Perhaps the word "denied" was a bit strong...it is a fact that a patient has a good chance of developing pneumonia if allowed to just stay in one position, which does not make for a comfortable death, given choices. I can see I have a lot of reading to do to understand the Hospice theory as opposed to good basic nursing care.
When my grandmother was in hospice, she was being told one thing by some of the nurses "We'll have you up and walking in no time" and other things by others "You don't have to get up to try and walk if you don't choose. We just want you to be comfortable..." Meantime, as a family we are cleaning out her home, dividing up her things (per HER request) and planning her funeral. She passed after less than 4 days in Hospice Care. I think for each individual, it's different. With daddy, we simply kept him out of pain (round the clock liquid morphine). To this day my mother insists "I killed your father". Well, if she is guilty, then so I am I. I gave him morphine too. AT some point, we are hanging on to someone's life for US, not them. Death is a deeply personal issue...we respected daddy, and grandma's wishes. I don't think we "denied" them anything. Hospice is about respect and comfort for the patient, and unless the patient wanted to go out and get sun, or do exercises.....my understanding is that you offer palliative measures only.
My husband did not make it to Hospice care (flesh eating bacteria took his life) As an R.N. from the 60's I am new to understanding Hospice theory. Presently am trying to understand why a patient, regardless of diagnosis, would be denied range of motion exercises, dangling feet off side of bed, or being wheeled out to see and get a bit of sunshine. These things could prevent blood clots (which could hasten demise) and as well known now, sunshine can lift depression which certainly can be present in a terminally ill patient. Just trying to understand.
Going thru this right now. Small growth on husbands ear has gotten much larger in past few months. One on elbow... same thing. Nothing will be done. Wish it could be, because it is 'in the way' so to speak. They catch/snag on things, causes bleeding. But... that is how it is with hospice. No way of knowing if it hurts because he has been unable to speak for several years.
If the lesion is uncomfortable, and if it can be removed without leaving a worse wound that itself would be unlikely to heal, its removal could be part of palliative care rather than therapeutic. I agree with Jeanne: don't take anyone else's word for it, ask direct questions.
My FIL had CLL and was in Hospice and he had several skin lesions removed, Why, I do not know, but he chose to. He actually wasn't totally healed from those when he passed away. He also had new dentures made just weeks before his death. This man was a fighter and in total denial to the moment he passed away.
Is the skin lesion painful? Would removing it have some immediate (not long-term) benefit?
I think the approach hospice takes is that the patient is dying (from you profile I'd guess from cancer) and their mission is to make him comfortable and at peace. If the goal of removing a cancerous lesion is to prolong his life or to provide a cosmetic benefit I doubt it would be approved. But if it provides some immediate benefit such as reduction of pain perhaps it would be considered.
Were you advised by Hospice that this could not be done? Don't take a second-hand opinion. Ask hospice directly.
The patient can, of course, withdraw from hospice and have the procedure done. You could discuss this option with the hospice folks, too.
That is correct. No more chemo, no radiation, just painkillers and meds for anxiety and to minimize hallucinations or delirium. So sorry for you to be at this juncture. Make him comfortable and try to accept this is how it is.
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chance of developing pneumonia if allowed to just stay in one position, which does not make for a comfortable death, given choices. I can see I have a lot of reading to do to understand the Hospice theory as opposed to good basic nursing care.
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As an R.N. from the 60's I am new to understanding Hospice theory. Presently
am trying to understand why a patient, regardless of diagnosis, would be denied
range of motion exercises, dangling feet off side of bed, or being wheeled out to see and get a bit of sunshine. These things could prevent blood
clots (which could hasten demise) and as well known now, sunshine can lift
depression which certainly can be present in a terminally ill patient.
Just trying to understand.
I think the approach hospice takes is that the patient is dying (from you profile I'd guess from cancer) and their mission is to make him comfortable and at peace. If the goal of removing a cancerous lesion is to prolong his life or to provide a cosmetic benefit I doubt it would be approved. But if it provides some immediate benefit such as reduction of pain perhaps it would be considered.
Were you advised by Hospice that this could not be done? Don't take a second-hand opinion. Ask hospice directly.
The patient can, of course, withdraw from hospice and have the procedure done. You could discuss this option with the hospice folks, too.