleasure/pain you're in the wrong. I value being able to do things (including thinking, visualizing, and dreaming) over being able to do nothing, even if the things I can do are limited.

I wouldn't want to be in a state where I can't do anything at all, even thinking or dream but supposing the chance of recovery were nonzero, even the smallest of chances I would rather be kept alive just in case. That includes factoring in the possibility of new discoveries in medical technology that might be able to help.

EDIT: Also you didn't answer my question. What is there to prepare for when it comes to death and what are the consequences of not preparing?

−4