Tuesday, September 28, 2010

The Deed is Done

It is official.   My father is officially a Hospice patient.  His diagnosis is "adullt failure to thrive".  He has lost 4.5 lbs, more or less, in the last 30 days.  Not good.  He is refusing most meals, except for his 3 bottles of Ensure daily, and some fruit.  He seldom gets out of bed, although he can still walk with his walker.  We are assured that he is getting plenty of fluid, although they are not measuring fluid in/fluid out.

There are some real positives about Hospice care.  He gets another layer of nursing care, with a Hospice Nurse visiting at least twice weekly.

I asked what that additional layer would add to his care.  The answer?  "Another pair of eyes, eyes looking just at on patient, eyes looking specifically for his comfort, for small changes in condition or attitude, eyes trained to evaluate patients at this stage of life."  Oh, another pair of eyes looking from the same view that we do as a family, looking for signs that might be missed by a CNA who is dealing with 8-12 patients, each one with their own very important needs.  Eyes that are not tied by regulatory requirements to desks, patient charts, or medicine carts.

From my own perspective, it means dealing with RNs whose native language is English.  Don't get me wrong here.  My dad has been getting very good nursing care.  But the primary language of most who work at Oahu Care Facility is Filipino, Korean or Vietnamese.  There are communication gaps.  I wrote about some of them the other day.  In the US, men wear suspenders to hold up their pants.  In the UK, suspenders hold up hosery.  Braces hold up pants.   If I asked about braces from a UK perspective, the American thinks about teeth straightening.  When your first problem is translation, the more subtle differences get lost.  You don't always understand what the other speaker is asking or telling you.

It means having a nurse on call 24/7.   I've used that wonderful service in another lifetime -- another place, another patient.  I am incredibly thankful that there was someone to call whenever I needed them.

From the perspective of the checkbook, Hospice Care is well covered by my parents' insurance.  Ordinary long term care is not.  So we have suddenly dropped out of full private pay status into a much more budget friendly  insurance patient.

St. Francis Hospital, manager of this Hospice program, is a Catholic hospital.  They believe that spiritual and emotional health is important to physical health.  They offer both social workers and a chaplaincy program.  I've asked that a chaplain visit my dad -- not as a Catholic priest, but as a friend who comes to talk and visit, and who offers to pray with or for my dad at the end of the visit. He is not a church go-er, has not been for many years.  But he did  regularly watch Dr. Robert Schuller (TV's Hour of Power), and he did grow up as part of an active church family.  It's worth at least  one visit.

Give thanks for Hospice care in local communities where ever they may be.  Give thanks for those devoted folk who dedicate their lives and service to those whose lives are drawing to and end.

Don't forget to pray.

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