To help provide the best possible care, our staff will set up a meeting with you and the doctor to discuss your goals and expectations. Prior to the meeting, we encourage you to read as many of the available articles listed below as possible.
For anyone admitted to hospital or into LTC, when their heart stops they will automatically receive CPR (CardioPulmonary Resuscitation) unless there is an order to Allow Natural Death (AND) or DNR. For this age group, especially if they have a life-limiting disease (ESRD, ESLD, CHF, most metastatic cancers, AIDS, ALS, Alzheimers liver failure), an AND/DNR order is appropriate for the following reasons:
What is VSED (Voluntary Stopping Eating & Drinking)?
This refers to the decision by a patient to stop eating food and drinking liquids when they have a terminal or life-limiting disease, so that their death can be hastened (and therefore their dying will not be prolonged).
Everyone wants to live as long as possible but also as comfortable as possible – clean, dry, pain-free, and well fed. Years ago most people died fairly quickly: they were active until they developed pneumonia or some overwhelming infection from an injury. Now, our drugs and technology can keep people alive for months or years but not necessarily without pain – chronic diseases can produce a “slow death”.
As we get older, it is natural to expect at least a few health problems. Aches and pains seem to go hand in hand with getting older and that we will have to endure more age-related symptoms. Several studies show that older people’s fears are related to unrelieved pain and/or to loneliness following the death of a spouse or friends.
Expectations and goals of care
Our expectations – residents’, families’, and staff’s – should be based on the following two realities: for almost all of our residents, this will be their final home; and, most elders, in our experience, are concerned more with function and comfort than just living years. Therefore, we have an obligation to keep our residents clean, dry, and both physically and emotionally comfortable, while encouraging as much independence as appropriate – in other words, to provide TLC (Tender Loving Care).
What is it?
A program that exists in many long-term care facilities to reduce drug use and drug side-effects in seniors, help evaluate the need for many drugs, decrease the risk of medication errors, and to allow nurses to spend more time with residents on other activities.
(For Physicians & Staff ) The following topics, which have a significant impact on the quality of life a resident and their family experience, should be discussed between the family and the staff and the doctor at the admission meeting or within 2wks of admission ideally, and then as needed during subsequent/annual meetings.