I'm a retired CNA, so I've been around the elderly when they were dying. I've watched many of your videos lately, so I was ready to give some answers when I needed to. I remembered the video where you said you came back the next day and the dying lady was sitting up in bed eating breakfast talking to her family and ended up passing a month later. I thought of this when this situation just happened to my sister. My 87 yr. old BIL just passed Feb. 7. I got a phone call on Feb. 1, telling me that my BIL was passing, it was just a matter of hours. I was told at that time that the funeral would tentatively be on Saturday. Two of his kids had flown home as quick as they could. The third one drove to the nursing home where dad was. He had been non-responsive for a couple days. All were at his bedside and apparently he heard their voices and came back around. My sister had left to go home and take a shower and when she got back the nurse told her that B. had woke up and asked for O.J. and was hungry. They walked him down to supper that night and he fed himself, eating his whole meal. Imagine the phone call the next day telling us that he rallied and was talking to his wife and kids. The next meal he didn't eat quite so much and then he quit eating and went right back to his non-responsive state like he was the week before. The only difference was this time my sister told me about him having the death rattle. I knew he would be gone very soon. He passed peacefully hours after I finished talking to my sister. I had told my sister that I thought he rallied because he heard his kids' voices. I told her it's the Miracle of Time. They all got that tiny bit of extra time to say, "Good-bye Dad," and have no regrets. My sister did say that B. was looking up at the corner of the room like he saw someone. Thank you Julie, for these videos. I've told numerous people to look up you videos.
My 91 year old father was on hospice and he was so mad about that. He didn’t want to admit that he was dying and was furious at us because we told his oncologist how he was really doing and not the “I’m fine” he was telling the oncologist. When the admissions nurses came to have the admission visit at their appointment., my mom and I met with the nurses and my dad pouted and refused to participate. Then the nurses came up to their apartment to take his vitals and he would not talk to them or let them touch him. He told them to get out of his house and they can’t make him participate. Every time they would come to visit and take his vitals and possibly adjust his pain meds. He died three weeks later. It came to a point where he could not fight them, which made it easier on my mom. He received the comfort meds and then passed in his sleep. It was a great experience for us even tho Dad actively fought the whole process. The nurses were great, so patient with this cranky old man and really provided emotional support for the family. I cannot sing their praises enough. Hospice is such a wonderful experience. God bless you for what you do! ❤
Such valuable information. Thank you. Neither of my parents were in hospice. Dad passed from a massive stroke at 56. Mom passed unexpectedly the morning she was to be released from the hospital after a minor fall at almost 91.
Who made it awful? The patient. He did it to himself, choosing to make himself a burden for longer on his family instead of being realistic & accepting help from hospice people. To be fair, there really isn't a lot of info out there until lately, so old people are still resistant or selfish about it.@@withgoddess7164
Mom was in hospice 6 days. It was the hardest 6 days I have ever spent in my life...the constant emotional walk to the end. I can't imagine families having to go through that with a child. How you and all the other hospice personnel manage it is beyond me. Thank you
My grandma was on hospice over a year. She just wouldn’t die. Was not ready. She finally went on 9-1-23 I miss her dearly . I saw the “death stare “ I basically spoke very loudly “I love you” said it numerous times. And it’s like she snapped out of it long enough to look at me and say “I love you too” and she went later that day. I know she is better dementia never robbed me of her knowing me for that I am grateful
My mother was in late stage dementia and had been talking to dead relatives for months. She kept asking to die when I made demands of the nursing home they couldn’t do and recommended hospice. I started the process immediately and 4 days later she was evaluated. When I told her she was being put on hospice she smiled and said thank you. Less than a week later she passed peacefully but I wasn’t there. The hospice nurse said they didn’t think she would go so quickly except sometimes patients need permission to die and my mother did. The aide had just left and she passed. I couldn’t have been happier for her, she’s at peace and no longer unable to do anything. I hope she’s in heaven with my dad dancing. Thank you for your videos. I’m trying to get my sister-in-law to discuss hospice for my FIL it’s so sad to see him suffer because the family isn’t ready to let him go.
BEAUTIFUL STORY K. YES, YOUR MOM IS IN HEAVEN DANCING WITH YOUR DAD ☺ I'M SO GRATEFUL THAT YOUR MOM WENT PEACEFULLY. YES, THEY DO NEED OUR PERMISSION TO GO SOMETIMES. OUR LOVED ONES NEED TO KNOW THAT WE WILL BE OKAY TOO. I WILL PRAY THAT YOUR SIL HELPS HER FIL BY GETTING HIM INTO HOSPICE. WE CANNOT BE SELFISH TO HOLD ON TO A LOVED ONE & MAKE THEM SUFFER BY KEEPING THEM HERE. WE HAVE TO LOVE THEM ENOUGH TO LET THEM GO. PEACEFULLY & IN NO MORE PAIN. GOD BLESS 🙏❤I
❤I absolutely love your channel, I have less fear and I an grateful for that. ❤ I feel like to actually go into hospice has to be very difficult to end all your treatments. 😢😢❤thank you for being so good to so many people
Julie, this was an amazingly appropriate, valuable, necessary, spot-on video. My goodness, thank you so, so much for doing what you do! I may have nailed this into the ground by being pedantic but, I'm a funeral director and I cannot with words express how invaluable this information is to EVERYONE! As I've said in previous comments, the majority of us are not prepared for dealing with the realities of death, an experience that literally none of us will escape. It is the case that we all experience this final scenario of our life in our individual ways but, if we are able to offer the best possible experience of this inevitability, why not take advantage of it? The information and awareness you are sharing is a critical component to all of us, around the world, being able to better understand the biological, physical, and fantastical ways we all come to our end, and how we can better prepare and settle our psychologies around it. I cannot thank you enough for what you are doing. You are essential! Thank you, thank you thank you!
You are very valuable nobody talks about the "Last Responders" as a nurse I can tell you esp. with old C. #19 you were also just as exhausted as we were . Thank you !
@@eugenepattivalitzski9757 It was certainly an intense experience for all of us in the broad scope of healthcare! Fingers-crossed we never have to do that again!
Downloaded this one. Having seen so many family members exist in denial until the very end, when their families stepped up and (most of the time) muddled everything because of lack of planning, I'm squirreling away research and information. HOPEFULLY, it won't be needed for another 10-20 years, but I intend to have a folder of facts to go by and directives in place.
I needed to see this video because I was not aware of what Hospice can --- and cannot do. Mom is 97 and her kidney function is declining. She was hospitalized in Feb of this year, 2023 for 5 days. I thought she was not gonna make it, but she has rallied and become more demanding, less kind, and overtly mean to me. I haven't had relief or respite since my sisters left on the 17th March. Mom and both sisters say we can't afford to have someone stay w/mom if I am out of the house for 1/2 a day. This feels like I'm responsible for EVERYTHING. Last week I oversleept on an morning when mom had an appointment. She drove herself to the Dr. but was angry as hell when she got home. Without any time off, living with mom has become my workplace. Although I'm a retired RN, I'm 70 and feel exhausted a lot of the time. I will contact our Home Health Case Manager to research options for respite care next week. I don't know how you do it....this work is stressful and fatiguing!
So many families don’t know how to care give , CZcams provides lots of videos that show how to change a bed with someone in it, How to give a bed bath etc. how to safely transfer someone, just wanted to put that out there.
I love your videos- such courage to explain to us all how death works.Supporting a dying person is a privilege, a passage though challengeing times. Almost like a midwife in many ways. Western culture hides the realities of dying and death, and we take great care to keep everything hidden under the carpet. I grew up in Scotland with Irish heritage and dealing with death seemed more authentic to me as a child. Our loved ones would be placed at home in a open casket, and families, loved ones and friends were encouraged to pay our respects. It all seemed very natural to me. My grandmother died at home in her sleep, when I was around 4 years old. I was curious and asked to see grandma- still lying in bed with her nightdress on.. I was left alone for a while, stroked her silver hair and was curious to understand the process. It was not traumatic or upsetting in any way for me, and I can still remember that time with great fondness.
When we had had hospice came in for our first initial meeting, there was three of them along with my husband and myself . We were sitting around the dining room table talking it was a little tense when I noticed they kept looking at each other. I wondered what was going ! It was at that moment that I heard it our little pug was laying under my husbands feet, she was snoring and making these weird sounds as pugs do. We were so used to the noise we didn’t think anything of it. It was then that I knew what they were hearing her. I started to laugh very inappropriate at the time, but it sure broke the ice . I told them the noise you’re hearing is my pug she’s sitting under my husbands feet . You could see the relief on their faces. They said we wondering if it could be my husbands esophagus and stomach making that awful noise ! He had esophageal and stomach cancer, it sure broke the ice we were able to talk and ask all the questions we wanted ! Our hospice nurses where are the absolute best. We all had a great laugh ! Thank you for all your awesome and very informative videos.
