When a loved one is dying and just wants to be at home with family, it is a very difficult decision to make. You want to honor his or her wishes, but at the same time you know you cannot be the one to provide end-of-life care. There is nothing wrong with that, and that is why there are so many medical groups that provide palliative care at home. This type of at home healthcare helps families work through the last moments of another family member's life while providing all of the necessary personal cares and comfort measures you might want for your ill and dying family member. Here is what you can and should expect from good palliative care at home.
Making Room for Hospital Equipment
The first concern you and your entire family will have is finding the space for the hospital bed and numerous devices to support your family member with end-term care. A heart rate monitor, IV cart and drip, oxygen tanks and/or artificial respirators all need room within the room that your family member will now stay in once he or she has returned home. Typically, a downstairs bedroom or a den is ideal because it is close to an exit and EMTs can get to the patient faster than if you place your family member on the second floor. It also limits visiting nurses to the ground floor of your home, allowing you to maintain your privacy on the second floor.
Care Provided
Nurses can stay around the clock or just come for certain times of the day and night. If your loved one is still able to eat and chew, nurses will assist him or her with getting enough nutrition at meal times. Otherwise, nurses can set up feedings via a G-tube or NG (naso-gastric)-tube.
When loss of bowel control or loss of bladder control is present, nurses will provide peri-care and make sure the genitals and buttocks are clean and free of urine and/or feces so that sores do not develop. Patients who are bedridden can develop bed sores if not turned and rotated every couple of hours, so nurses will help your family member turn from side to back and then to the other side throughout the night and during the day as needed. Oral hygiene is also provided, even if the patient has an NPO (nothing per oral) order so that teeth and gums are maintained and the mouth remains moist and free of infections.
As for the treatment of pain, an IV drip may be prescribed. A doctor may do a home visit to get the prescription started, and then a registered nurse or licensed practical nurse will make routine visits to keep the pain medication flowing and going. Comfort measures require a doctor's signature, but the nurses that provide the at-home care will execute those orders.
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