My grandmother lives with my family and I. She is 88 with severe end stage copd, afib, chf and stage 3-b kidney failure. She has been on palliative since last October, but they have been no help at all. We went to see the case manager on May 6th. She suggested we start thinking about hospice, and said "It won't be long". (I don't know what that means). Made a follow up appt. for July. She is on 4 ltr oxygen 24/7, still moves about with a walker, but looks like she'll pass out at any moment. The cough has changed, the wheezing is loud and constant. Breo not helping as of 3 days ago, now nebulizer not helping. She says she's dying. I did call hospice today but they cannot come out til next Tues. She is already DNR, and has a refusal for intubation. I don't know what I'm supposed to do to help her feel more comfortable. She doesn't want to go to the hospital, but I can't just watch her die :/ Can anyone offer advice?
Call other providers.
If it’s genuine, and she’s really close to death, it would be a good idea to find a hospice that will come quickly. They will talk you through how to make her more comfortable.
You say “I can't just watch her die”. If she won’t go to hospital and is going to die at home with you, that is more or less what will happen. Just go out of the room at the end if you feel the need.
My mom actually threatened suicide if I didn't take her to Target with me. I didn't take her and she was still alive and b!itching when I got back.
You are now in a bigger city, interview other hospice providers. Call around until you get one that can show up sooner.
If, after interview with HOSPICE (instead of you telling her this or that) SHE (and she alone) can make her own decision.
Yes, she can keep going to ER but eventually no one will do anything but discharge her home, where apparently her meds aren't working.
Tell her hospice will keep her comfortable. They are not there to kill her. They are there recognizing that she is dying. As to what "it won't be long" means tell the person saying it you don't understand their meaning. Do they mean an hour, a day, a week, a month, a year? It is a ridiculous thing to say.
Basically a doctor needs to explain to her that medical has done what they can. That hospice can administer morphine, but that she cannot stay in hospital on morphine. It isn't acute care. It is care given for comfort and to ease the breathing.
I think you are left now with awaiting hospice. If they aren't there in time, then send grandma to ER. They can do what they will, but they MAY get hospice visit bumped up.
If your Grandmother doesn't want any hospice care she needn't accept it. But she should maintain that appointment. Otherwise it is on you to say, when she is distressed, that there is nothing else you can do but call the ambulance. And of course that you can do. No one can stop you. Eventually the doctor will speak to your grandmother about Hospice, that they ARE visiting, and that she needn't accept them, but that they have the good meds and he has done what he can.
I am so sorry. I can only imagine how distressing this is for you all. I have seen death come in all sort of ways, as a nurse. For me, that death that comes when hospice is there to help us be below the level of comprehension, is the one I would fight to get.