OMGOSH, AT WHAT COULD BE A VERY STRESSFUL TIME, THIS IS SUCH A CUTE STORY 😂 I'M SO SORRY FOR YOUR BELOVED HUSBAND'S DIAGNOSIS. MY FATHER HAD THE SAME 😢 I HOPE THAT YOUR HUSBAND DIDN'T SUFFER. I HATE CANCER. IT TOOK BOTH OF MY PARENTS. NOW IT IS TAKING MY YOUNGEST DAUGHTER. MAY YOU FIND PEACE & GOD BLESS HOSPICE WORKER'S EVERYWHERE 🙏❤
That was really helpful. We tried to get our mom into a nursing facility but they never responded, in the meantime she had to go into emergency, then was moved to palliative care, then into a hospice facility all in the same hospital (which I didn't know they even had), all within a little over a week until she passed. She had congestive heart failure, kidney disease, ,weeping edema, sepsis at the end. I do think the doctors and medical staff were reluctant to tell us how dire her condition was. Thankfully she passed quickly and peacefully with no pain and the hospice nurses were wonderful both at caring for her and keeping us informed. Thanks for what you do, Julie.
Thank you. My husband went into hospice last week. He has gbm, all treatments have been stopped. He is still able get around on his own and mostly understand what is happening (for now). I had a much different idea how hospice works. The video really helps understand the process even though the hospice social worker explained, I will watch again, (several times). Ive been watching your videos and each one gives me info and insight into the care of a dying patient and their families. Thank you for caring and all the effort and information you put into your videos ❤
I wish I found you when my mom was on hospice. Oh Julie, it was so hard. We didn't even know she was sick. She goes in to the ER end of October 2021 with an eye infection, falls down in there the next morning, breaks her hip, and then they find metastatic lung cancer. Sent to rehab, hated it. Finally came home and accepted the hospice. I was with her 24/7 (had the aid, and I would go to the store or whatever when she would come). I became so sick end of April, hospice nurse tested me for covid, I was positive. Wanted my mom at respite, she said no way. I said no. I masked up and did the best I could until around 4am that morning. I'm sitting on the toilet with the clothes hamper in front of me throwing up, and something SO strong came over me with the feeling that I had to send her to respite. She was so upset, and so was I. I promised her it would just be the 5 days. They took her later that day when a bed was available at our hospice respite place. She called me miserable, said her breathing was worse "But we won't talk about that" she said. I said mom, just give it one night, if you still hate it, I will tell them to bring you back. Next morning she calls me, all happy. "Oh they did my nails (I assume clipped, hers grew so thick and so fast), cleaned me up real good, I think I might come back here next week!" I was so happy that I could rest and recover and she would be ok. Next day phone in her room rang endlessly. Found out she was now "actively dying". I took the covid meds, had by that time reached the 5 days and could go see her. She was doing the same as the people in your videos, the rattle, the mouth open. I decided to go home to sleep, and after seeing her, I honestly hoped she would pass that evening. SW came back next morning to take me back, she passed on our way in. A few hours after my brother went up to see her. The plan was for her to pass at home, but after seeing her, and not being prepared for that image, I really don't think I could have handled it. I feel like I was given covid for a reason. I am still bothered that she passed without me. I hope she was okay. That lady was my very best friend. Partners in crime. Her hospice nurse and SW were AMAZING. Thank you for what you do!
Once again, this video could and should be used as a course key for palliative, hospice and end-of-life care training! I so wish you were my Momma's nurse almost 15 years ago, have mercy it would have been a lot better all around. Bless you and thank you from the bottom of my heart! 🕊️🙏❤️🕯️
You were reading my mind! Ive been wondering about your admission process. I a 30 yr nurse now a Hospice Admission Nurse. I consider you a mentor Julie, keep it coming you are awesome.
@@hospicenursejulie I LOVE YOU TOO JULIE ♥ MY BEAUTIFUL DAUGHTER HAS ENTERED HOSPICE. YOU ARE ALL A GODSEND. CAITLYN WANTS TO BE AT HOME & COMFORTABLE. WE WILL HONOR HER WISHES WITH RESPECT. I KNOW THAT MY BABY GIRL IS IN GREAT & LOVING HANDS. PLUS SHE GETS TO BE NEXT TO HER FIANCÉ & BABY GIRL EVERYDAY. WE ALL LOVE HER SO MUCH. GOD BLESS YOU NURSES 🙏♥
Another great video Julie! We just got Dad home today after 6 weeks in hospital for Covid organizing pneumonia. He is 92. GP said he would never come home as he is now on 24/7 O2 at 2L. Said if released will go to nursing centre YIKES. His desire is to be home. So glad he is home. We cook, clean, give meds, supervise washroom and shower time. Asked his hospital Dr about home care and hospice. He was SO SHOCKED I even asked about palliative or hospice care?! Like little young Dr he is 92 survived Covid and has severe lung damage, he not surviving long. He has a clear health directive. So guess no support! We are in Canada.
Thank you for making this video for us. My dad has CHF, and has just been offered hospice services, now he's dealing with organ failure. We're meeting the hospice team today at the hospital and this information has been very helpful. Thank you for the many other videos on death and dying as well.
I worked as a hospice nurse in vermont. I do feel that the patient's Dr. should have taken the time to explain the time she had left to patient and family. It gives them more time to grieve and to go through the stages of knowing and preparing for this stage of life ending.
The hospice team we had, included a music therapist every other week. The man I cared for loved this! For about a 1/2 hour he got to sing along or listen to a therapist playing guitar/singing , and play instruments like drums or bells or Moroccas if he wanted. It gave him so much joy.
My father in law had colon cancer that spread throughout his body. He was in hospice for a few months. When he got close to dying he went to the hospice center . Once he was pronounced dead by a hospice nurse and she vocally said he’s gone he sat up in bed and said no I’m not. Then a few seconds later she checked again and he was gone. We were all shocked but knew he would have the last word always even till the end.
Can you please make a video about/discussing admission criteria between inpatient free-standing hospice facilities and home hospice? I had several relatives die in a hospice facility vs. being at home. It was a very good experience. Only one relative had home hospice and it left her adult children traumatized, they had no medical background yet had to do injections and other things including sitting there while their mother died and the hospice nurse sat in her car. Totally bizarre!! The nurse said she didn’t like death. What?! 😳 Clearly a terrible nurse and agency. My cousin said she would’t come in the house until the mom died! I am an RN and I was appalled.
So sorry that your experience with home hospice was so traumatic . Were the people in a dedicated hospice unit admitted for symptom management or were they in a facility such a a nursing home and then elected to go on hospice care ?
Sorry to hear this! I think that nurse should be reported, and go into a different line of nursing. Hospice nurses are called and usually love their work, as it is so meaningful.
That's how the hospice nurses were when my dad had terminal agitation. He was pacing the house and wouldn't sit or lay still .They came and kept uping a medicine until he was in a coma state. When I asked how long do you think he has left and a nurse told me 24 hours. A nurse showed my 75 year old mother how to crush his pill medicine to a powder consistency and add water and then use a syringe without the needle and fill the syringe to a certain dose and how to slowly push the syringe medicine slowly into his mouth. How often to give him numerous meds. My 75 year old mother couldn't do that because she has tremors in her hands , so guess who had to give give my Dad his medicines some every 2 hours leading up to his death 11 hours later , yep I did and I held his hand and talked to him even though the medicine put him in a coma state. I did that alone throughout the night until he passed away early that next morning. My mother was exhausted so she got some sleep. Giving my dad all his medicine leading up to his death was traumatizing to me. I felt one of the 3 nurses should've stayed overnight with him being they said he had 24 hours and he passed away in 11 hours. I read online that when a patient has terminal agitation it's considered an emergency and my Dad should've gotten 24 hour continus around the clock hospice nurse care that night . I wanted to be with my dad when he died , but I was also grieving and upset that he was soon going to be gone and felt family should not be the one to also administer and give him all his end of life medicines after 3 hospice nurses had a very hard time controlling his terminal agitation. The part of giving my dying Dad all of his end of life medicine was very traumatizing to me, but I did it for my mom and Dad. Is that normal procedure for family to give end of life medication after having a very hard time controlling his terminal agitation ?? Edit: It's now been 3 weeks and I haven't received an answer to my last question. My guess is my father didn't get proper hospice care at the end , during and after his terminal agitation which had him pacing the house nonstop for hours. The nurses had a hard time stopping his terminal agitation and kept upping the med until he was laying in bed in a coma state and couldn't talk. We were told by 3 nurses that he had only 24 hours to live and the nurses showed me how to crush his pills , mix in water , put it a syringe and how to give it to my dad and how often . They put me in charge of giving my father his last 24 hour end of life medication and all 3 nurses left at 10 pm. He died 11 hours later.. I read on a hospice website that terminal agitation is to be considered an emergency and requires 24/7 around the clock in home hospice care that he/his family didn't get . I was left very tramatized giving my father his last 24 hour meds while grieving he was soon going to be gone. After my dad died; I questioned his end of life medication and how often he got his morphine pain meds. I was told to give it to him every 2 hours. Every 2 hours is a lot because any pain med I've ever gotten has always been every 4 hours to every 6 hours and don't take it more of it or more often or you can overdose especially elderly people who are more prone to overdosing. Which had me wondering if he actually died from an overdose of morphine medicine every 2 hours ?? and I was the one that overdosed him ?? He also took 2 other medicines. Lorazepam and a med that starts with an H , I can't remember the name, but if I saw it I would recognize it. Another thing I questioned about hospice is when my dad was living a lot longer than expected , he was going out to eat every day . He wasn't in pain . He had pancreatic cancer and after surgery he became diabetic. When he was feeling good the hospice nurse told my mom to stop giving him his insulin and take no vitamins ! I told my mom to keep giving him is vitamins they won't know and do not stop his insulin . Tell them you will not stop while he's doing good. She told the nurse we will not stop his insulin and she didn't have anything else to say about it. Why would they want insulin stopped when he was doing good ?!? I was shocked . He kept getting his insulin to the end. Our experience wasn't good with hospice and with what I saw , im convinced my dad lived a lot longer being at home where family could control how he was treated than if he was in a hospice hospital setting and you are not there to 24/7 to see what they're doing .
