Hospice Care/Hospice

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Question
If called by a hospice nurse and told loved one has 24 to 72 hours to live, and given the vitals at 9:30 a.m.  Then at 12:44 p.m. called by a sibling saying to call other family members and get to the nursing home......arriving at the nursing home to find loved one dead.....why didn't the hospice nurse CM call me as I was the one who signed the documents for the care of the loved one?  Why didn't the hospice nurse know that the loved one was closer to death then the 24 to 72 hour information given?  I'm at a loss for an explanation.  Even the nursing home nurse would not look at me when I arrived......

A friend of mine, her mother passed and they gave her almost to the exact minute of her mother's passing.....I know everyone is different.  

Thank you

Answer
Dear Marcy:

I am a little unclear here--it sounds at first as though you were called by the hospice nurse, but then you say you weren't called but someone else was?

There is no way to know until the person is actually dead, what time they will die.  People can hover at any level along the way.  About the only way you can be certain someone is dead is when they stop breathing and have no heart beat for at least one minute.

If someone told your friend the exact minute her mother would die and then her mother died at that moment, it was coincidence, I assure you.  Or your friend's memory may well be a little different from what she actually experienced.  People react differently when someone they care about dies.  For that matter, even nurses and physicians do not trust their own memories for the time someone dies, this is why they announce "time of death" and then write it down.

I don't know how far away you were when your "loved one" supposedly had 24 to 72 hours to live, but there is a gap of more than three hours there.....

For your other questions, you'll need to talk with the hospice case manager, or the nurse who was on call, or the supervisor.

It does sound as though you experienced your loss very recently.  Please know that this is as traumatic to your feelings and thoughts as loss of a limb in an accident, for example, would be traumatic to your body.  Take some deep breaths, eat something, cry a little, hug someone.  These things can all help you deal with the loss.  Looking for explanations and answers to the questions you mention will change nothing.  I understand that you are angry, and you may be angry with me now as well.  As far as why someone else was called and you weren't called first, whether or not you signed the paperwork doesn't mean you were the one who, for example, may have visited and called more often, or that you were the only one to whom information could be shared.

I wish I could offer you more solace, but this is the best I have.  Please do recognize that you are in the throes of grief, and take care of yourself.  You are going to feel different over time.  Recognize your sense of loss, celebrate the life the person who is no longer with you.  The answers that will be important to you from now on will come from those kinds of activities, rather than from trying to button hole hospice staff for specific answers about why they weren't more accurate.

Do take care, and I hope you will accept my sincerest sympathies for your loss.

Christine

Hospice Care

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Christine Johnson

Expertise

I can give suggestions, encouragement and direction on what hospice is and is not, when it is appropriate, and how to go about getting it. I am familiar with Medicaid and Medicare hospice benefits. I can answer general questions about disease process, what dying looks like, how hospice handles pain and other symptoms, what to expect from a hospice when end of life nears. I can provide support, direction and encouragement related to spiritual matters and psychological matters related to death and dying.

Experience

I am a certified hospice and palliative care nurse, and have been the director of nurses for three hospice centers, under two different companies. I have also worked as a contract hospice nurse for a large American hospice company. On a personal level, my father died without benefit of hospice (it was not popular then). I have taken care of dying patients in hospitals and recognize that for most of us, it is preferable to die at home (or in our residence, wherever that may be), comfortably and without anxiety. Also I had no support when my father died; hospice clients are the whole family (however that is defined by the "patient"), and support is provided at least a year after the patient passes. These are the sorts of things (and probably others) that I can help with.

Organizations
HPNA (Hospice and Palliative Nurses Association)

Publications
none yet

Education/Credentials
Registered Nurse (TX), Licensed Marriage and Family Therapist (TX) ADN Nursing, Excelsior College, Albany, New York (2004) 4.0 GPA BA, Psychology (minor Social Work), Oklahoma University, Norman, OK (1986) 3.67 GPA MHR (MA) Human Relations, Oklahoma University, Norman, OK (1988) 3.5 GPA

Awards and Honors
Phi Beta Kappa (and others)

Past/Present Clients
Unable to name as this would violate their privacy (and HIPAA....)

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