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| *Women health>>>Heart Disease |
My grandmother is 88, has severe COPD, CHF, End Stage Heart Disease,pneumonia, been in hosp 3 times in month.? |
Some of her family refuse to ask her what her wishes are about DNR or full code status. She is mentally competent to make her own decisions, but they do not want her to die which I understand, but at the same time I feel they have no respect for her and what she may or may not want. I personally do not think that she would want to be coded or put on life support. I am a RN and her grandchild, but I am also the one she wants to stay with her in the hospital. I do not know what to do since her children will not talk to her about what she wants even at the Doctors request for them to do so. She is so very tired and is having more and more problems. Please help, I do not know what to do! I sorta know what you are going through...i too am a RN and my grandma was hospitalised and ended up coding and i was on my way to the hospital and mum rang me and said they want to know what to do, should we put her on life support? and i said tell them to tube her till i get there. The second i got off the phone my heart sank and i was like...that was so thoughtless...she doesn't want to be on life support and i knew that turning the machine off would be near impossible. Thankfully they got her back without having to put her on a ventillator. but this then raised the question of what were we going to do next time. Let me garrantee you that when it happens/if it happens all your medical knowledge and knowing whats best for her will fly out the window and it will just be your emotion as a grandchild talking in that split second.It is so important to have it down on paper and it all talked about before it happens. I know you and i have probably both talked to many families about NFR orders. Its never easy but when its your own family it damn near impossible. If your grandma is able to make her own mind up then maybe let her. She can order her own NFR orders if she is competent. They can't overule her if she's competent. perhaps the family needs to sit down with a social worker and the doctors and have a discussion about it all...but in the end it's you grandma's decision and not theirs. make sure you allow yourself time to be the grandchild and not the nurse too. Try not to lose family over this fight because long after your gran is gone your mum and dad and uncles and aunts will still be around. maybe explain the options to them...maybe you could come to some resolution...for bag and mask/suction only. no tubes or ventilation. In the end though you might find that the decision is taken out of your hands...there is only so much you can do in a resus before the doctors call it anyway. I hope you find a peaceful resolution to all this. It is so hard. i know. They are just scared. When it is her time, she will go. Just continue doing what you are doing and that is being by her side. Death is not an ending, but a very beautiful beginning. Pray and meditate. Have some fun. She lived her life. Just do not discuss anything with the family since that is the way they feel. Take care of yourself. If you are an RN and she does not have a DNR there is only one thing you can do if you are with her at the end. Otherwise I feel your predicament. You have to respect her families wishes. Hang in there. They'll see the light before she does. I suggest that you bring up the subject the next time the doctor comes to check on her. If your grandmother is competent to make the decision, then the subject should be directed to her specifically by the medical personnel providing her care. If you are the one staying with her most of the time, this should be easily enough arranged. And I would suggest doing it at the first opportunity you have. That way it is on record before something drastic happens, and drastic action gets taken. nurse I am a RT. I know that sometimes in situations like that a family member can ask for the hospital's social worker to intervene. You can ask for the social worker to speak with your grandmother to decide whether or not an advance directive is something she wants. You can do this anonymously and ask the social worker not to reveal to your grandmother or other family members that this was your idea. If the social worker does that, then everyone will just think it is standard procedure and no one will take offense. There really is no way to approach this subject. Maybe you can ask your grandmother when the two of you are alone. Bring up a conversation about what is happening in the news...then somehow lead up to start talking about the Terri Schivo case from a couple of yrs back, ask if she remembers it. Tell her your wishes, that you wouldn't want to be in that position, and that you wouldn't want your family to have to make that decision for you. You can approach this in a gentle and loving way as only a loving granddaughter can. This will open up the subject and make it easier for her to discuss. Whatever you do be careful in how you use your words. You don't want her to make a decision because she feels like a burden. You want her to make a decision based on what she wants. She may feel like being around you for an extra day or two may be worth the tubes and the pain. And if she loves you enough to be willing to endure that kind of pain for one more day of your love, then you can grant her that. But, she needs to tell you what she wants so you all can have closure that her needs and wants were met. And no matter what she decides...just know she is making a decision based more on the love she feels for her family, and not on how convenient it is for everyone, and accept her decision with all the love in your heart. I am sorry that you are having to go through this. May you find the peace you need to sustain you. |
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