Thank you so much Julie for the info my mom just started hospice for heart failure 😢 I am so thankful for you for posting this info it has really helped me to understand 👍🏻
I love watching you Julie ...I wish you were around fifteen years ago when my Mom passed. I would have learned so much from you, keep up the video's they are great.😊
As a hospice nurse, I had been accused of being too technical on a resident by the family. I was taken aback by this, and realized that the family just want their loved ones to be cared for with compassion, while they rest.
I was my daughter's hospice caregiver until her last few days and couldn't control her pain.When it was time to take her to the hospice facility it took almost half an hour to walk through the doors, I laterally froze. I knew I'd be leaving alone
Thank you Julie for what you do!! Our Dad was in hospice for a day and a half! We were not expecting that!! He was Gone before we knew it!! It was so hard!! But we so appreciate the Nurses from his VA hospital who cared enough to come over there and be with us!!!
We had hospice for my mother in 2010, but we literally took care of her. We had a great hospice nurse. We were 7 children, so we all were my mother's caregivers. The nurse came like every other day or whenever. We needed her. She told us she had never seen such great care we gave our mother. I miss my mom still, but thanks to our other caregivers who helped us and the hospice nurse, my mother went peacefully
Great video Julie! Perfectly explained. I’m going to send this to my neighbor who is dealing with the stage 4, brand new Dx of her brother, and she is struggling with that plus being unable to constantly be there to help him. We are in Northern California,north of the Napa County region...and the brother is on a smaller island in Hawaii. Quite an expensive journey, but she already has done her best to do “her part” , and that has been responsible for minimizing, or alleviating the first trigger of the “guilt stages” that tend to be self induced, or culturally or personally expected. Sadly, much of the “ guilt” has become the “norm” in today’s society. Often, family and close friends tend to fall into patterns of behavior simply due to what they’ve seen on television;. and certain “internalized feelings” have become “” the expected behaviors that have become the accepted Normal expressions of grief. Strange as the phenomenon sounds, almost everything we experience is pretty much as it has been pushed over the past 6 decades the by Hollywood movie culture, and the soap opera scripting. Ironically , that has become the reality and education of many, especially those who lack any previous personal experience with the process of death and dying . We emulate what we have seen, until we have our own experiences to rely upon and learn coping skills from. Thank you for actually advocating for the processes for both the patient and the family....and for Nursing, too! Just one old retired nurse, Kitty😎😇
The hospice nurse that did my mom's admission was amazing. She spent plenty of time answering questions for me my cousin in person and then I called my aunt's that lived out of town and she took all of her time to answer everyone's questions. Getting my family on the same page from the beginning really made the process so much easier as the power of attorney. It was getting. Just getting very stressful to remember my aunt's questions and then remember the answers to this questions and sometimes those questions would cause more questions and so the hospice nurse really helped me manage all of that. The biggest blessing was being able to get more regular updates on my mom.
Thank you! 🌹I've been in love with my man for 30 years! I'm 18 years younger!!! He's just started slowing down a lot, he beats his self up! He still goes to work as a janitor and a landscaper!!! For a American legion! He gets home and is so sore. All he feels is over worked pain!!! He's 83. I'm 67, Ive loved this man for 30 years. I want to know when I need to get help? He is very stubborn, he helped me plant bulbs yesterday, that a neighbor gave us!!! I can't stop him from doing too much!!! But I know the after effects?! Thank you for the information!!! I will do the nurse thing!!! I think I will try and find a good one!!!🌹😘
Hi Nurse Julie - re: Editor. I'm a software engineer. Camtasia is a very affordable editing software that allows you to edit your videos. It's very easy to use, and you can use multiple tracks if you'd like a little intro music or to run another video while you're talking or if you need arrows or words on the screen. It will also allow you to save in your favorite media format. When you're done, you just upload your finished video like any other. Hope that is helpful advice 🙂.
Such a great educational video Julie! This is exactly how it went when I had my mom under Hospice at home care. Unfortunately, the need also occurred directly after a major hurricane here and we had no hospice nurses available because so much housing was destroyed. Our only nurse was the one available 24 hrs via phone, so after the initial visit, we were pretty much on our own. My mother passed within 8 days but no one ever came pick up the end of life medications the pharmacy sent over to us. Those were some powerful drugs too.
Mom was on hospice for less than 24h. (She went into hospice in the ICU.) Our hospice nurse was so kind. She kept us in the loop and told us what to look for to make sure Mom was comfortable. The nurse knew Mom wouldn't have long but I don't think she was expecting hours. (We don't hold that against the nurse. We stayed at Mom's side as Dad and I knew it wouldn't be much longer.) Her nurse did such a great job making sure Mom was comfortable and making sure Dad and I felt empowered to be Mom's advocate if Mom didn't look peaceful. ❤
"Hospice s about living." Excellent comment because until the brain waves stop it is still a quality of life matter. My question generally speaking what are indications the patient is ready for hospice? I wonder if well intedned families wait too long or quit too soon.
Because I am alone, your videos are such a comfort. Knowledge is power and having control over one's own death, no matter when, is really important. Thank you for all you are giving us. ❤
You are precious!!!! I just started as a hospice admission nurse. I have worked many years at the hospital. CVICU, Cath lab, case manager, house supervisor PRN only. CDI coding and now hospice admission nurse. I am 65. I am so thanks for this opportunity. I pray I can be at least half as good as you are. Thank you for this video. The charting is my biggest challenge. It is crazy. But I am ready to learn. ❤️
My 88 yr old daddy is in a Alzheimer’s unit . He has a 20+ yr history of TIA’S and had an ischemic stroke to his hippocampus in 2020. He has been put on hospice for CAD . His mixed dementia escalated quite drastically after his bigger stroke in July. Hospice has already came to my rescue when I needed to take daddy some new sweat suits and my 88 yr old momma called and was very Ill with the flu. The y man that originally came to my house to explain hospice, was out running errands on my side of town and was kind enough to come pick up daddy’s clothes. I took momma to dr and she tested positive for flu B. Unfortunately, as of right now, this local hospice doesn’t have any volunteers, so everyone is filling in with things a volunteer would normally do. I would volunteer but I already have plenty of plates spinning 😵💫. 1:23
I have a serious question. I do private home-based care. My client went on hospice. The hospice nurse only came once a week. I was thare everyday. Hospice would not come when called. Only gave us information over the phone. The family was so confused. I stayed and camped out on the floor for 3 nights. I would rum home in the afternoon for a few hours because I have my own family. I was thare for every change. Explaining what's going on. When the time came. Breathing change. I woke the family up. They were able to hold his hands as he took his last breath. My question is. Why doesn't hospice actually sit with the patient and family? I'm in Michigan.
Nurse Julie, this has been enlightening. My 92 year old Mom has been on hospice for 9 months. Congestive heart failure. Pulse ox 98% with oxygen. 90% without. Our family was not included in Mom’s decision and unaware of Mom being on hospice. No one will talk to us. My sister is PoA. Very upset by the process.
Your info is so valuable. My husband has stage 4 cancer. We are not near hospice time, but I don’t kid myself. I know how quickly that can change. I would appreciate if you can cover 2 things - how to choose a hospice, and how much it costs.
@@cindyvitale9515 So true. This is a very fine line indeed. Especially when they are still walking and talking. When my Dad was dying from kidney failure, my mom kept fighting to keep him alive. Any talk about letting him be comfortable without interventions were frown upon. As if stopping his treatments are the same as we want him dead and gone. The fact of the matter is he was dying and in the process of leaving. It's inevitable. My mom didn't get that. My poor Dad.
@@cindyvitale9515 Oh, dear. This must be very difficult. My husband is bedbound with COPD, he turns away any talk about the last wishes or will , just with a joke..... But I try sometimes again and again.🤗
My mother never received any of these things you are speaking of. They checked my mother for blood pressure only because I insisted on it. I wish we had all this by us. I know it wouldn't have changed the out come but it would really have made things so much easier for me.😔
Great information. Julie, could you talk about what you have to be able to do for someone on hospice at home like changing, bathing, etc. not everyone is able bodied enough to be able to change a bed with someone in it or change diapers. What does a family do about this especially if they aren’t rich enough to be able to afford 24/7 caregivers or nurses? Thanks for helping people understand this aspect of at home hospice.
Thank you so much for this. While we don't have a need for this right now, it is good to know. When the need arises, it's overwhelming and hard to mentally digest and especially when most people are very emotional at this sad time.
