I have a family member in a nursing home. They have become very dehydrated, due to not eating or drinking, but we pay a lot of money for them to stay in the nursing home. There is always a registered nurse on duty and was wondering why they can't put an intravenous fluids up. After all it is nursing care is it not?
Nursing home Drip?
- Thread starter James123456789
- Start date
An IV drip can cause serious problems very quickly and several nursing homes are not prepared to take the risk, possibly even saying they require the presence of a doctor in case there are problems.
Not all homes are the same.
A well known health charity is "...currently recruiting Registered Nurses with IV competence in a number of locations across the country...both nursing home and domiciliary..."
There may be CCG rules/guidance on what can be done.
I don't know how IV competence is decided.
A quick glance at
http://www.indeed.co.uk/
shows that being IV competent can mean a large increase in salary.
Not all homes are the same.
A well known health charity is "...currently recruiting Registered Nurses with IV competence in a number of locations across the country...both nursing home and domiciliary..."
There may be CCG rules/guidance on what can be done.
I don't know how IV competence is decided.
A quick glance at
http://www.indeed.co.uk/
shows that being IV competent can mean a large increase in salary.
My 91-year mother with Alzheimer's was in exactly the same position as your family member - having had first a sickness virus which was going round her nursing home and than a UTI, she was severely dehydrated.
I was told by the RN in the nursing home and by her GP that to get IV rehydration treatment she would have to be taken to hospital, as IV therapy is a specialist field with high risk which a RN is not qualified to provide unless specially trained. My mother was given subcutaneous rehydration in the nursing home, which is a less specialised therapy and can be ineffective in older people if they have reduced body fat. My mother did have to go to hospital in the end, although we did not want to move her, and the ambulance men who took us told me that NICE guidelines on IV treatment meant that it could only be given by "IV-competent" nurses, of which there are very few in nursing homes. As the IV treatment required constant monitoring/adjustment by doctors and my mother also kept trying to pull out the drip, I could see that it would be difficult to carry out IV rehydration in a nursing home and that it would probably not be safe to do so. I hope that you find a good way forward for your family member.
I was told by the RN in the nursing home and by her GP that to get IV rehydration treatment she would have to be taken to hospital, as IV therapy is a specialist field with high risk which a RN is not qualified to provide unless specially trained. My mother was given subcutaneous rehydration in the nursing home, which is a less specialised therapy and can be ineffective in older people if they have reduced body fat. My mother did have to go to hospital in the end, although we did not want to move her, and the ambulance men who took us told me that NICE guidelines on IV treatment meant that it could only be given by "IV-competent" nurses, of which there are very few in nursing homes. As the IV treatment required constant monitoring/adjustment by doctors and my mother also kept trying to pull out the drip, I could see that it would be difficult to carry out IV rehydration in a nursing home and that it would probably not be safe to do so. I hope that you find a good way forward for your family member.
Dear James, there are several reasons why someone can become dehydrated, but you seem to imply that the reason why she is dehydrated is simply because she is no longer eating and drinking. One of the things that can cause this is that they are at end of life and the body is shutting down. Have you discussed this with her doctor? What do they say is the reason for her not eating and drinking? If she is, indeed, at end of life, then they may not want to rehydrate her as this can cause pain at this stage.
Please forgive me if she is not at this stage.
James
This is a really scary time for relatives, we all feel so helpless but I think that you really need the help of your nursing home. You are quite right, you pay them enough and they should be there supporting you and explaining to you what is happening and why it is happening and why they think that their approach is a good one. If I were you I would ask to see the Manager and have a serious talk and also ask to see the visiting doctor.
Have they had a conversation with you about end of life care? If not then they need to because they need to know what you, the family want. Are there any palliative care nurses involved? If not and the nursing home think that she is moving towards the end of life then ask them to involve the palliative care team and you together so that you can have all have a conversation about how things are moving forward.
Please please speak to them at the home and ask these questions - at least you will begin to feel better when you have detailed information from the 'professionals'. My thoughts are with you at this extremely difficult time, take care of yourself and please keep posting x
This is a really scary time for relatives, we all feel so helpless but I think that you really need the help of your nursing home. You are quite right, you pay them enough and they should be there supporting you and explaining to you what is happening and why it is happening and why they think that their approach is a good one. If I were you I would ask to see the Manager and have a serious talk and also ask to see the visiting doctor.
Have they had a conversation with you about end of life care? If not then they need to because they need to know what you, the family want. Are there any palliative care nurses involved? If not and the nursing home think that she is moving towards the end of life then ask them to involve the palliative care team and you together so that you can have all have a conversation about how things are moving forward.
Please please speak to them at the home and ask these questions - at least you will begin to feel better when you have detailed information from the 'professionals'. My thoughts are with you at this extremely difficult time, take care of yourself and please keep posting x
