Doctor insights on:
End Of Life Care Home Nursing
If pt. is D/C'd back to a RCFE but now receives nursing services from a hospice, does this mean end of life care? Pt. had aspirational pneumonia.
If true hospice care: Yes, if it is true hospice care. However, some hospice services also provide "bridge care" for patients whose end is not quite in sight yet (it's like palliative care). Hospice services are a wonderful asset to have at the end of one's life. We all have an end. When our end is in sight, hospice is the way to go. It lets one die a good death, at home, pain-free, worry-free, in peace and quiet. ...Read more
Palliative/ Hospice: Hospice serves pts in their own homes, nursing homes, long-term care or assisted living facilities or hospitals. Pts receive palliative care to ease pain, and discomforting symptoms; psycho-social, and spiritual support. Hospice care is focused on maintaining dignity, increasing quality of life, and providing comfort , including pain and symptom management. Hospice gives best care at end of life ! ...Read more
When you order home nursing for a complex pedi patient, do you define the hours in your order? Do you expect full coverage or think of it as "prn"?
All different: Every order is different. It depends on the needs of the patient and family. ...Read more
HH Nurse: Your residual limb issue is an important one. You will require some level of assistance in the home. Those needs require determination before you leave the hospital. Separate those needs into two categories: your activities of daily living (eating, toileting, dressing, etc); and the care of your residual limb (nursing, physician, therapist). If there is wound care, then a hh should be involved. ...Read moreSee 2 more doctor answers
Mrs. Rose is a hospice patient in the nursing home. She has gangrene of her foot. What can she do to cure it?
It depends: Depending on her current health status, whether the gangrene is wet/dry, if there is neuropathy (which may spare the patient pain), and prognosis are to all be considered. Hospice care is palliative in nature, so if intervention for the gangrene is to be considered, a change in her hospice status is necessary. ...Read moreSee 2 more doctor answers
High level needs: Hospice is extremely useful in skilled nursing facilities for patients who have a high symptom burden and cannot be managed at home or do not have a home or home caregivers that allow for this. Hospice clinicians are specially trained to deal with symptoms and generally add expertise to the staff at skilled nursing facilities because the patient will get extra attention. ...Read moreSee 2 more doctor answers
Hospice: Hospice is an end of life service through medicare or private insurance. It will not pay for 24/7 care unless the person is in the active dying process of the last few days. If you need care in the home you should hire an in home care agency. This is private pay and not covered by medicare. Some long term care insurance may cover it. Check with your agent. ...Read moreSee 2 more doctor answers
Dementia pt. had aspirational pneumonia D'C'd back to RCFE even tho needs higher level of care. Nursing scvs provided by hospice. Why not sent to SNF?
A different focus: Hospice services are a wonderful asset to have at the end of one's life. We all have an end. When the end is near, we don't go to a skilled nursing facility (think of an SNF as a place to recover and get back to good mental and good physical functioning). When our end is in sight, hospice is the way to go. It lets one die a good death, at home, pain-free, worry-free, in peace and quiet. ...Read more
My mom 89, had severe dementia and was yelling out. Hospice, nurs. Home and state tried morphine in case she was in pain. 1/5 of a tsp every 2 hours as needed. 2 days later she died is morph. Cause?
Morphine: Morphine is often used for respiratory distress and agitation from lack of oxygen in a terminal disease. It is difficult to answer your question because the amount and frequency of the morphine dosing during this time period is not provided in your question. I would discuss your concerns with the medical provider so you can gain understanding and closure from your loss. ...Read moreSee 2 more doctor answers
Confused.dad in nursing home. Parkinsons with lewy body's x7 yrs.failing.dr said no more can be done and that he's not suffering.meaning death soon?
Questions on end-of-life care at home: who approves it? Do they do autopsy? Who do you call if you find an elderly person died in sleep?
Difficult ?: If a person is found alone, it depends on the state, but in most states an autopsy is required and you should call 911 if the person is found dead alone. If a person desires to die at home, that is usually their choice if they are capable of making those decisions. If not and it is their desire and have advanced directives, then the decisions rest with their power of attorneys and finances. ...Read moreSee 1 more doctor answer
Yes: SNF = skilled nursing facility. Key word is nursing which means nurses have to be available around the clock. Assisted living facilities don't require presence of nurse at all times. BTW, we mean RN or LPN when referring to nurses. Check out http://www.diffen.com/difference/Assisted_Living_vs_Nursing_Home as a starting point. ...Read more
Specialized services: A skilled nursing home offers more than custodial services. They also provide physical and occupational therapy, dietary services , and give services such as respite care, feeding tubes, continue IV therapy. Usually a doctor is assigned to patients and psychiatrist will also follow patients with psychotropic medications. ...Read more
Skilled Nursing : Facilities (snf) have nursing home level of care within their building. For example, one wing of the snf or certain rooms are dedicated to people receiving short term rehabilitation services (those who will not be living there once therapy is complete) and those who stay long term. People who live there are under custodial care, or the same level of care as a nursing home. ...Read moreSee 1 more doctor answer
Anything: Bad nursing home reputation, failed annual inspections, loss of independence, change of environmental or cultural settings, uncooperative residents, unprofessional staffing, fire safety, aging building, inner city location, falls resulting fractures, infections among other residents, food poisoning and fear of institutionalization. ...Read moreSee 1 more doctor answer
A caring staff: A good nursing home has a caring staff and physicians who are available and willing to meet with family members. These two characteristics are not easy to discern. I recommend that you visit any nursing home you are considering for yourself or a family member. Walk around, and talk to visitors and family members of patients. Don't go by what the admissiions folks tell you - they are in sales. ...Read moreSee 2 more doctor answers
No: By definition, skilled nursing facilities or nursing homes must have nurses eg RN/LPN available around-the-clock. Assisted living facilities do not. Memory care units are a secure subset of assisted living, w/greater staffing. Check out http://www.aplaceformom.com/alzheimers-care, http://www.seniorhomes.com/p/memory-care/ & http://assistedlivingtoday.com/p/memory-care/ for more info. ...Read more
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