Thanks Julie for the info. I'm getting ready to sign up for hospice & I'm trying to get all the info I can. You have been very helpful. God bless you. Love you.
Sometime in the future it’s us, you and me who are going to be needing palliative care That’s how it goes , we’re all heading in that direction . Thanks for all the informative videos
@@susangoodman4925 I wish I go suddenly and quickly, I Don’t want to end up in a hospice needing palliative care and suffer the time I have left . I would rather take my own life
It became apparent that my mom was ready for hospice because she was not getting better and needed better pain control. Trips to the hospital we're not helping her get better and she needed much more care than what the nursing home could provide. I was concerned about my mom knowing that I was putting her in hospice. What ended up happening was that after the hospice admission took place (she was still at the same nursing home for hospice care) My mom smiling cheek to cheek. I asked my mom why she was so happy and she said "You got it taken care of". And I asked her what she meant by that and she said hospice. I'm thankful that my mom appreciated it. I can't say my mom was doing better in hospice but she was definitely feeling better and much more comfortable.
What can be really tricky is when your patient is also a retired nurse. And in my case, my Mom! So she often tells me what to do, but she has early dementia and when she request Hospice, this is along with “ go get my cigarettes “. I may not be a nurse, but I’m thinking “ not yet….” Thank you for this very helpful video!! Get some local honey on board for that tickle!! ❤️
Thank you. Been living with stage 3 metastatic thyca for 10yrs now. My heart isn't happy with all the high levothyroxine doses. It's incurable so they use surgery or radiotherapy for pain or if I get in trouble. I have never been offered anything. I just found out I was stage 3 like 3 years ago. I'm getting weaker the last couple years and appetite nothing sounds good, I eat once I try to 2 times daily. Especially your talk on DNR got me talking to my nurse hubby. Yes he is a real nurse as well lol. I think he is in doubt because I've been doing this 10yrs. I'm in bed 80% I would say.
@@Rebecca-1111 it's sounds like your husband will continue being a great dad after your journey end but I can see why that worries you. I have a special needs daughter too
Thank you sooooo much for doing these videos!!!!!! I sure wish I had seen your videos before my parents died. I took care of both of them before they died, my dad was months but my mother was 15 years. I can't tell you how many arguments we had because I wanted to "get them better", eat when they don't want to or take their medicine or swallow. I wish I had just let them be. Let them do what they would like. Eat or not, smoke or not etc. Anyway thank you for your videos!!!
Hi, Julie. This was very informative, and your videos are educational. My best friend was very ill. Her condition was ongoing with no signs of improvement. She called me one day and was upset stating that the hospice nurses were coming over. Sadly, we lived in different states and I couldn't physically be there for her. She called me shortly after starting hospice at home saying that she was no longer on hospice. I was confused by this and worried why her hospice was stopped. She told me "I am going to fight this" and I responded "of course." I was always her sounding board and I could hear the relief in her voice when I supported her. Even though I was worried for her I knew she was not going to go down without a fight and deal with this on her own terms. We were friends who served in the military together and were best friends for 40 years. She fought for quite a while and at the end she entered a VA hospice. Julie, question: when a patient is being evaluated to start hospice can the nurse suggest therapy or alert the team that it might be helpful for someone to visit a new hospice patient to assess them and help them adjust? I think that may have been helpful for my friend. Well, thank you for your service, Julie. Even though that's something we veterans hear, you are providing a valuable service to your audience. Keep up the good work!
I was a continuous care RN for 5 years. The way it actually works is there has to be an LPN or an RN in the home for 12 out of 24 hours. The other 12 hours can be done by an Aide, or the patient can have continuous care only at night. Usually a nurse is only provided around the clock if medication can’t be managed by the family, or the pt has an IV or requires more skilled care. The average length of time on CC is about 3 - 5 days, but it can be extended for as long as the team thinks it’s necessary. There’s more leeway than you would think. I worked for what is pretty much the largest hospice company in the country and this is how it was done.
I asked our hospice admission nurse if my dad was showing signs of actively dying because I learned about that here and she told me no but he died right after she left. I know it's just a guess but it still bothers me for some reason. She told me he wasn't showing any signs of actively dying. And the hospital doctor told me that by phone before he came home because I asked him too. I knew he didn't have long but I never expected him to not show any signs of actively dying and then died right away
Same here. I think the hospice nurse was surprised I knew the term to ask if my mom was in the actively dying stage the night before she died. She told me that her breathing hadn't changed and that she was still responding when they asked her questions. So things can change quickly and the nurses can be just as surprised.
At the point of your tickle you are just sooo freaking Cute! J love your personality and your face lights up when you talk. What a great Hospice nurse to have.
Excellent advice julie, my sister in law died from constantly drinking 12 years ago, before hand she was a stunning and fabulously good looking however her emotional state got the better of her and her belly ballooned she died 12 years ago seeing spider's crawling every where it was hard to watch. Doctors actually to her to her face that it was over and nothing else could be done for her ,😢
My dad was only on hospice for 3 days but for them 3 days they were wonderful for my dad it helped him with his pain. Iam so grateful for our hospice team❤
I wish you were our hospice nurse. The one who started coming for my mother in law told her she needs to eat and gain 15lbs but she really doesn’t want to eat much. She is 95 and has dementia. My MIL was really bothered by that because she has been eating what she can and it’s not easy for her.
With my dad was in the hospital and ready for hospice, they asked me to choose a hospice company. The hospice company I chose was related to the location that I wanted my dad and same for my mom. That definitely made the decision much easier
My area of expertise is the traditional HH RN visiting nurse. I have done hospice in the past, and I just completed an eight weeks local contract on hospice. I do have a somewhat difficult time for the first few weeks focusing on the actual needs of hospice patients against the hope and goal for improvement with the traditional area. Like BP is usually abnormal on someone who is dying, doing nothing and calling drs with the other expected to improve or stabilized patient program. I have to really get my focus straight and separate my two HH nursing purposes. Thanks, it is a good refresher for me.
My sister was doing okay, sat up and talked to us when we visited her at home , she was eating and watched tv, but her family decided to bring in hospice for support, She was drugged and slept all the time, never talked to us again, she died. No offense to you but that's when she seemed to get worse. No more conversations and no eating. Her condition wasn't that bad to begin with. No blame on hospice, they were wonderful but It happened to my other family member also. I don't understand?????
Wow, I was never told this. Spouse in facility, git a random call from some NP telling me to think about it, agreed, had that one for a few mos, went to another, and then was told he's chronic and has been off hospice about 11 mos. Never really needed it. Few benefits but wasn't worth the stress of both facility and hospice. Been crazy 2.5 yrs. I'd have to go look at info. Had a SW come to me both times. PD is so bad, especially after a brain bleed.
I'm a retired CNA, so I've been around the elderly when they were dying. I've watched many of your videos lately, so I was ready to give some answers when I needed to. I remembered the video where you said you came back the next day and the dying lady was sitting up in bed eating breakfast talking to her family and ended up passing a month later. I thought of this when this situation just happened to my sister. My 87 yr. old BIL just passed Feb. 7. I got a phone call on Feb. 1, telling me that my BIL was passing, it was just a matter of hours. I was told at that time that the funeral would tentatively be on Saturday. Two of his kids had flown home as quick as they could. The third one drove to the nursing home where dad was. He had been non-responsive for a couple days. All were at his bedside and apparently he heard their voices and came back around. My sister had left to go home and take a shower and when she got back the nurse told her that B. had woke up and asked for O.J. and was hungry. They walked him down to supper that night and he fed himself, eating his whole meal. Imagine the phone call the next day telling us that he rallied and was talking to his wife and kids. The next meal he didn't eat quite so much and then he quit eating and went right back to his non-responsive state like he was the week before. The only difference was this time my sister told me about him having the death rattle. I knew he would be gone very soon. He passed peacefully hours after I finished talking to my sister. I had told my sister that I thought he rallied because he heard his kids' voices. I told her it's the Miracle of Time. They all got that tiny bit of extra time to say, "Good-bye Dad," and have no regrets. My sister did say that B. was looking up at the corner of the room like he saw someone. Thank you Julie, for these videos. I've told numerous people to look up you videos.
My 91 year old father was on hospice and he was so mad about that. He didn’t want to admit that he was dying and was furious at us because we told his oncologist how he was really doing and not the “I’m fine” he was telling the oncologist. When the admissions nurses came to have the admission visit at their appointment., my mom and I met with the nurses and my dad pouted and refused to participate. Then the nurses came up to their apartment to take his vitals and he would not talk to them or let them touch him. He told them to get out of his house and they can’t make him participate. Every time they would come to visit and take his vitals and possibly adjust his pain meds. He died three weeks later. It came to a point where he could not fight them, which made it easier on my mom. He received the comfort meds and then passed in his sleep. It was a great experience for us even tho Dad actively fought the whole process. The nurses were great, so patient with this cranky old man and really provided emotional support for the family. I cannot sing their praises enough. Hospice is such a wonderful experience. God bless you for what you do! ❤
Not so "great" if it was great for the family and awful for the patient ...
