The Little Things

Many times it's the little things that seem to mean the most. A patient came off of dialysis and we all decided that fluid restriction seemed pretty stupid. Water never tasted so good. Another patient came in wanting a cup of coffee. He had been in a hospital where no one had given him coffee for several days. He had been given iced tea and milk, but no coffee. He enjoyed that cup of java more than anything else we did for him, at least at first.

The best thing, is it's so easy to do these things. There was nothing difficult about getting either the water or the coffee. Either would have happened in the usual course of events. But for these patients, these were not ordinary, or usual, they were special occasions. The satisfaction for me is being a small part of making this happen for them.

For this reason, I never order special diets for my hospice patients. I do not impose any limits. If the patient wants to impose limits, that's a different matter. But I think that at this time of life, what is the worst that can happen? The person dies sooner? I also never order for a patient to be NPO. If a person is unable to eat, we note they are "not eating", which is more a statement of function than a restriction.

There are many other "little things" we do that mean so much. The extra blanket, the fan for the COPD patient, many things. But taken altogether, they become a large part of what makes hospice care different and special.