shadowtinker742 said:Hello,
Does anyone have info on how palliative care works here in the States?
My grandmother is an oncology patient in the terminal stage of breast cancer that has metastasized to her lungs and other organs. She was discharged from the hospital today after a week (she was in pulmonology), where they drained 7L of "fluid" from her lungs (she has a drain).
The situation is critical; she’s in immense pain and moaning constantly—it is devastating to watch and hear.. They brought her an oxygen tank as well..
Her primary doctor "arranged" home health visits once a day to manage the drain and whatever else..
On top of that, grandma has a stoma (from colon cancer twenty years ago) that needs daily changing.
We are all in a state of shock because she lives alone; luckily, my mother (her daughter) lives nearby and was practically with her all day today, but what about at night?
To be honest, I don't even know what kind of therapy she's on now; I just know she had some chemo throughout this year, though she didn't go for radiation.
What can we do for pain management? Can morphine be obtained through a primary physician?
/we haven't dealt with anything like this in our family before, so we're lost)
Thank you all for any constructive answers.
Hello,
I completely understand you because I went through the exact same thing with my husband recently. Unfortunately, the disease was stronger. Basically, grandma needs to be registered in the system as a palliative patient, and based on that, she is entitled to a mobile palliative team (there is such a team in Chicago, though I'm not sure how it works in other cities). The primary physician issues the order. While I was busy arranging all of this, my husband passed away; it would have meant so much to us if they had come, as it prevents those constant trips to the ER, and I believe they could recognize the signs (since they deal with this constantly) when the end is truly near, which we couldn't. That said, they won't be with you 24/7. The team includes a doctor who can administer IVs for pain and things like that. My husband used pain patches (Durogesic)—they come in different strengths, prescribed by the doctor, applied to the skin (rotating locations each time), and they last about 3 days. They were honestly great for him.
I'm also familiar with the stoma situation. A home health nurse can handle all of that for you. Just have her show you how it's done. It isn't rocket science, but unfortunately, you are forced into being the caregiver, which involves 24-hour supervision. For us, the nights were the hardest part.
Generally, a home health nurse can also give an IV if she's trained, but regarding the fluid in the lungs—since we went through that too, including the drain—everyone tends to pass on it; they don't want to take the risk in that specific scenario. Hospital conditions are just more controlled compared to home.
I recommend investing in a used medical bed (you can find them for $2500-$1167). You can always resell it, and it's priceless.
In any case, nowadays, no one should have to suffer in their final days; medicine has progressed far enough for that.
Anyway, I hope this helps.
Best, Noble