Mom medical - Revision history

Tim: /* hospice care */

2020-03-20T15:10:24Z

hospice care

← Older revision		Revision as of 11:10, 20 March 2020
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	</blockquote>		</blockquote>

	My takeaway from this is, let mom have water or whatever she wants, vodka if she wants, yogourt if she wants, by having, at her side, a cup of liquid that she can dip those little spongy things whenever she wants. If she asks to be fed something through the tube than give it to her. If you are leaving for the night ask her if she wants any of the above.		My takeaway from this is, let mom have water or whatever she wants, vodka if she wants, yogourt if she wants, by having, at her side, a cup of liquid that she can dip those little spongy things whenever she wants. If she asks to be fed something through the tube than give it to her. If you are leaving for the night ask her if she wants any of the above. Otherwise there is no need, moral or legal imperative to follow an artificial feeding schedule.

	Tim's post 3/13/20 Fri		Tim's post 3/13/20 Fri

Tim: /* hospice care */

2020-03-20T15:08:56Z

hospice care

← Older revision		Revision as of 11:08, 20 March 2020
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	Artificial nutrition and hydration is a medical treatment, with intended beneficial effects but many side effects and complications attached to its use. Decisions about its use need to be based on a dispassionate look at what, if any, benefits will occur, what side effects and burdens are likely to occur, and what the individuals’ and families’ goals are for the treatment... When artificial nutrition and hydration is more likely to be burdensome than helpful, it should be avoided or discontinued.		Artificial nutrition and hydration is a medical treatment, with intended beneficial effects but many side effects and complications attached to its use. Decisions about its use need to be based on a dispassionate look at what, if any, benefits will occur, what side effects and burdens are likely to occur, and what the individuals’ and families’ goals are for the treatment... When artificial nutrition and hydration is more likely to be burdensome than helpful, it should be avoided or discontinued.
	</blockquote>		</blockquote>

			My takeaway from this is, let mom have water or whatever she wants, vodka if she wants, yogourt if she wants, by having, at her side, a cup of liquid that she can dip those little spongy things whenever she wants. If she asks to be fed something through the tube than give it to her. If you are leaving for the night ask her if she wants any of the above.

	Tim's post 3/13/20 Fri		Tim's post 3/13/20 Fri

Tim at 15:02, 20 March 2020

2020-03-20T15:02:34Z

← Older revision		Revision as of 11:02, 20 March 2020
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	==hospice care==		==hospice care==
			Tim's post 3/20/20

			Kelly and I have been in conversation about whether or not we are required to follow strict procedures on amounts and timing of artificial feeding. I went back to the best article that I had found [https://americanhospice.org/caregiving/artificial-nutrition-and-hydration-at-the-end-of-life-beneficial-or-harmful/ \|Artificial Nutrition and Hydration at the End of Life: Beneficial or Harmful? By Cheryl Arenella MD, MPH ] to help me think about the question. I have extracted below some of the most relevant information.

			<blockquote>
			let us ''dispel the myth'' that artificial nutrition and hydration is not really a medical treatment at all but rather basic care, like giving a meal to someone. (it is a ) medical intervention

			...a person given artificial nutrition and/or hydration will often feel bloated, nauseated, and/or develop diarrhea. Studies have shown that the majority of dying patients never experience hunger, and in those who do, small amounts of food and fluids, offered whenever the person wants, relieves the hunger.

			Myths that have been held about the usefulness of artificial nutrition and hydration are being challenged, particularly as they have been used for persons who have incurable disease, in persons who have neurologic or brain disorders, and in the frail elderly person.

			Fact: There is no good evidence that demonstrates that gastrostomy tubes, or tubes into the small intestine, prevent aspiration pneumonia in a person who has difficulty swallowing...evidence shows that tube feeding may actually increase episodes of aspiration pneumonia. '''Careful feeding by hand is a better alternative'''...thirst that occurs is easily alleviated by small amounts of fluids or ice chips given by mouth, and by lubricating the lips.

			artificial nutrition and hydration does not help the person to live longer, feel better, feel stronger, or be able to do more. In fact, such a person given artificial nutrition and/or hydration will often feel bloated, nauseated, and/or develop diarrhea. Studies have shown that the majority of dying patients never experience hunger, and in those who do, small amounts of food and fluids, offered whenever the person wants, relieves the hunger.