Such valuable information. Thank you. Neither of my parents were in hospice. Dad passed from a massive stroke at 56. Mom passed unexpectedly the morning she was to be released from the hospital after a minor fall at almost 91.
Who made it awful? The patient. He did it to himself, choosing to make himself a burden for longer on his family instead of being realistic & accepting help from hospice people.
To be fair, there really isn't a lot of info out there until lately, so old people are still resistant or selfish about it.@@withgoddess7164
Mom was in hospice 6 days. It was the hardest 6 days I have ever spent in my life...the constant emotional walk to the end. I can't imagine families having to go through that with a child. How you and all the other hospice personnel manage it is beyond me. Thank you
It's a calling.
I’m so sorry for your loss , I’m going through something similar currently ❤ *gentle hugs *
@@Ginger_Sweet Prayers for you and yours.
My mom, and I'm 60 but my momies been gone for awhile. I appreciate 🙏 your comment
Seriously all you said. I can't even comprehend how it would be to be with your child😢😢😢bless all the ❤beautiful children always
My grandma was on hospice over a year. She just wouldn’t die. Was not ready. She finally went on 9-1-23 I miss her dearly . I saw the “death stare “ I basically spoke very loudly “I love you” said it numerous times. And it’s like she snapped out of it long enough to look at me and say “I love you too” and she went later that day. I know she is better dementia never robbed me of her knowing me for that I am grateful
My mother was in late stage dementia and had been talking to dead relatives for months. She kept asking to die when I made demands of the nursing home they couldn’t do and recommended hospice. I started the process immediately and 4 days later she was evaluated. When I told her she was being put on hospice she smiled and said thank you. Less than a week later she passed peacefully but I wasn’t there. The hospice nurse said they didn’t think she would go so quickly except sometimes patients need permission to die and my mother did. The aide had just left and she passed. I couldn’t have been happier for her, she’s at peace and no longer unable to do anything. I hope she’s in heaven with my dad dancing. Thank you for your videos. I’m trying to get my sister-in-law to discuss hospice for my FIL it’s so sad to see him suffer because the family isn’t ready to let him go.
BEAUTIFUL STORY K. YES, YOUR MOM IS IN HEAVEN DANCING WITH YOUR DAD ☺ I'M SO GRATEFUL THAT YOUR MOM WENT PEACEFULLY. YES, THEY DO NEED OUR PERMISSION TO GO SOMETIMES. OUR LOVED ONES NEED TO KNOW THAT WE WILL BE OKAY TOO. I WILL PRAY THAT YOUR SIL HELPS HER FIL BY GETTING HIM INTO HOSPICE. WE CANNOT BE SELFISH TO HOLD ON TO A LOVED ONE & MAKE THEM SUFFER BY KEEPING THEM HERE. WE HAVE TO LOVE THEM ENOUGH TO LET THEM GO. PEACEFULLY & IN NO MORE PAIN. GOD BLESS 🙏❤I
❤I absolutely love your channel, I have less fear and I an grateful for that. ❤ I feel like to actually go into hospice has to be very difficult to end all your treatments. 😢😢❤thank you for being so good to so many people
Julie, this was an amazingly appropriate, valuable, necessary, spot-on video. My goodness, thank you so, so much for doing what you do! I may have nailed this into the ground by being pedantic but, I'm a funeral director and I cannot with words express how invaluable this information is to EVERYONE! As I've said in previous comments, the majority of us are not prepared for dealing with the realities of death, an experience that literally none of us will escape. It is the case that we all experience this final scenario of our life in our individual ways but, if we are able to offer the best possible experience of this inevitability, why not take advantage of it? The information and awareness you are sharing is a critical component to all of us, around the world, being able to better understand the biological, physical, and fantastical ways we all come to our end, and how we can better prepare and settle our psychologies around it. I cannot thank you enough for what you are doing. You are essential! Thank you, thank you thank you!
And a thank you for all that you do to support families, loved ones and friends at this difficult time.
Perfectly expressed.
Wow you are AMAZING what a special lady you are 😊
You are very valuable nobody talks about the "Last Responders" as a nurse I can tell you esp. with old C. #19 you were also just as exhausted as we were . Thank you !
@@eugenepattivalitzski9757 It was certainly an intense experience for all of us in the broad scope of healthcare! Fingers-crossed we never have to do that again!
Downloaded this one. Having seen so many family members exist in denial until the very end, when their families stepped up and (most of the time) muddled everything because of lack of planning, I'm squirreling away research and information. HOPEFULLY, it won't be needed for another 10-20 years, but I intend to have a folder of facts to go by and directives in place.
I needed to see this video because I was not aware of what Hospice can --- and cannot do.
Mom is 97 and her kidney function is declining. She was hospitalized in Feb of this year, 2023 for 5 days.
I thought she was not gonna make it, but she has rallied and become more demanding, less kind, and overtly mean to me.
I haven't had relief or respite since my sisters left on the 17th March. Mom and both sisters say we can't afford to have someone stay w/mom if I am out of the house for 1/2 a day. This feels like I'm responsible for EVERYTHING.
Last week I oversleept on an morning when mom had an appointment.
She drove herself to the Dr. but was angry as hell when she got home.
Without any time off, living with mom has become my workplace.
Although I'm a retired RN, I'm 70 and feel exhausted a lot of the time.
I will contact our Home Health Case Manager to research options for respite care next week.
I don't know how you do it....this work is stressful and fatiguing!
So many families don’t know how to care give , CZcams provides lots of videos that show how to change a bed with someone in it, How to give a bed bath etc. how to safely transfer someone, just wanted to put that out there.
I love your videos- such courage to explain to us all how death works.Supporting a dying person is a privilege, a passage though challengeing times. Almost like a midwife in many ways. Western culture hides the realities of dying and death, and we take great care to keep everything hidden under the carpet. I grew up in Scotland with Irish heritage and dealing with death seemed more authentic to me as a child. Our loved ones would be placed at home in a open casket, and families, loved ones and friends were encouraged to pay our respects. It all seemed very natural to me. My grandmother died at home in her sleep, when I was around 4 years old. I was curious and asked to see grandma- still lying in bed with her nightdress on.. I was left alone for a while, stroked her silver hair and was curious to understand the process. It was not traumatic or upsetting in any way for me, and I can still remember that time with great fondness.
When we had had hospice came in for our first initial meeting, there was three of them along with my husband and myself . We were sitting around the dining room table talking it was a little tense when I noticed they kept looking at each other. I wondered what was going ! It was at that moment that I heard it our little pug was laying under my husbands feet, she was snoring and making these weird sounds as pugs do. We were so used to the noise we didn’t think anything of it. It was then that I knew what they were hearing her. I started to laugh very inappropriate at the time, but it sure broke the ice . I told them the noise you’re hearing is my pug she’s sitting under my husbands feet . You could see the relief on their faces. They said we wondering if it could be my husbands esophagus and stomach making that awful noise ! He had esophageal and stomach cancer, it sure broke the ice we were able to talk and ask all the questions we wanted ! Our hospice nurses where are the absolute best. We all had a great laugh ! Thank you for all your awesome and very informative videos.
OMGOSH, AT WHAT COULD BE A VERY STRESSFUL TIME, THIS IS SUCH A CUTE STORY 😂 I'M SO SORRY FOR YOUR BELOVED HUSBAND'S DIAGNOSIS. MY FATHER HAD THE SAME 😢 I HOPE THAT YOUR HUSBAND DIDN'T SUFFER. I HATE CANCER. IT TOOK BOTH OF MY PARENTS. NOW IT IS TAKING MY YOUNGEST DAUGHTER. MAY YOU FIND PEACE & GOD BLESS HOSPICE WORKER'S EVERYWHERE 🙏❤
I’m so sorry you are going through so much. Prayers for strength and blessings for your daughter. Cancer is such a hard thing. Thinking of you!
That was really helpful. We tried to get our mom into a nursing facility but they never responded, in the meantime she had to go into emergency, then was moved to palliative care, then into a hospice facility all in the same hospital (which I didn't know they even had), all within a little over a week until she passed. She had congestive heart failure, kidney disease, ,weeping edema, sepsis at the end. I do think the doctors and medical staff were reluctant to tell us how dire her condition was. Thankfully she passed quickly and peacefully with no pain and the hospice nurses were wonderful both at caring for her and keeping us informed. Thanks for what you do, Julie.
