I had a novel experience two nights ago when I visited one of our hospice patients at his home. He is a delightful elderly man who suffered a stroke 9 months ago.
His illness left him bedridden and requiring total care. He lives with his son, who, along with a paid caregiver and hospice service, provides the care that enables him to stay at home.
Unable to do a gallbladder removal 6 months ago when his gallbladder emptying duct closed off, radiologists inserted a drain tube that runs from his gallbladder out to his abdominal wall. These drains are designed to last a few weeks. His had been in for months.
I went to the house late on a Friday night because the drain had clogged. Foul-smelling pus was erupting around the drain and stinging the skin on his abdomen.
My attempts at flushing the drain were unsuccessful. But, working with the patient’s son, we created a home-spun drain, and it worked very well.
We were delighted that were able to relieve this man’s suffering at home. We were also able to save medicare thousands of dollars in the hospital costs that no doubt would have come about had we not been able to resurrect the drain function.
There is a case to be made here for more extensive physician or nurse practitioner involvement in hospice care. I think that without physician involvement at the bedside, the only viable option would have been hospitalization.
