I have a patient whose family has abandoned him.
He's dying. Soon. There was apparently a meeting with the family last week, and they said they wanted him to stay in the hospital until he died, but the hospital said he can't, he has to go to another facility, a nursing home or somewhere that can handle hospice care, there's no more treatment, he's just taking up a bed, it's sad but he can't stay...
And so the family disappeared. They haven't been in to visit him since, they don't answer the phone, they ignored a registered letter, no one can reach them. They've left him to die, and now the hospital has to figure out what to do with him.
I don't know how some people live with themselves, I really don't.
On a brighter note, I learned about a new medical procedure today. We have a patient with an infection that's not healing, the patient is colonized with the infectious bacteria and needs the normal gut flora-- so they're thinking about doing a stool transplant. They said this on rounds and I did a double-take. A what? You're going to do what?
They're going to take a relative's stool, and transplant it.
How?
Oh, via the throat.
They're going to put someone's stool down this guy's throat.
Seriously. This is an actual medical procedure.
We did not learn about this in medical school.
And this was right before lunch, which, of course, made lunch extremely enjoyable.
Monday, November 16, 2009
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Its actually a pretty interesting procedure, and an even funnier article read. Pubmed fecal bacteriotherapy, toying with human motions. Yes, thats a real review of the available literature
ReplyDeleteSometimes the most effective methods are the lowest tech.
ReplyDeleteMy mother was in Medicare-paid hospice, clearly near death; end-of-the-line, right? To my family's shock and horror, apparently not; the facility's administrators called a meeting with my family and required that she be moved to a $6000 a month nursing home, which would have been financially devastating to my father. She died that night, no surprise to anyone except the clueless hospice staff. To tell the truth, I think my mother's outrage about the idea of my father paying luxury hotel rates just so she could be moved to a different bed in a different cheerless institution (with the same lousy food) hastened her death.
ReplyDeleteFinances should not be a consideration, but they may be in your patient's case as well. Perhaps the family has previous experience with another relative languishing in an overpriced human warehouse. They may have concerns with patient care as well; the words "nursing home" have negative connations for most people.
Having said all that, is it possible there is some family pathology and a lack of emotional ties? In which case, having performed their obligatory visitation duties, perhaps family members are now ready to wash their hands of him.
For C. dif, right? I went to a lecture last year and they spoke briefly about the procedure. I couldn't focus for the rest of the lecture...I kept thinking how strange...
ReplyDeleteI've seen a few cases like the family issue you wrote about...families avoiding phone calls from residents, etc. Truly sad indeed.
From what I know about hospice, in house hospice or nursing homehospice with Medicare should be covered by Medicare. And not trying to be coldhearted but just because your dying does not mean we the people should have to pay for you to dye comfortably. Back in the day family members took care of their own dying family members. Get a hospice doc to get you the good pain relief and take your family member home and sit with them and hold their hand and help them make it to the other side.
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