			Artificial nutrition and hydration is a medical treatment, with intended beneficial effects but many side effects and complications attached to its use. Decisions about its use need to be based on a dispassionate look at what, if any, benefits will occur, what side effects and burdens are likely to occur, and what the individuals’ and families’ goals are for the treatment... When artificial nutrition and hydration is more likely to be burdensome than helpful, it should be avoided or discontinued.
			</blockquote>

	Tim's post 3/13/20 Fri		Tim's post 3/13/20 Fri

Tim: /* hospice care */

2020-03-13T16:54:26Z

hospice care

← Older revision		Revision as of 12:54, 13 March 2020
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	Megan has agreed to talk to mom about the question of, if hospice care is the correct decision, then would she prefer in-home hospice or hospice at a hospice facility.		Megan has agreed to talk to mom about the question of, if hospice care is the correct decision, then would she prefer in-home hospice or hospice at a hospice facility.

	One scenario, might be that mom does qualify for hospice care, gets the new feeding tube and is released in to either in-home or facility hospice. The the primary objective is keeping mom comfortable and able to visit with her family. If complications occur, that, were she not in hospice, require another hospitalization and more procedures, her decision to be in hospice would allow her to pass into the next world comfortably as the complications eventually do her in. OR ... The feeding tube works, her esophagus heals, she has no further heart or GI complication, she starts eating tacos and drinking margaritas and gets kicked out of hospice.		One scenario, might be that mom does qualify for hospice care, gets the new feeding tube and is released in to either in-home or facility hospice. The the primary objective is keeping mom comfortable and able to visit with her family. If complications occur, that, were she not in hospice, would require another hospitalization and more procedures, her decision to be in hospice would allow her to pass into the next world comfortably as the complications eventually do her in. OR ... The feeding tube works, her esophagus heals, she has no further heart or GI complication, she starts eating tacos and drinking margaritas and gets kicked out of hospice.

	==discharge planning==		==discharge planning==

Tim: /* hospice care */

2020-03-13T16:53:40Z

hospice care

← Older revision		Revision as of 12:53, 13 March 2020
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	Megan has agreed to talk to mom about the question of, if hospice care is the correct decision, then would she prefer in-home hospice or hospice at a hospice facility.		Megan has agreed to talk to mom about the question of, if hospice care is the correct decision, then would she prefer in-home hospice or hospice at a hospice facility.

	One scenario, might be that mom does qualify for hospice care, gets the new feeding tube and is released in to either in-home or facility hospice. The the primary objective is keeping mom comfortable and able to visit with her family. If complications occur that, were she not in hospice, require another hospitalization and more procedures, her decision to be in hospice would allow her to pass into the next world comfortably as the complications eventually do her in. OR ... The feeding tube works, her esophagus heals, she has no further heart or GI complication, she starts eating tacos and drinking margaritas and gets kicked out of hospice.		One scenario, might be that mom does qualify for hospice care, gets the new feeding tube and is released in to either in-home or facility hospice. The the primary objective is keeping mom comfortable and able to visit with her family. If complications occur, that, were she not in hospice, require another hospitalization and more procedures, her decision to be in hospice would allow her to pass into the next world comfortably as the complications eventually do her in. OR ... The feeding tube works, her esophagus heals, she has no further heart or GI complication, she starts eating tacos and drinking margaritas and gets kicked out of hospice.

	==discharge planning==		==discharge planning==

Tim: /* hospice care */

2020-03-13T16:52:53Z

hospice care

← Older revision		Revision as of 12:52, 13 March 2020
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	Megan has agreed to talk to mom about the question of, if hospice care is the correct decision, then would she prefer in-home hospice or hospice at a hospice facility.		Megan has agreed to talk to mom about the question of, if hospice care is the correct decision, then would she prefer in-home hospice or hospice at a hospice facility.

			One scenario, might be that mom does qualify for hospice care, gets the new feeding tube and is released in to either in-home or facility hospice. The the primary objective is keeping mom comfortable and able to visit with her family. If complications occur that, were she not in hospice, require another hospitalization and more procedures, her decision to be in hospice would allow her to pass into the next world comfortably as the complications eventually do her in. OR ... The feeding tube works, her esophagus heals, she has no further heart or GI complication, she starts eating tacos and drinking margaritas and gets kicked out of hospice.

	==discharge planning==		==discharge planning==

Tim: /* hospice care */

2020-03-13T16:23:37Z

hospice care

← Older revision		Revision as of 12:23, 13 March 2020
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	Tim's post 3/13/20 Fri		Tim's post 3/13/20 Fri

	Since mom has brought hospice care up to Megan and Shaun and Megan I spent some time talking about it this morning ~~with Meg~~, here is some information that we can share with mom. Also, it can do no harm to ask for some representatives of end of life care organizations to come in and talk to mom and it may put her at ease. A surgeon or hospital doctor's job is different, their job is to keep people alive. At this point I am going to share this information only with those who have been directly involved with her care, ie Colleen Megan, Kelly Shaun and Peri. The most important of us is Colleen as mom has appointed her as medial proxy.		Since mom has brought hospice care up to Megan and Shaun and Megan I spent some time talking about it this morning, here is some information that we can share with mom. Also, it can do no harm to ask for some representatives of end of life care organizations to come in and talk to mom and it may put her at ease. A surgeon or hospital doctor's job is different, their job is to keep people alive. At this point I am going to share this information only with those who have been directly involved with her care, ie Colleen Megan, Kelly Shaun and Peri. The most important of us is Colleen as mom has appointed her as medial proxy.

