Wednesday, September 16, 2009

A Wonderful Sales Job

Sister took Dad to Doctor today, so he could make a fully informed decision about hospice. Doctor believes in and supports the hospice way, he resigned as medical director of the hospice because it took too much time.
.
Doctor wanted Dad to know that hospice wouldn't draw blood to monitor his kidney function.
.
Doctor wanted Dad to know that he could provide everything hospice provides because he is board certified and doesn't need hospice. He would write an order that they weren't to transport him to the hospital without consulting Doctor. Dad has been miserable the last few times he's been in the hospital and they haven't been successful in getting any of the fluid off of him when he's been in the hospital. I'm sure that while Dad is in respiratory distress the assisted living place will be glad to wait until Doctor finds time to return their page to transport Dad.
.
Doctor said Dad is waking up and calling the aides multiple times a night because of the Ambien he's been taking to help him sleep. It has nothing to do with anxiety or not being able to breathe. He'll order oxygen at night, though, so he'll be a little more comfortable. He doesn't see the need for any medication for anxiety. He'll just stop the Ambien and everything will be fine.
.
Doctor didn't seem to be concerned about emotional or spiritual support for Dad, and didn't see the need for anyone to be in there monitoring his care or assuring he's not sitting in urine soaked depends all day because he's too weak to go to the bathroom on his own, and too proud to ask for help. Doctor didn't seem concerned about the possibility that his skin might be breaking down because of sitting in urine all day.
.
I'm so glad Doctor is so concerned that Dad make an informed decision. Sister was very surprised when Dad chose to follow his doctor's advice and not go on hospice. Far Away Sister and I weren't. We knew Doctor didn't want Dad on hospice. Sister still isn't speaking to me, of course. Doctor didn't tell Dad he wasn't dying. He didn't tell Dad that he wasn't in end stage congestive heart failure. He didn't offer Dad anything that will improve his condition or lengthen his life. Sister thinks it's wonderful that Doctor wants to make sure Dad can make an informed decision about hospice. Of course, an informed decision doesn't involve pointing out any of the benefits of hospice. No, that's not necessary. I saw a billboard yesterday: "Death is inevitable. Suffering is optional." It was an advertisement for hospice.
.
I'm just very sad that Dad is being denied the kind of care that would make this final journey a little easier. Very sad.

6 comments:

maeve said...

Wouldn't you love to know the truth about this doctor's separation from Hospice? He simply doesn't get the concept of palliative care, does he? Make the patient as comfortable as possible and don't intervene in the process except for comfort.

My DH said it well: "we all have to go sometime and I want to go in the easiest way there is." He did, thanks to Hospice.

Easier is so much better than harder.

I'm sorry this is happening to all of you, especially your dad.

debinca said...

Very sorry Dad was not pointed to the love ad caring hospice can provide. Denying hospital transport is NOT the same as providing emotional end of life care to patient and family..... sigh I know you know this, but I am miffed along with you!tr

Munchkin Mom said...

How sad that your father (and the REST of you) are denied the care provided by hospice.

I don't know what I would have done without them.

Reverend Mom said...

Thank you both. Far Away Sister hopes he just won't wake up some morning soon. That would be the best possible outcome.
Peace--- RM

maeve said...

Munchkin Mom makes a wonderful point. Hospice care for families is one of the most wonderful things they do. My Miss K got music therapy and group grief counseling and I went to grief counseling for months after he died. I couldn't have survived without the visits of that wonderful nurse and the social worker and DH so loved the guy who came to bathe and shave and talk about sports. Does sister know about this stuff?

Reverend Mom said...

MM & M,

Wonderful point about aftercare. I'm not local, so I'm not sure what was offered. I know not much has been received. Sister finally called and asked for a bereavement counselor to visit Dad. I think there may have been one visit, but we were never told if it happened or not. This hospice is a national for-profit chain. They aren't going to be overly generous.

I've raised Dad's need for emotional and spiritual support. I've seen Sister's need. They insist there is no need. Remember, they know much more than I do. I've never dealt with death or hospice in my 24 years of ministry.... Oh, excuse me, was that sarcastic?

Peace,
RM