I have to agree,  remember Section G also measure the resources by the
faciltiy to take care of this resident. Nursing resources are utilized to
administer the flushes as ordered.  I would code as a 4/2.

Ron

-----Original Message-----
From: Brenda Chance [mailto:[EMAIL PROTECTED]
Sent: Friday, February 06, 2004 4:46 PM
To: [EMAIL PROTECTED]
Subject: RE: Gtube without feeding


I still say we are splitting hairs here.  In a lot of end-stage dementia
residents that do not have pegs, of course, the water is not going to do
enough to hydrate them because of the disease process, but do we quit
trying?  No, because if we did,that would be withholding nutrition.  If
you are administering any water via a peg, you are still providing
hydration.  Plain and simple.

Brenda W. Chance, RN, RAC-C
MDS Coordinator
 
 
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-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] 
Sent: Friday, February 06, 2004 11:07 AM
To: [EMAIL PROTECTED]
Subject: Re: Gtube without feeding

In a message dated 2/3/2004 11:41:28 AM Eastern Standard Time,
[EMAIL PROTECTED] writes:

> How would you code a resident who has a tube, is no longer being fed
(dying), but is getting flushes to keep the tube patent in case she
needs any pain meds?  For eating would she be 8/8 or 4/2 for the
flushes?  Do the flushes count as 
> feeding?  They are not being used for hydration.
> Thanks, Karen 

Is she on Hospice?  Is she a DNR?  Your message states she is no longer
being fed - does that also mean no hydration either?  If you are giving
her flushes she is being hydrated and you are losing the body's natural
response to not receiving hydration or nutrition.  Please see the
following website for some info on this:

http://endoflifecare.tripod.com/Caregiving/id90.html

I have learned from working with dying patients, doctors and hospice
nurses that even small sips of water shouldn't be given for the reasons
noted in the website.  The flushes are something you might want to
rethink.

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/----------------------------------------------------------
The Case Mix Discussion Group is a free service of the
 American Association of Nurse Assessment Coordinators
      "Committed to the Assessment Professional"
Be sure to visit the AANAC website. Accurate answers to your
         questions posted to NAC News and FAQs.
    For more info visit us at http://www.aanac.org
-----------------------------------------------------------/
/----------------------------------------------------------
The Case Mix Discussion Group is a free service of the
 American Association of Nurse Assessment Coordinators
      "Committed to the Assessment Professional"
Be sure to visit the AANAC website. Accurate answers to your
         questions posted to NAC News and FAQs.
    For more info visit us at http://www.aanac.org
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