	The most pressing issue seems to be that of the feeding tube. Since mom's concerns are happening as this moves forward it would be good for us all to take her concerns seriously. The best of what I have researched so far is in this article from the American Hospice Association. [https://americanhospice.org/caregiving/artificial-nutrition-and-hydration-at-the-end-of-life-beneficial-or-harmful/ \|Artificial Nutrition and Hydration at the End of Life: Beneficial or Harmful? ]. Mom should know some of this and she already seems to intuit some of it.		The most pressing issue seems to be that of the feeding tube. Since mom's concerns are happening as this moves forward it would be good for us all to take her concerns seriously. The best of what I have researched so far is in this article from the American Hospice Association. [https://americanhospice.org/caregiving/artificial-nutrition-and-hydration-at-the-end-of-life-beneficial-or-harmful/ \|Artificial Nutrition and Hydration at the End of Life: Beneficial or Harmful? ]. Mom should know some of this and she already seems to intuit some of it.

Tim: /* hospice care */

2020-03-13T16:09:25Z

hospice care

← Older revision		Revision as of 12:09, 13 March 2020
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	Tim's post 3/13/20 Fri		Tim's post 3/13/20 Fri

	Since mom has brought hospice care up to Megan and Shaun and Megan I spent some time talking about it this morning with Meg, here is some information that we can share with mom. Also, it can do no harm to ask for some representatives of end of life care organizations to talk to mom and it may put her at ease. A surgeon or hospital doctor's job is different, their job is to keep people alive. At this point I am going to share this information only with those who have been directly involved with her care, ie Colleen Megan, Kelly Shaun and Peri. The most important of us is Colleen as mom has appointed her as medial proxy.		Since mom has brought hospice care up to Megan and Shaun and Megan I spent some time talking about it this morning with Meg, here is some information that we can share with mom. Also, it can do no harm to ask for some representatives of end of life care organizations to come in and talk to mom and it may put her at ease. A surgeon or hospital doctor's job is different, their job is to keep people alive. At this point I am going to share this information only with those who have been directly involved with her care, ie Colleen Megan, Kelly Shaun and Peri. The most important of us is Colleen as mom has appointed her as medial proxy.

	The most pressing issue seems to be that of the feeding tube. Since mom's concerns are happening as this moves forward it would be good for us all to take her concerns seriously. The best of what I have researched so far is in this article from the American Hospice Association. [https://americanhospice.org/caregiving/artificial-nutrition-and-hydration-at-the-end-of-life-beneficial-or-harmful/ \|Artificial Nutrition and Hydration at the End of Life: Beneficial or Harmful? ]. Mom should know some of this and she already seems to intuit some of it.		The most pressing issue seems to be that of the feeding tube. Since mom's concerns are happening as this moves forward it would be good for us all to take her concerns seriously. The best of what I have researched so far is in this article from the American Hospice Association. [https://americanhospice.org/caregiving/artificial-nutrition-and-hydration-at-the-end-of-life-beneficial-or-harmful/ \|Artificial Nutrition and Hydration at the End of Life: Beneficial or Harmful? ]. Mom should know some of this and she already seems to intuit some of it.

Tim: /* hospice care */

2020-03-13T16:08:48Z

hospice care

← Older revision		Revision as of 12:08, 13 March 2020
Line 2:		Line 2:
	Tim's post 3/13/20 Fri		Tim's post 3/13/20 Fri

	Since mom has brought hospice care up to Megan and Shaun and Megan I spent some time talking about this, here is some information that we can share with ~~her~~. Also, it can do no harm to ask for some representatives of end of life care organizations to talk to mom and it may put her at ease. A surgeon or hospital doctor's job is different, their job is to keep people alive. At this point I am going to share this information only with those who have been directly involved with her care, ie Colleen Megan, Kelly Shaun and Peri. The most important of us is Colleen as mom has appointed her as medial proxy.		Since mom has brought hospice care up to Megan and Shaun and Megan I spent some time talking about it this morning with Meg, here is some information that we can share with mom. Also, it can do no harm to ask for some representatives of end of life care organizations to talk to mom and it may put her at ease. A surgeon or hospital doctor's job is different, their job is to keep people alive. At this point I am going to share this information only with those who have been directly involved with her care, ie Colleen Megan, Kelly Shaun and Peri. The most important of us is Colleen as mom has appointed her as medial proxy.

