A 100 year old female with a broken hip needs a Foley.
Maybe yes. But if they were told NO, then it should have been NO. WHich was my question, not if she needed it.
Turning her every time she needs to void is going to cause extreme pain.
Diapering her so that the urine sits against her skin causing it to break down into a bedsore is going to cause extreme pain, not to mention death, not to mention that the hospital is going to get blamed for not taking good care of her.
Having to change that diaper every time she is wet is going to cause extreme pain.
She is in a diaper no matter what. Having the foley doesn't take away her diaper.
A 100 year old female with dementia may have been screaming during a Foley insertion for a number of reasons beyond pain....fear, embarrassment, not understanding what was going on.
If she was screaming in pain, then I would agree with you that the nurses should have premedicated her with pain medicine or something to relax her...however, the concern with that in someone who is 100 years old is that they are 100 years old. Giving a lot of medication to someone who is 100 years old can be dicey at best. Medication affects the elderly far differently than younger people....It can be a "darned if you do and darned if you don't" situation.
The nurses should have followed what the family said. They have her POA and they ignored the request.
Your friend in the ER doesn't really have any pull or power elsewhere in the hospital. Frankly, if the ER chief came up to my floor to intrude in the care of one of his personal friends he'd be told to go back and run his department and let us run ours.
Well the chief wouldn't have gone to the floor, he would have spoken to their bosses. He has offered to help us in the past with any needs we might have in the hospital, whether it be in the ER or the hospital in general.
You didn't ask opinions on the surgery but I'm going to throw one out there. You stated above that if she has the surgery she probably won't survive it and if she doesn't have the surgery she'll probably die in a few months. My question would be "then why put her through surgery?"
I didn't ask since it is not my choice and I don't need anyone elses opinions about that, it is the choice of my fil, ultimately and my DH and bil if they differ in opinions. There was no choice. If we don't do the surgery then she will die a cruel inhumane death by rotting in bed (the words of her doctor, not the surgeon). Any surgery on a 100 year old women is high risk. But when she had her other hip replaced years ago, the anestisia/anesntsist almost killed her. So they would rather risk her death in surgery to give her fighting chance at a humane painless life then being bedridden.
She probably won't survive the surgery.
If she survives the surgery, what do they expect in terms of her recovery? Was she walking prior to this event? Was she able to care for herself? Was living independently or semi-independently? if she survives the surgery, will she be back to some sort of functional status or will she just be in less pain? And pain relief may be a good reason to do the surgery, but I think you all need to get an idea of what realistic expectations to have post-operatively if she survives, what will her quality of life be, how will she be cared for and by whom? In other words, what positive thing will this surgery do for her?
Yes, she was walking, with a walker, sometimes without, but she needed it. She lives in her condo with 24/7 care. She lives 10 minutes from her son, and her two grandsons, and two of her great granchildren. She usually has no idea who we are. But my DH said that when I walked into her hospital room last night, she lit up and said hello, which she hadn't been doing. She was also very happy to see her great grandchildren. Recovery?? Hopefully that she wouldn't be bedridden and would still be able to get around and be mobile, even in a limited capacity.
To be perfectly honest I think most of us were hoping she wouldn't survive the surgery and could be at rest and peace for her own sake. But that is not why the surgery was approved. It was approved so that if she did survive her quality of life would be similar to what she had before she fell.
If this were my 100 year old grandmother with dementia (and I am aware that it is not), I would think long and hard about putting her through a surgery that might kill her as opposed to doing what is neccesary to keep her comfortable and take care of her.
Not doing the surgery would be subjecting her to rotting in bed in pain and on constant pain meds. I can't think of a more cruel way to die or to do to a loved one.
In any event, I wish you well. These are not easy discussions to have or decisions to make. Just be certain you are looking at your grandmother's whole picture, quality of life etc. Sometimes the last loving thing we can do for someone is to let them go.....