tag:blogger.com,1999:blog-37811152.post8998123056786973491..comments2024-03-20T10:44:38.106-05:00Comments on madness: tales of an emergency room nurse: How old is too old?Unknownnoreply@blogger.comBlogger7125tag:blogger.com,1999:blog-37811152.post-60187254498370393702012-08-07T11:50:58.663-05:002012-08-07T11:50:58.663-05:00Who makes the decision that someone is "too o...Who makes the decision that someone is "too old" to receive "expensive interventions"? Who decides that a patient is too old to survive an intervention?<br /><br />My mother in her early 80's was rushed to the ER and diagnosed with a bowel perf. The ER physician stated, "If you were younger we would do surgery. Because of your age, we will try to make you as comfortable as possible." <br /><br />Many years earlier, my mother and I had serious talks regarding quality vs quantity of life. I knew this was something that could potentially be "fixed" without compromising her quality of life and demanded a surgical consult. <br /><br />In the ER, you only have a short time to interact with the patients and their families. You do not know the patient prior to this "crisis". How can you judge that they are "too old" to receive "expensive intervention"? Remember, age is but a number. Hopefully you will live to be "old" one day. When you do, I hope that your healthcare provider considers all the facts and not just your age.<br /><br />(BTW - mom had successful surgery and lived many more quality years.)Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-37811152.post-90179919958110185392012-06-06T22:11:58.785-05:002012-06-06T22:11:58.785-05:00My grandpa was cared for at home and had a living ...My grandpa was cared for at home and had a living will just in case the time came when he needed care by professionals. Our family in it's entirety was present when he had it written and notarized and we all were willing to follow his direction. He died peacefully in his sleep a few weeks later. <br /><br />These decisions are very hard for families but they MUST be made. There was an article in last week's Time magazine Titled "How to Die" it was a good article. I suggest that everyone read it. It outlined how one family walked through the aging and death of parents in a very gracefully way.Anonymoushttps://www.blogger.com/profile/03117955596684157030noreply@blogger.comtag:blogger.com,1999:blog-37811152.post-52913166931982793182012-06-06T21:20:43.820-05:002012-06-06T21:20:43.820-05:00Oh, this is such a tough one for me. My grandpa i...Oh, this is such a tough one for me. My grandpa is 92, and hospice for FTT. Extremely forgetful, but alert and knows family. <br />Obviously he's a DNR--he is hospice. However, when the assisted living facility called saying he had a GI bleed, and I raced over to check him out in time for him to vagal on the toilet as he passed quite a bit of blood, I knew I couldn't let him die like that. <br />Off to the ER we went. 1 unit PRBC and FFP, fluids, overnight observation stay, and back to the assisted living facility he went. Our family understands completely that this was only a bandaid to what could be a much larger problem, but no regrets. Hospital staff was made aware that we didn't need any testing (so no scopes, CTs, etc) as we wouldn't treat CA. He stayed a DNR, and we did not want pressors or intubation or CPR. <br /><br />I always thought it would be much more black and white than the decision making process was, though. Knowing what I know as a nurse, I still was unable to NOT treat this GI bleed. Who knows what it was--diverticulum, perfed polyp, huge ruptured hemorrhoid, or cancer. He's been back to himself the last 4 weeks though, and I'm grateful for that.Christiehttps://www.blogger.com/profile/09670593753947680118noreply@blogger.comtag:blogger.com,1999:blog-37811152.post-8401454285741834362012-06-05T14:09:54.828-05:002012-06-05T14:09:54.828-05:00Living wills are the biggest joke ever. Even if t...Living wills are the biggest joke ever. Even if the patient signs one saying they're DNR/DNI and don't want heroic measures taken for them, the family can just revoke that at any time. It's more like a suggestion versus a document that anyone has to follow. People revoke these all the time in the ER.Nurse Khttps://www.blogger.com/profile/06408755992926959084noreply@blogger.comtag:blogger.com,1999:blog-37811152.post-44734158479194021352012-06-05T10:16:09.093-05:002012-06-05T10:16:09.093-05:00As a retired ICU nurse I saw this day in and day o...As a retired ICU nurse I saw this day in and day out. It was sad because most of my elderly patients never made it out of the ICU. Their families could not say no to whatever intervention was being touted by the doctors. These elderly folk never thought to make a living will themselves. So others made their decisions for them and these most always went against what the patient wanted.<br />Why can we not let go of those older members of our families whom we love, and let them die a completely natural death? Who knows????Phiddyhttps://www.blogger.com/profile/16948777206154226450noreply@blogger.comtag:blogger.com,1999:blog-37811152.post-21850948923007626232012-06-05T08:06:45.189-05:002012-06-05T08:06:45.189-05:00Thank you for voicing this. It is obvious to many...Thank you for voicing this. It is obvious to many that this type of 'care' cannot continue. We certainly need to be thinking and talking about this before change can be made.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-37811152.post-52216616664109919092012-06-04T21:59:07.241-05:002012-06-04T21:59:07.241-05:00Very valid point. The population is definitely get...Very valid point. The population is definitely getting older, which would be fine if they were also getting chronic diseases later, but of course they're not... sigh.<br /><br />I guess it's different in ED where you have to do everything to save the patient, but in hospitals here there's definitely a cut-off point for age for certain procedures.Frootytootynoreply@blogger.com