How do you educate both the patient and the family on practices in hospice? (ie: no iv fluids)

I explain to both the patient and their family that as they are going through the process of dying the bodies systems begin to slow down eventually shutting down. If you give IV fluids the body cannot process it and the fluid will eventually go into the spaces outside the cells filling the lungs and tissue up with fluid in essence drowning them. It can be a painful death or a peaceful death if done correctly with medication and family support

At end of life, the body naturally stops wanting or needing food and fluids. To give fluids or nutrition artificially can cause negative symptoms for the patient. It's important for family to understand this and to be reassured that it is okay to not give fluids, that it is the natural process of dying and that giving fluids does not really prolong life and can cause discomfort for the patient. Reevaluate goals with the family and find out why they want fluids. Is it because they think they are causing their loved one pain/discomfort? Usually families are ok once they are allowed to verbalize their feelings and their fears are addressed. If a family insists on artificial hydration, subcutaneous is the best way to proceed. It infuses really slowly, no iv access, and allows the family to feel like they are doing something positive for the patient.

Be up front, discuss pros to cons in relation to the bodies ability at end of life to react to extra fluids, natural process of body at end of life

IV's can be ordered on a case to case basis for gentle hydration if patient has had this in the past. But also know, it will probably stop at some point.

Many hospice providers have brochures that they use to help explain hospice practices to pts/families.
Also - you can explain very open-ended - by saying hospice provides care to alleviate symptoms & make a pt comfortable & then answer specific questions voiced by pt/family.

Different hospice providers allow different treatments they define as palliative so sometimes it’s better to allow the hospice rep to answer questions of the pt/family.

You just need to explain clearly that as the body prepares to transition it no longer needs all the excess intake. The patient does not have an appetite due to lack of mobility and slowing the bodily systems. The amount of supplements that actually would get absorbed into the body diminishes as their bodies shut down and as long as you keep them comfortable that is all that matters.

It is very hard for families to let go, but the hardest this is the honesty in which you answer and the explanations some times are repeated. Never ever lie families do know what is happening but acceptance is so hard

This one can be tricky. Many times in hospice, your patient suffers from dementia or some other type of cognitive deficit. Because of this, much of your education is primarily for the family. However, in the exceptional case, you often will find the alert and oriented patient who chose hospice is more accepting of their impending death. They have thought it through, and have chosen the route of no intensive treatments or hospitalizations. It can be difficult to educate families, but I find that if I make my explanations layman friendly, families are generally very receptive to truthful explanations. They are often very appreciative of someone being "straight" with them instead of sugar-coating things. The patients are usually grateful for this, as well.

You need to start education at the hospice introduction. We are here to provide you and you family comfort. How long someone has left is an estimate. The goals of hospice are pain management, quality over quantity of life. The greatest hospice issues come with revocation from lack of eduction.

Well first of all you need to explain to them that Hospice is not meant to prolong your life or cure an illness. The benefits of Hospice are to provide comfort measures and support for the patient/family.

Primarily the hospice vision and practices are explained to the patient and family by a sales team or hospice care consultant. In the event that the family elects hospice care and an episode arrives in which the family request a service that is not provided by hospice or do not understand why a service is not an option for a hospice patient the nurses get the provider involved in explaining why this would not be an appropriate solution. If the patient and family cannot agree of course they have the right to revoke hospice services at any time. Mainly we ensure that the patients and families are educated on what services are provided and not provided prior to agreeing to services. Nurses are responsible for ongoing education related to their admitting diagnosis, functional and mental decline, maintaining comfort, comorbidities, and etc. The nurses are supported by medical social workers, volunteers and chaplains for additional support and help maintain the patient and family relationship.