Thank you. My husband went into hospice last week. He has gbm, all treatments have been stopped. He is still able get around on his own and mostly understand what is happening (for now). I had a much different idea how hospice works. The video really helps understand the process even though the hospice social worker explained, I will watch again, (several times). Ive been watching your videos and each one gives me info and insight into the care of a dying patient and their families. Thank you for caring and all the effort and information you put into your videos ❤
I wish I found you when my mom was on hospice. Oh Julie, it was so hard. We didn't even know she was sick. She goes in to the ER end of October 2021 with an eye infection, falls down in there the next morning, breaks her hip, and then they find metastatic lung cancer. Sent to rehab, hated it. Finally came home and accepted the hospice. I was with her 24/7 (had the aid, and I would go to the store or whatever when she would come). I became so sick end of April, hospice nurse tested me for covid, I was positive. Wanted my mom at respite, she said no way. I said no. I masked up and did the best I could until around 4am that morning. I'm sitting on the toilet with the clothes hamper in front of me throwing up, and something SO strong came over me with the feeling that I had to send her to respite. She was so upset, and so was I. I promised her it would just be the 5 days. They took her later that day when a bed was available at our hospice respite place. She called me miserable, said her breathing was worse "But we won't talk about that" she said. I said mom, just give it one night, if you still hate it, I will tell them to bring you back. Next morning she calls me, all happy. "Oh they did my nails (I assume clipped, hers grew so thick and so fast), cleaned me up real good, I think I might come back here next week!" I was so happy that I could rest and recover and she would be ok. Next day phone in her room rang endlessly. Found out she was now "actively dying". I took the covid meds, had by that time reached the 5 days and could go see her. She was doing the same as the people in your videos, the rattle, the mouth open. I decided to go home to sleep, and after seeing her, I honestly hoped she would pass that evening. SW came back next morning to take me back, she passed on our way in. A few hours after my brother went up to see her. The plan was for her to pass at home, but after seeing her, and not being prepared for that image, I really don't think I could have handled it. I feel like I was given covid for a reason. I am still bothered that she passed without me. I hope she was okay. That lady was my very best friend. Partners in crime. Her hospice nurse and SW were AMAZING. Thank you for what you do!
Once again, this video could and should be used as a course key for palliative, hospice and end-of-life care training! I so wish you were my Momma's nurse almost 15 years ago, have mercy it would have been a lot better all around. Bless you and thank you from the bottom of my heart! 🕊️🙏❤️🕯️
You were reading my mind!
Ive been wondering about your admission process.
I a 30 yr nurse now a Hospice Admission Nurse.
I consider you a mentor Julie, keep it coming you are awesome.
Thank you!!! And I’m so glad you’re here!
@@hospicenursejulie I LOVE YOU TOO JULIE ♥ MY BEAUTIFUL DAUGHTER HAS ENTERED HOSPICE. YOU ARE ALL A GODSEND. CAITLYN WANTS TO BE AT HOME & COMFORTABLE. WE WILL HONOR HER WISHES WITH RESPECT. I KNOW THAT MY BABY GIRL IS IN GREAT & LOVING HANDS. PLUS SHE GETS TO BE NEXT TO HER FIANCÉ & BABY GIRL EVERYDAY. WE ALL LOVE HER SO MUCH. GOD BLESS YOU NURSES 🙏♥
What a blessing you are to those under your care and to their families. Thanks for continuing to educate us.
Thank you. Your calm conversation and clear explanation is needed by so many. What a blessing you are!
I've said this before and I'll say it again. I love you Nurse Julie ♥️
You give such comfort. Bless you.
Another great video Julie! We just got Dad home today after 6 weeks in hospital for Covid organizing pneumonia. He is 92. GP said he would never come home as he is now on 24/7 O2 at 2L. Said if released will go to nursing centre YIKES. His desire is to be home. So glad he is home. We cook, clean, give meds, supervise washroom and shower time. Asked his hospital Dr about home care and hospice. He was SO SHOCKED I even asked about palliative or hospice care?! Like little young Dr he is 92 survived Covid and has severe lung damage, he not surviving long. He has a clear health directive. So guess no support! We are in Canada.
Thank you for making this video for us. My dad has CHF, and has just been offered hospice services, now he's dealing with organ failure. We're meeting the hospice team today at the hospital and this information has been very helpful. Thank you for the many other videos on death and dying as well.
Another stellar video so many people are going to be helped by this Julie thank you!!
Thank you
I worked as a hospice nurse in vermont. I do feel that the patient's Dr. should have taken the time to explain the time she had left to patient and family. It gives them more time to grieve and to go through the stages of knowing and preparing for this stage of life ending.
The hospice team we had, included a music therapist every other week. The man I cared for loved this! For about a 1/2 hour he got to sing along or listen to a therapist playing guitar/singing , and play instruments like drums or bells or Moroccas if he wanted. It gave him so much joy.
My father in law had colon cancer that spread throughout his body. He was in hospice for a few months. When he got close to dying he went to the hospice center . Once he was pronounced dead by a hospice nurse and she vocally said he’s gone he sat up in bed and said no I’m not. Then a few seconds later she checked again and he was gone. We were all shocked but knew he would have the last word always even till the end.
Can you please make a video about/discussing admission criteria between inpatient free-standing hospice facilities and home hospice? I had several relatives die in a hospice facility vs. being at home. It was a very good experience. Only one relative had home hospice and it left her adult children traumatized, they had no medical background yet had to do injections and other things including sitting there while their mother died and the hospice nurse sat in her car. Totally bizarre!! The nurse said she didn’t like death. What?! 😳 Clearly a terrible nurse and agency. My cousin said she would’t come in the house until the mom died! I am an RN and I was appalled.
So sorry that your experience with home hospice was so traumatic . Were the people in a dedicated hospice unit admitted for symptom management or were they in a facility such a a nursing home and then elected to go on hospice care ?
Sorry to hear this! I think that nurse should be reported, and go into a different line of nursing.
Hospice nurses are called and usually love their work, as it is so meaningful.
That's how the hospice nurses were when my dad had terminal agitation. He was pacing the house and wouldn't sit or lay still .They came and kept uping a medicine until he was in a coma state. When I asked how long do you think he has left and a nurse told me 24 hours. A nurse showed my 75 year old mother how to crush his pill medicine to a powder consistency and add water and then use a syringe without the needle and fill the syringe to a certain dose and how to slowly push the syringe medicine slowly into his mouth. How often to give him numerous meds. My 75 year old mother couldn't do that because she has tremors in her hands , so guess who had to give give my Dad his medicines some every 2 hours leading up to his death 11 hours later , yep I did and I held his hand and talked to him even though the medicine put him in a coma state. I did that alone throughout the night until he passed away early that next morning. My mother was exhausted so she got some sleep. Giving my dad all his medicine leading up to his death was traumatizing to me. I felt one of the 3 nurses should've stayed overnight with him being they said he had 24 hours and he passed away in 11 hours. I read online that when a patient has terminal agitation it's considered an emergency and my Dad should've gotten 24 hour continus around the clock hospice nurse care that night . I wanted to be with my dad when he died , but I was also grieving and upset that he was soon going to be gone and felt family should not be the one to also administer and give him all his end of life medicines after 3 hospice nurses had a very hard time controlling his terminal agitation. The part of giving my dying Dad all of his end of life medicine was very traumatizing to me, but I did it for my mom and Dad.
Is that normal procedure for family to give end of life medication after having a very hard time controlling his terminal agitation ??
Edit: It's now been 3 weeks and I haven't received an answer to my last question. My guess is my father didn't get proper hospice care at the end , during and after his terminal agitation which had him pacing the house nonstop for hours. The nurses had a hard time stopping his terminal agitation and kept upping the med until he was laying in bed in a coma state and couldn't talk. We were told by 3 nurses that he had only 24 hours to live and the nurses showed me how to crush his pills , mix in water , put it a syringe and how to give it to my dad and how often . They put me in charge of giving my father his last 24 hour end of life medication and all 3 nurses left at 10 pm. He died 11 hours later.. I read on a hospice website that terminal agitation is to be considered an emergency and requires 24/7 around the clock in home hospice care that he/his family didn't get . I was left very tramatized giving my father his last 24 hour meds while grieving he was soon going to be gone. After my dad died; I questioned his end of life medication and how often he got his morphine pain meds. I was told to give it to him every 2 hours. Every 2 hours is a lot because any pain med I've ever gotten has always been every 4 hours to every 6 hours and don't take it more of it or more often or you can overdose especially elderly people who are more prone to overdosing. Which had me wondering if he actually died from an overdose of morphine medicine every 2 hours ?? and I was the one that overdosed him ?? He also took 2 other medicines. Lorazepam and a med that starts with an H , I can't remember the name, but if I saw it I would recognize it.
Another thing I questioned about hospice is when my dad was living a lot longer than expected , he was going out to eat every day . He wasn't in pain . He had pancreatic cancer and after surgery he became diabetic. When he was feeling good the hospice nurse told my mom to stop giving him his insulin and take no vitamins ! I told my mom to keep giving him is vitamins they won't know and do not stop his insulin . Tell them you will not stop while he's doing good. She told the nurse we will not stop his insulin and she didn't have anything else to say about it. Why would they want insulin stopped when he was doing good ?!? I was shocked . He kept getting his insulin to the end. Our experience wasn't good with hospice and with what I saw , im convinced my dad lived a lot longer being at home where family could control how he was treated than if he was in a hospice hospital setting and you are not there to 24/7 to see what they're doing .
This is soooo important for EVERYONE to see!
Thank you so much Julie for the info my mom just started hospice for heart failure 😢 I am so thankful for you for posting this info it has really helped me to understand 👍🏻
I love watching you Julie ...I wish you were around fifteen years ago when my Mom passed. I would have learned so much from you, keep up the video's they are great.😊
As a hospice nurse, I had been accused of being too technical on a resident by the family. I was taken aback by this, and realized that the family just want their loved ones to be cared for with compassion, while they rest.