	The most pressing issue seems to be that of the feeding tube. Since mom's concerns are happening as this moves forward it would be good for us all to take her concerns seriously. The best of what I have researched so far is in this article from the American Hospice Association. [https://americanhospice.org/caregiving/artificial-nutrition-and-hydration-at-the-end-of-life-beneficial-or-harmful/ \|Artificial Nutrition and Hydration at the End of Life: Beneficial or Harmful? ]. Mom should know some of this and she already seems to intuit some of it.		The most pressing issue seems to be that of the feeding tube. Since mom's concerns are happening as this moves forward it would be good for us all to take her concerns seriously. The best of what I have researched so far is in this article from the American Hospice Association. [https://americanhospice.org/caregiving/artificial-nutrition-and-hydration-at-the-end-of-life-beneficial-or-harmful/ \|Artificial Nutrition and Hydration at the End of Life: Beneficial or Harmful? ]. Mom should know some of this and she already seems to intuit some of it.

Tim: /* hospice care */

2020-03-13T16:07:06Z

hospice care

← Older revision		Revision as of 12:07, 13 March 2020
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	The most pressing issue seems to be that of the feeding tube. Since mom's concerns are happening as this moves forward it would be good for us all to take her concerns seriously. The best of what I have researched so far is in this article from the American Hospice Association. [https://americanhospice.org/caregiving/artificial-nutrition-and-hydration-at-the-end-of-life-beneficial-or-harmful/ \|Artificial Nutrition and Hydration at the End of Life: Beneficial or Harmful? ]. Mom should know some of this and she already seems to intuit some of it.		The most pressing issue seems to be that of the feeding tube. Since mom's concerns are happening as this moves forward it would be good for us all to take her concerns seriously. The best of what I have researched so far is in this article from the American Hospice Association. [https://americanhospice.org/caregiving/artificial-nutrition-and-hydration-at-the-end-of-life-beneficial-or-harmful/ \|Artificial Nutrition and Hydration at the End of Life: Beneficial or Harmful? ]. Mom should know some of this and she already seems to intuit some of it.

	~~Another~~ question is whether hospice will accept patients who are preserving their life with a feeding tube . The best I could find is from [https://www.hospicesect.org/hospice-and-palliative-care/feeding-hydration-and-hospice-care \| this organization]S which says		This information leads to the question of whether hospice will accept patients who are preserving their life with a feeding tube . The best I could find is from [https://www.hospicesect.org/hospice-and-palliative-care/feeding-hydration-and-hospice-care this organization]S which says
	<blockquote>		<blockquote>
	Hospice doesn't include the placement of feeding tubes, or any other steps taken to prolong life at this stage of care. However, patients who already have a feeding tube in place may benefit from hospice services. We will never ask anyone to remove a feeding tube in order to be eligible for assistance.		Hospice doesn't include the placement of feeding tubes, or any other steps taken to prolong life at this stage of care. However, patients who already have a feeding tube in place may benefit from hospice services. We will never ask anyone to remove a feeding tube in order to be eligible for assistance.
	</blockquote>		</blockquote>

	"Hospice care is appropriate for anyone doctors believe to have a life expectancy of less than six months." is another [https://www.hospicesect.org/hospice-and-palliative-care/hospice-requirements?gclid=Cj0KCQjw3qzzBRDnARIsAECmryphZqsnB2FpyhZD7NJywNG8zwb7LLkNcSsXJuvzFdoRMiu6MyNLp4AaAgNGEALw_wcB \|thing] I found out so we need to ask her doctors for their input as well.		"Hospice care is appropriate for anyone doctors believe to have a life expectancy of less than six months." is another [https://www.hospicesect.org/hospice-and-palliative-care/hospice-requirements?gclid=Cj0KCQjw3qzzBRDnARIsAECmryphZqsnB2FpyhZD7NJywNG8zwb7LLkNcSsXJuvzFdoRMiu6MyNLp4AaAgNGEALw_wcB thing] I found out so we need to ask her doctors for their input as well.

	Megan has agreed to talk to mom about the question of, if hospice care is the correct decision, then would she prefer in-home hospice or hospice at a hospice facility.		Megan has agreed to talk to mom about the question of, if hospice care is the correct decision, then would she prefer in-home hospice or hospice at a hospice facility.