somethingblue331

I am a director of nursing in large skilled nursing facility. A this is a very sensitive issue that comes up more often than you would imagine with our population. Our determination of whether a resident has the ability to consent to sexual activity of any kind is based on a detailed interview with both people, together and separately. If during this interview it is not extremely clear that they are capable of expressing their intent it is my obligation to protect them or it is considered abuse. This is complicated as sometimes it involves married couples in which one is no longer capable of giving consent. However, I have bought a lot of condoms for my residents and tied stuff on the door knobs to provide privacy for intimate encounters.

I have a long haired cat that was adopted from a shelter 3 years ago.. so it’s difficult to figure out her age. She’s straight up not eating or drinking. She’s lost half her body weight in the last 6 weeks give or take.

I took her to our vet.. labs show she is anemic (hgb 8.3 hct 26) and has elevated liver enzymes.. he didn’t give me the numbers. WBC is wnl. No masses, lumps, nodules.. noted jaundice in her mouth. She’s low energy, but not outright lethargic. She doesn’t have any overt signs of pain.. purring and sweet still. No loose stools, no vomiting, no skin issues..

He gave her a decent sized fluid Bolus that was absorbed within 4 hours, dexamethasone injection and an Rx for liquid abx. Check back in 2 weeks..

I have given her everything I can think of to get her to eat.. we have 6 cats total.. there are water dishes and dry food scattered all over our house.. along with 6 litter boxes. Wet food of various brands, changed the dry food, soft treats, human type tuna, rotisserie chicken, Turkey, roast beef, ice cream.. (I know, but I am desperate) but she sniffs and turns away from everything.

What’s the prognosis for something like this?? And what else could I tempt her with?

Thank you so much. I’ll follow up with our vet. It seems like this has gone very quickly.. on Christmas she was climbing on the table to get lobster tails.. and within a month is skin and bones.. with zip for appetite.

I can answer this question comfortably.. in the facilities I have worked (none of them were Hospice) death is considered a milestone of life.. like birth or marriage.. we do everything we can to make residents who have made their wishes clear to be DNR and comfort care, as well as their loved ones, have a positive passing. Depending on the persons needs that can include being moved to a private room, music therapy, visits from clergy, gentle massage, special bed linens, aromatherapy and the like. Loved ones are provided with bed side meals, cots and support for this difficult time. It is by far my preference to hold some ones hand as they take their last breath to breaking their ribs and shoving tubes down their throat. I professionally and competently participate in full codes when it is the residents wish but always with tears running down my face because it hurts my heart.

He was hoping the dexamethasone would help jump her appetite but so far no! I am a geriatric (people) nurse.. and I know mirtazipine works for my failure to thrive patients which is how she is presenting! Thank you again for your input!!