The spontaneous variation of catheter life, i.e. the time in days between catheter changes, was observed in 20 long-stay geriatric inpatients with initially short catheter lives. The study ran for 6 months. The catheter regimen was standardized throughout the study. The intra-individual and inter-individual catheter lives showed considerable variation. Each patient retained his individual pattern of catheter life. It is concluded that, despite the variation of isolated catheter lives, the median value of repeated observations of catheter life provides a reliable parameter of catheter function.
One hundred and forty-three nurses' aids and 48 enrolled nurses at nursing homes in Sweden were interviewed about food refusal among patients. It became evident that their concepts of 'food refusal' and 'forced feeding' were very vague. This could partly be explained by the lack of knowledge among staff of how to interpret the frequent ambiguous eating behaviours among demented patients. It has been suggested that concept clarification and ethical analysis might reduce anxiety among staff caring for patients with severe eating problems.
The patient-care worker relationship was analysed by observation and unstructured group discussion in four long-stay somatogeriatric wards at Saint Lars Hospital. Investigation centred on patients entering the terminal phase who could no longer be spoon-fed. The relationship was complicated and reciprocal, and failure by the care worker to interpret her role and the dying patient's behaviour correctly led to emotional conflict and double-binding, with resultant anxiety for both herself and the patient. Infusions and tube-feeding prescribed in such cases were given not for the patient's benefit but to relieve anxiety in care workers and relatives. Permitting the patient a natural, painless death from water deficiency may be preferable to prolonging pain and discomfort by intervening with infusions and tubefeeding.
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