God Bless You Julie. You are wonderful.
You are one cool Hospice Nurse,saying how 'it' is,confident ,knowledgeable,caring in such a way that families feel cared for if that makes sense! 😊
Oh Julie, you are a delight! My husband’s hospice team was wonderful! He is gone now but your videos are cathartic and I still watch them.
I was my daughter's hospice caregiver until her last few days and couldn't control her pain.When it was time to take her to the hospice facility it took almost half an hour to walk through the doors, I laterally froze. I knew I'd be leaving alone
I'm soooo sorry for your loss. That is devastating
So sorry for your loss
So sorry you had to go through that.
@@carolmartin4413 🤗
@@ssjess2504 🤗
Thank you Julie for what you do!! Our Dad was in hospice for a day and a half! We were not expecting that!!
He was Gone before we knew it!! It was so hard!! But we so appreciate the Nurses from his VA hospital who cared enough to come over there and be with us!!!
We had hospice for my mother in 2010, but we literally took care of her. We had a great hospice nurse. We were 7 children, so we all were my mother's caregivers. The nurse came like every other day or whenever. We needed her. She told us she had never seen such great care we gave our mother. I miss my mom still, but thanks to our other caregivers who helped us and the hospice nurse, my mother went peacefully
Great video Julie! Perfectly explained. I’m going to send this to my neighbor who is dealing with the stage 4, brand new Dx of her brother, and she is struggling with that plus being unable to constantly be there to help him.
We are in Northern California,north of the Napa County region...and the brother is on a smaller island in Hawaii. Quite an expensive journey, but she already has done her best to do “her part” , and that has been responsible for minimizing, or alleviating the first trigger of the “guilt stages” that tend to be self induced, or culturally or personally expected.
Sadly, much of the “ guilt” has become the “norm” in today’s society. Often, family and close friends tend to fall into patterns of behavior simply due to what they’ve seen on television;. and certain “internalized feelings” have become “” the expected behaviors that have become the accepted Normal expressions of grief. Strange as the phenomenon sounds, almost everything we experience is pretty much as it has been pushed over the past 6 decades the by Hollywood movie culture, and the soap opera scripting. Ironically , that has become the reality and education of many, especially those who lack any previous personal experience with the process of death and dying . We emulate what we have seen, until we have our own experiences to rely upon and learn coping skills from.
Thank you for actually advocating for the processes for both the patient and the family....and for Nursing, too!
Just one old retired nurse, Kitty😎😇
Your content is so helpful to me as a hospice nurse! Thank you!
The hospice nurse that did my mom's admission was amazing. She spent plenty of time answering questions for me my cousin in person and then I called my aunt's that lived out of town and she took all of her time to answer everyone's questions. Getting my family on the same page from the beginning really made the process so much easier as the power of attorney. It was getting. Just getting very stressful to remember my aunt's questions and then remember the answers to this questions and sometimes those questions would cause more questions and so the hospice nurse really helped me manage all of that. The biggest blessing was being able to get more regular updates on my mom.
Thank you ! Thank you ! So so much for all of this info nurse Julie!
Just love you.. ♥️🤗🤗👍👍😊 have a good night..🙂
♥️♥️♥️♥️
Love your videos . I watch so hopefully I can get rid of my fear of dying. Still extremely scared but Love watching
Thank you! 🌹I've been in love with my man for 30 years! I'm 18 years younger!!! He's just started slowing down a lot, he beats his self up! He still goes to work as a janitor and a landscaper!!! For a American legion! He gets home and is so sore. All he feels is over worked pain!!! He's 83. I'm 67, Ive loved this man for 30 years. I want to know when I need to get help? He is very stubborn, he helped me plant bulbs yesterday, that a neighbor gave us!!! I can't stop him from doing too much!!! But I know the after effects?! Thank you for the information!!! I will do the nurse thing!!! I think I will try and find a good one!!!🌹😘
Fwiw, very few people, if any, care about editing out coughs, errors or mistakes of any kind.
You are awesome. ❤️🍀
Hi Nurse Julie - re: Editor. I'm a software engineer. Camtasia is a very affordable editing software that allows you to edit your videos. It's very easy to use, and you can use multiple tracks if you'd like a little intro music or to run another video while you're talking or if you need arrows or words on the screen. It will also allow you to save in your favorite media format. When you're done, you just upload your finished video like any other.
Hope that is helpful advice 🙂.
Such a great educational video Julie! This is exactly how it went when I had my mom under Hospice at home care. Unfortunately, the need also occurred directly after a major hurricane here and we had no hospice nurses available because so much housing was destroyed. Our only nurse was the one available 24 hrs via phone, so after the initial visit, we were pretty much on our own. My mother passed within 8 days but no one ever came pick up the end of life medications the pharmacy sent over to us. Those were some powerful drugs too.
Mom was on hospice for less than 24h. (She went into hospice in the ICU.) Our hospice nurse was so kind. She kept us in the loop and told us what to look for to make sure Mom was comfortable. The nurse knew Mom wouldn't have long but I don't think she was expecting hours. (We don't hold that against the nurse. We stayed at Mom's side as Dad and I knew it wouldn't be much longer.) Her nurse did such a great job making sure Mom was comfortable and making sure Dad and I felt empowered to be Mom's advocate if Mom didn't look peaceful. ❤
"Hospice s about living." Excellent comment because until the brain waves stop it is still a quality of life matter. My question generally speaking what are indications the patient is ready for hospice? I wonder if well intedned families wait too long or quit too soon.
THANKS FOR SHARING YOUR BRAIN WITH US!!!
Great video----I have learned so much Thank You.
Glad it was helpful!
It's people like you that make this world a better place ❤️
Because I am alone, your videos are such a comfort. Knowledge is power and having control over one's own death, no matter when, is really important. Thank you for all you are giving us. ❤
You are precious!!!! I just started as a hospice admission nurse. I have worked many years at the hospital. CVICU, Cath lab, case manager, house supervisor PRN only. CDI coding and now hospice admission nurse. I am 65. I am so thanks for this opportunity. I pray I can be at least half as good as you are. Thank you for this video. The charting is my biggest challenge. It is crazy. But I am ready to learn. ❤️
Not me getting an ad right after you say got it- lol. 😂
My 88 yr old daddy is in a Alzheimer’s unit .
He has a 20+ yr history of TIA’S and had an ischemic stroke to his hippocampus in 2020.
He has been put on hospice for CAD .
His mixed dementia escalated quite drastically after his bigger stroke in July.
Hospice has already came to my rescue when I needed to take daddy some new sweat suits and my 88 yr old momma called and was very Ill with the flu.
The y man that originally came to my house to explain hospice, was out running errands on my side of town and was kind enough to come pick up daddy’s clothes.
I took momma to dr and she tested positive for flu B.
Unfortunately, as of right now, this local hospice doesn’t have any volunteers, so everyone is filling in with things a volunteer would normally do.
I would volunteer but I already have plenty of plates spinning 😵💫. 1:23
I have a serious question.
I do private home-based care. My client went on hospice. The hospice nurse only came once a week. I was thare everyday. Hospice would not come when called. Only gave us information over the phone. The family was so confused. I stayed and camped out on the floor for 3 nights. I would rum home in the afternoon for a few hours because I have my own family. I was thare for every change. Explaining what's going on. When the time came. Breathing change. I woke the family up. They were able to hold his hands as he took his last breath. My question is. Why doesn't hospice actually sit with the patient and family? I'm in Michigan.
GOD BLESS YOU TONYA JEAN 🙏❤
Nurse Julie, this has been enlightening. My 92 year old Mom has been on hospice for 9 months. Congestive heart failure. Pulse ox 98% with oxygen. 90% without. Our family was not included in Mom’s decision and unaware of Mom being on hospice. No one will talk to us. My sister is PoA. Very upset by the process.
Thanks again Julie for the information.
You are so welcome!
Your info is so valuable. My husband has stage 4 cancer. We are not near hospice time, but I don’t kid myself. I know how quickly that can change. I would appreciate if you can cover 2 things - how to choose a hospice, and how much it costs.
Maybe you can get already non binding offers of 2 or 3 companies in your region, and ask all questions?
@@kathidori8504 yes. The trick is to do it without my husband knowing. It would freak him out.
@@cindyvitale9515 So true. This is a very fine line indeed. Especially when they are still walking and talking. When my Dad was dying from kidney failure, my mom kept fighting to keep him alive. Any talk about letting him be comfortable without interventions were frown upon. As if stopping his treatments are the same as we want him dead and gone. The fact of the matter is he was dying and in the process of leaving. It's inevitable. My mom didn't get that. My poor Dad.
@@cindyvitale9515 Oh, dear. This must be very difficult. My husband is bedbound with COPD, he turns away any talk about the last wishes or will , just with a joke.....
But I try sometimes again and again.🤗
@@kathidori8504 It seems we have to meet them where they are. I’m learning how to do that with these videos.
My mother never received any of these things you are speaking of. They checked my mother for blood pressure only because I insisted on it. I wish we had all this by us. I know it wouldn't have changed the out come but it would really have made things so much easier for me.😔
Starting my new job as an Admissions RN for a hospice company next month and this was a great video! Thanks Julie!
