Comfort care

I have had a few patients on comfort care with unsupported families about that pts wishes, which makes it difficult for me to provide appropriate care to that patient. I am never sure how to address the family, and what to say. Any adive or personal experiences that would help? Thank you
First of all is there an RP? Is there a living will? Without the express wishes in place in that living will, the minute that resident gets to the place they are not longer alert and oriented, the family can change it if they so desire.This might be a long complicated process for them, but in the mean time you and your facility are the ones stuck in the middle.You need to get your social worker together with the entire family and have a long discussion.

Assuming that the orders for comfort care only have resulted from the patient's expressed wishes, please use that as a point of reference in any discussions you have with the family. I don't mean bulldozing them, as in, "well, this what Mom wants, so what you think doesn't matter" but more like highlighting the care being provided, and using a gentle reminder that this is in line with the patient's expressed wishes as a recurring punctuation mark. It's just another flavor of providing patients/families choice where possible, but not where none exist. You can also gently turn the conversation so that they are more aware that their disagreement with the plan of care results from their own impending grief. "Are you saying that you're concerned that she'll experience pain?" or "What did you go over re: test results in your last conversation with the MD?"If staff avoid engaging these families, their sense of discomfort with the palliative treatment plan only increases.

I'm not clear on the scenario. Does the family lack support from nursing staff and needs help understanding the patient's wishes or is the family non supportive of the patient's wishes?

How about "I am your Dad's nurse, and his wishes were bla bla bla, which I am legally and morally bound to abide by. I'm sorry that you are in this situation and understand you are grieving but I must do what your dad wanted".

Quote from KiwidanniHow about "I am your Dad's nurse, and his wishes were bla bla bla, which I am legally and morally bound to abide by. I'm sorry that you are in this situation and understand you are grieving but I must do what your dad wanted".

Can it be reversed even if in writing?

It depends on what state you're in. Some states allow living wills as legally binding documents. Some do not. Health care proxies are supposed to do what they know the patient wants, but that doesn't always happen. It makes it hard for those of us who are trying to do the best we can for the patient.

Quote from student foreverCan it be reversed even if in writing?

Quote from meghanlsI have had a few patients on comfort care with unsupported families about that pts wishes, which makes it difficult for me to provide appropriate care to that patient. I am never sure how to address the family, and what to say. Any adive or personal experiences that would help? Thank you

Is this patient on hospice? If not, bring 'em in. Hospice can help support families with their issues, staff support for problems they are having and most of all the patient with their own desire for a good death in their own way.