Author Topic: On Caregiving  (Read 272956 times)

Offline serious crayons

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Re: On Caregiving
« Reply #270 on: September 07, 2017, 10:36:04 am »
What issue was that in? I've looked through all my issues but haven't found it. I also looked online and couldn't find it either (I was rushed, as I always am, these days).

Sorry, I should have clarified -- it's a book, a really good one. I've talked about it before here, somewhere, and I didn't want to sound like a broken record. (Now there's a saying that won't mean much to future generations!  :laugh:)

He published it a couple of years ago. Parts of it were published in the New Yorker, but some years back. For instance, he wrote some of the "end of life care" stuff back when Sarah Palin was ranting about "death panels." Based on what you've been going through, you might find it helpful -- or not.

He was on BBC World News America yesterday evening.

Talking about what?


Offline Front-Ranger

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Re: On Caregiving
« Reply #271 on: September 07, 2017, 10:45:16 am »
Okay, I put in a request at the library for it.
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Offline Jeff Wrangler

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Re: On Caregiving
« Reply #272 on: September 07, 2017, 10:54:58 am »
Talking about what?

About what you'd expect, considering his book that you recently read: EOL issues, asking patients what their goals are (for the time they have left), will further surgery do any good or just cause the patient needless pain, and so forth.
"It is required of every man that the spirit within him should walk abroad among his fellow-men, and travel far and wide."--Charles Dickens.

Offline Front-Ranger

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Re: On Caregiving
« Reply #273 on: September 07, 2017, 07:45:21 pm »
There are so many twists and turns every day that it makes my head spin. Today was another stomach-churning day. Mom was sitting in the dining room when I arrived but she was in her trancelike state. I started holding her hand and gently talking to her and trying to wake her up. I noticed that every so often she would have tremors and seem a little distressed. She wouldn't open her eyes or her mouth to drink the water I brought her. Little by little, she started to be more conscious, but would have periods of agitation. I asked her if she was in pain, and she shook her head no. Her food came and I fed her tiny little tastes of chopped up brats. Then I fed her a couple of tastes of potato salad which she definitely liked. But then, more agitation, after which she burped loudly. I was alarmed because she looked like she might gag or throw up. I asked for the nurse to look at her and explained her symptoms and the nurse said, "Do you want me to give her more morphine?"

"Morphine?" I said in a still small voice. "She is taking morphine?" "Oh, yes," said the nurse. "Morphine's part of the hospice care." I staggered about, verbally and finally said, "I'll have to think about that and could you please print out a list of her meds." Ended up in an hour long conversation with the hospice nurse going over the EIGHTEEN meds she is now taking (a large chunk of them are meds for constipation, caused by the other meds). Now, granted, I am a total dummy when it comes to pharmaceuticals, since I take absolutely zero medications. But that is not going to stop me from ploughing into this subject. A care conference is planned for tomorrow at 11:30 and I don't see how we're going to resolve everything in 30 minutes, but we'll try!
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Offline Jeff Wrangler

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Re: On Caregiving
« Reply #274 on: September 07, 2017, 08:38:08 pm »
Why is she being given morphine if she's not in pain?  ???

Or is she in pain?  ???

No wonder she's constipated if she's being given morphine. Narcotics are constipating. Even acetaminophen (Tylenol) with codeine will constipate you.

What's going on? Some kind of one-size-fits-all hospice care? This is not right. This is not what hospice is about. Hospice is about individualized care.
"It is required of every man that the spirit within him should walk abroad among his fellow-men, and travel far and wide."--Charles Dickens.

Offline serious crayons

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Re: On Caregiving
« Reply #275 on: September 08, 2017, 10:11:20 pm »
Or is she in pain? If she is, then the philosophy of hospice is that patients should get whatever pain meds they need without worry that they'll become addicted or suffer other ill effects. That's not an instruction to give morphine no matter what, just permission not to withhold it if it's needed.

Of course, constipation is an ill effect of opioids. But I guess I don't know what your mother's medical condition is -- what she is suffering from and whether it involves pain, or how much, so it's hard to tell whether they're giving it routinely or because it's helpful. I'm definitely glad you're in such good health that you don't need any, Lee, but I don't think there's anything wrong with taking them when they're needed or helpful.

I may have missed something, and if so I apologize, but I've seen you mention your mother being kind of absent minded about things but not a more serious physical condition.


Offline Jeff Wrangler

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Re: On Caregiving
« Reply #276 on: September 09, 2017, 02:31:35 pm »
Opioids--that's the word I was trying to think of. Thanks, Katherine.

Word-finding difficulty. ...  ::)
"It is required of every man that the spirit within him should walk abroad among his fellow-men, and travel far and wide."--Charles Dickens.

Offline Front-Ranger

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Re: On Caregiving
« Reply #277 on: September 09, 2017, 03:27:24 pm »
I may have missed something, and if so I apologize, but I've seen you mention your mother being kind of absent minded about things but not a more serious physical condition.

Mom has had mild dementia for several years. Her breaking her hip in a fall on July 25 exacerbated her condition (as well as the hospital stay and anesthesia) so now she has advanced dementia. Alzheimers, to be exact.

I did get them to hold off on the morphine today, and Mom was much better. I'm going over there at 6:30 am tomorrow, because that's when the new shift makes their rounds and decides what pills or shots are needed.
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Re: On Caregiving
« Reply #278 on: September 09, 2017, 03:32:03 pm »
Why is she being given morphine if she's not in pain?  ???


After observing the interactions this morning, I now think morphine is given to keep the patients docile.
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Offline serious crayons

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Re: On Caregiving
« Reply #279 on: September 09, 2017, 06:19:46 pm »
Mom has had mild dementia for several years. Her breaking her hip in a fall on July 25 exacerbated her condition (as well as the hospital stay and anesthesia) so now she has advanced dementia. Alzheimers, to be exact.

But that shouldn't cause pain.  ???

After observing the interactions this morning, I now think morphine is given to keep the patients docile.

I don't doubt nursing homes sometimes do that. But that strikes me as an extremely off-label use of the medication. Maybe you could schedule a meeting with her health-care team so they can answer all of your questions about her condition. If she's getting morphine, is it because she's in pain? If yes, from what? If no, then what's the morphine for? Depending on your legal arrangements, you could probably arrange to have all physicians' recommendations be presented to you first (except in an emergency, that is).