Great videos. This work is brilliant
Great information. Julie, could you talk about what you have to be able to do for someone on hospice at home like changing, bathing, etc. not everyone is able bodied enough to be able to change a bed with someone in it or change diapers. What does a family do about this especially if they aren’t rich enough to be able to afford 24/7 caregivers or nurses? Thanks for helping people understand this aspect of at home hospice.
Yes yes yes- I will make a video about this- thank you!!
Thank you so much for this. While we don't have a need for this right now, it is good to know. When the need arises, it's overwhelming and hard to mentally digest and especially when most people are very emotional at this sad time.
Thanks Julie for the info. I'm getting ready to sign up for hospice & I'm trying to get all the info I can. You have been very helpful. God bless you. Love you.
Sometime in the future it’s us, you and me who are going to be needing palliative care
That’s how it goes , we’re all heading in that direction .
Thanks for all the informative videos
unless we go suddenly or quickly.
@@susangoodman4925 I wish I go suddenly and quickly, I Don’t want to end up in a hospice needing palliative care and suffer the time I have left . I would rather take my own life
@@Paralyzer I understand.
Great video with lots of really good information
Happy you’re here! Thank you!
It became apparent that my mom was ready for hospice because she was not getting better and needed better pain control. Trips to the hospital we're not helping her get better and she needed much more care than what the nursing home could provide. I was concerned about my mom knowing that I was putting her in hospice. What ended up happening was that after the hospice admission took place (she was still at the same nursing home for hospice care) My mom smiling cheek to cheek. I asked my mom why she was so happy and she said "You got it taken care of". And I asked her what she meant by that and she said hospice. I'm thankful that my mom appreciated it. I can't say my mom was doing better in hospice but she was definitely feeling better and much more comfortable.
I used to tell them it will be "longer than I think and shorter than I hope".
What can be really tricky is when your patient is also a retired nurse. And in my case, my Mom! So she often tells me what to do, but she has early dementia and when she request Hospice, this is along with “ go get my cigarettes “. I may not be a nurse, but I’m thinking “ not yet….” Thank you for this very helpful video!! Get some local honey on board for that tickle!! ❤️
Thank you. Been living with stage 3 metastatic thyca for 10yrs now. My heart isn't happy with all the high levothyroxine doses. It's incurable so they use surgery or radiotherapy for pain or if I get in trouble. I have never been offered anything. I just found out I was stage 3 like 3 years ago. I'm getting weaker the last couple years and appetite nothing sounds good, I eat once I try to 2 times daily. Especially your talk on DNR got me talking to my nurse hubby. Yes he is a real nurse as well lol. I think he is in doubt because I've been doing this 10yrs. I'm in bed 80% I would say.
So sorry you're going through that
@@ssjess2504 thank you 🤗. I'm really ok just don't want to leave my children 1 has autism and my hubby is a nurse
@@Rebecca-1111 it's sounds like your husband will continue being a great dad after your journey end but I can see why that worries you. I have a special needs daughter too
@@Rebecca-1111 I hope you continue to have lots of good days to come ❤️🙏
@@ssjess2504 thank you.
Thank you sooooo much for doing these videos!!!!!! I sure wish I had seen your videos before my parents died. I took care of both of them before they died, my dad was months but my mother was 15 years. I can't tell you how many arguments we had because I wanted to "get them better", eat when they don't want to or take their medicine or swallow. I wish I had just let them be. Let them do what they would like. Eat or not, smoke or not etc. Anyway thank you for your videos!!!
Hi, Julie. This was very informative, and your videos are educational. My best friend was very ill. Her condition was ongoing with no signs of improvement. She called me one day and was upset stating that the hospice nurses were coming over. Sadly, we lived in different states and I couldn't physically be there for her. She called me shortly after starting hospice at home saying that she was no longer on hospice. I was confused by this and worried why her hospice was stopped. She told me "I am going to fight this" and I responded "of course." I was always her sounding board and I could hear the relief in her voice when I supported her. Even though I was worried for her I knew she was not going to go down without a fight and deal with this on her own terms. We were friends who served in the military together and were best friends for 40 years. She fought for quite a while and at the end she entered a VA hospice. Julie, question: when a patient is being evaluated to start hospice can the nurse suggest therapy or alert the team that it might be helpful for someone to visit a new hospice patient to assess them and help them adjust? I think that may have been helpful for my friend. Well, thank you for your service, Julie. Even though that's something we veterans hear, you are providing a valuable service to your audience. Keep up the good work!
I was a continuous care RN for 5 years. The way it actually works is there has to be an LPN or an RN in the home for 12 out of 24 hours. The other 12 hours can be done by an Aide, or the patient can have continuous care only at night. Usually a nurse is only provided around the clock if medication can’t be managed by the family, or the pt has an IV or requires more skilled care. The average length of time on CC is about 3 - 5 days, but it can be extended for as long as the team thinks it’s necessary. There’s more leeway than you would think. I worked for what is pretty much the largest hospice company in the country and this is how it was done.
God Bless you nurse Julie. My mom's 84 and tired. I hope she gets the care you give here in Australia
With my dad we only had the hospice admission nurse out because he died 2 hours after she left. But the admission went exactly like you described
Mwaaaaaaaah 💋 love you nurse Julie you are awesome ❤️🙏
I asked our hospice admission nurse if my dad was showing signs of actively dying because I learned about that here and she told me no but he died right after she left. I know it's just a guess but it still bothers me for some reason. She told me he wasn't showing any signs of actively dying. And the hospital doctor told me that by phone before he came home because I asked him too. I knew he didn't have long but I never expected him to not show any signs of actively dying and then died right away
Same here. I think the hospice nurse was surprised I knew the term to ask if my mom was in the actively dying stage the night before she died. She told me that her breathing hadn't changed and that she was still responding when they asked her questions. So things can change quickly and the nurses can be just as surprised.
At the point of your tickle you are just sooo freaking Cute! J love your personality and your face lights up when you talk. What a great Hospice nurse to have.
What a cool lady! Great story 😊
Excellent advice julie, my sister in law died from constantly drinking 12 years ago, before hand she was a stunning and fabulously good looking however her emotional state got the better of her and her belly ballooned she died 12 years ago seeing spider's crawling every where it was hard to watch. Doctors actually to her to her face that it was over and nothing else could be done for her ,😢
You are Truly an Angel. Please keep up as long as you can. Don’t be hard on yourself. EVER.
❤
Thank you very much
I thank God for hospice. If I am wrong God forgive me but I don't want anyone to suffer
My dad was only on hospice for 3 days but for them 3 days they were wonderful for my dad it helped him with his pain. Iam so grateful for our hospice team❤
I wish you were our hospice nurse. The one who started coming for my mother in law told her she needs to eat and gain 15lbs but she really doesn’t want to eat much. She is 95 and has dementia. My MIL was really bothered by that because she has been eating what she can and it’s not easy for her.
Julie, you are amazing! Thank you for the information!
Wow, I wish you had been the one to admit my dad into hospice. Very little of what you said was relayed during his time with hospice.
Hi Julie! Minnesota hospice nurse here again. Love the video as well as the tickle in your throat 😅
My brother went through Hospice in 2011 and passing in 2012. They were a wonderful service.
With my dad was in the hospital and ready for hospice, they asked me to choose a hospice company. The hospice company I chose was related to the location that I wanted my dad and same for my mom. That definitely made the decision much easier
You are such a kind loving person to give of yourself in this fashion
Thank you for discussing this!
What happens if the patient doesn't have anyone to be with them, but they want to die at home?
My area of expertise is the traditional HH RN visiting nurse. I have done hospice in the past, and I just completed an eight weeks local contract on hospice. I do have a somewhat difficult time for the first few weeks focusing on the actual needs of hospice patients against the hope and goal for improvement with the traditional area. Like BP is usually abnormal on someone who is dying, doing nothing and calling drs with the other expected to improve or stabilized patient program. I have to really get my focus straight and separate my two HH nursing purposes. Thanks, it is a good refresher for me.
My sister was doing okay, sat up and talked to us when we visited her at home , she was eating and watched tv, but her family decided to bring in hospice for support, She was drugged and slept all the time, never talked to us again, she died. No offense to you but that's when she seemed to get worse. No more conversations and no eating. Her condition wasn't that bad to begin with. No blame on hospice, they were wonderful but It happened to my other family member also. I don't understand?????
I just started watching you. You are very clear and helpful. Thank you for sharing your super power! :)
No worry about the coughing! I’m the same way when I do a video! LOL Great info! Thanks!
What if you have no caregivers? Who changes diapers?
I’m on hospice and you’ve really helped me by your videos I enjoy them I thank you ❤
Wow, I was never told this. Spouse in facility, git a random call from some NP telling me to think about it, agreed, had that one for a few mos, went to another, and then was told he's chronic and has been off hospice about 11 mos. Never really needed it. Few benefits but wasn't worth the stress of both facility and hospice. Been crazy 2.5 yrs. I'd have to go look at info. Had a SW come to me both times. PD is so bad, especially after a brain bleed.
now that i listen all the way i think it was dilantin..anti seizure..that makes sense...
This was so helpful! Thank you.