Just my opinion. I would code
persistent anger with self or others---anger that it is taking so long, hurts
or even is happening at all.
Perhaps repetitive health complaints—she
may not be complaining about a specific minute complaint but she is about her
whote circumstance.
Other than that I would look at the
appearance-she sounds like she is restless, “nervous” acting; sleep
issues, and loss of interest in what normally were routine “activities”
and code what I see.
I do not agree that “I am going to
die” is either a negative statement or unrealistic fear .. As
(fortunately for me) a cancer survivor I will say many of her statements are statements
of fact. It used to amaze me when I would talk realistically about what I was
experiencing and everyone would react like I was nuts to say those
things. People would express amazement that I was making
arrangements for my then 13 year old son etc and say things like “oh you
don’t need do worry about that” Of course you do.
She doesn’t truly sound like she has
reached total acceptance and that is where I would take the care planning.
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Toni
Rounds
Sent: Friday, February 20, 2004
10:58 AM
To: [EMAIL PROTECTED]
Subject: Re: how to code "I'm
going to die"
I would think this would be coded as
Negative Statements. Regardless of why a resident exhibits any of these
indicators of depression or what we perceive their reasons for doing so are,
they still need to be coded. She has every right to feel this way, but I
would still code it. "How can I end this?", "Is there
anything I can do to speed this up", "I wish there was a pill to say
bye bye". These are all negative statements regarding her wish to
die soon.
Toni Rounds, RN, BSN, RCC
----- Original Message -----
Sent: Tuesday,
February 17, 2004 3:59 PM
Subject: RE: how to
code "I'm going to die"
Thank you all for your comments, but my question
was how to code this on the MDS in section E. It's not a negative
statement (E1a), E1f? unrealistic fear? E1i is for non health
related complaints/concerns, it doesn't fit E1h either. Where/how
should I code it on the MDS?
I used to manage an in
patient Hospice unit.
Perhaps she's got
unresolved issues that she may need someone to help her get resolved.
Unresolved issues can have a very negative impact on the rest of her life.
Dorothy Wolfe, BSN, MDS Coordinator
The
Virginia Home
1101
Hampton St.
Richmond,
VA 23220
Phone:
804-359-4093 X227
Fax:
804-358-4075
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-----Original
Message-----
From: MDSNancy
[mailto:[EMAIL PROTECTED]
Sent: Tuesday, February 17, 2004
2:08 PM
To: [EMAIL PROTECTED]
Subject: how to code "I'm going
to die"
I have a hospice resident who is alert and oriented,
young. She has been told that she only has 6-9 months left to live.
She has cancer, trache, peg tube, ambulates with walker. She make
frequent complaints of "anxiety" and receives ativan. She makes
statements of "what am I going to do? how can I end
this?" "is there anything I can do to speed this up? I
wish there were a pill for saying bye bye?" She
knows her condition, she knows she is going to die, she is making
statements about her condition. It's not an unrealistic fear. But how do
we code this? These don't seem to fit in any of the categories in section
E. I'm hurrying here, so am probably leaving something out.
She is obviously anxious and depressed. She is being seen by
psychiatrist. Her antidepressants have been increased.
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