[Dysphagia] IV hydration

[nando11504 at hotmail.com (nando poppy)]

i work in a long term care facility and we no longer use waivers as my 
administrator says they do not hold up in court.  the best thing to do is 
present the information, give literature to families and patients, and even 
set up a meeting with the social worker with the fammily and patient so you 
have a witness to your education.  everyone  likes to sue each other so do 
your best to CYA.

>From: Annemarie Sargeant <sargeantannemarie@yahoo.com>
>To: dmhignight@comcast.net, dysphagia@b9.com
>Subject: Re: [Dysphagia] IV hydration
>Date: Wed, 19 Oct 2005 03:31:07 -0700 (PDT)
>
>
>" I actually had one patient who's family signed a
>waiver to give him thin liquids ama, then overheard
>the nurse telling them to push fluids!  Has anyone
>else encountered this?"
>
>Don't forget that patients/families have a right to
>direct their own care and therefore reject our
>suggestions.  If you have given the information and
>your reasoning for why thicker liquids may be safer,
>they can still decide that for quality of life they
>still want thin fluids.  I think it is our role to
>present both sides and let the patient decide ,
>especially in the geriatric/near end of life
>population.  I am surprised that they needed to sign a
>waiver in order to go against your advice.  In my
>practice I just document that they have been given all
>the info (pros/cons, possible consequences) and state
>that they have made an informed decision to take
>whatever despite risk.  Signing a waiver sounds a
>little harsh.
>
>"hydrating dysphagia patients with an IV when they are
>not getting
>enough fluids through thickened liquids."
>
>Have you spoken with the dietician regarding this?  In
>my setting, it is the RD's role , not mine, to
>evaluate whether or not a patient is dehydrated.
>Perhaps you can work together to determine if the
>patient on thick liquids is acually dehydrated and
>then on solutions.  IV is a temporary solution and if
>the patient is likely to stay on thick liquids it may
>be a shortsighted fix to a long term problem.
>
>Good luck.
>Annemarie
>
>
>
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