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有很多插了鼻胃管的病人,因为无法排泄,所以必须作“造口”手术,就是在腹部开个洞,接上管子,让肠胃里的废物可以排出来。有了“造口”,就有“细菌或病毒感染,甚至于溃烂”的风险,而且几率颇高,等于是“潜在性”地“制造了”另外一个更难处理的问题。
There are many patients with nasogastric tube inserted due to they are having difficulties to excrete. They need to go through "stoma" surgery which results in a small opening on the surface of the abdomen being surgically created in order to divert the flow of faeces and/or urine. With a stoma, there is a high risk of getting bacterial or viral infection or even festering wound. It is almost like potentially creating another harder problem.
There are many patients with nasogastric tube inserted due to they are having difficulties to excrete. They need to go through "stoma" surgery which results in a small opening on the surface of the abdomen being surgically created in order to divert the flow of faeces and/or urine. With a stoma, there is a high risk of getting bacterial or viral infection or even festering wound. It is almost like potentially creating another harder problem.
多数插了鼻胃管的末期或临终病人,因为一直卧病在床,甚至于意识昏沉,身体没有活动,也无法活动,所以胃肠的消化功能也随之退化甚至于停滞,因此有不少病人最后“走的时候”,不是肚子涨得鼓鼓的(就如俗话所说的“一肚子大便”),就是大小便失禁,在体内囤积已久而且发酵的废物倾泻而出,让往生者躺在满床粪便中告别人生舞台,情何以堪。
Most of the terminally ill or dying patients with nasogastric tubes inserted, have to rest on their beds in long term. Thus, they tend to feel drowsy or have low conciousness. They have low level of activity simply because they are not convenient to move their bodies. Hence, their gastrointestinal digestive function will be degenerated or even stop functioning. Therefore, there are many patients, the moment when they are passing away, are having bulging abdomen or fecal incontinence. Many of them are passing away in their beds which are full of excreta.
Most of the terminally ill or dying patients with nasogastric tubes inserted, have to rest on their beds in long term. Thus, they tend to feel drowsy or have low conciousness. They have low level of activity simply because they are not convenient to move their bodies. Hence, their gastrointestinal digestive function will be degenerated or even stop functioning. Therefore, there are many patients, the moment when they are passing away, are having bulging abdomen or fecal incontinence. Many of them are passing away in their beds which are full of excreta.
我并不是一味地反对插管,二弟曾经动过手术拿掉一颗肾脏,手术后因肠道严重阻塞无法排便而插鼻胃管喂食,我自己也曾经因肠道严重阻塞无法排便而插鼻胃管引流,这些都是必要或不得已的“治疗”措施。但是妈妈在这个关键时刻最最需要的,不是”治疗“,而是“亲情关怀”和“灵性照顾”,安宁照顾的原则与精神就是:from cure to care。
I do not blindly oppose to intubation. My younger brother had a surgery before to remove one of his kidneys. The surgery had caused him severe intestinal obstruction and constipation. Thus, he was inserted a nasogastic tube for feeding. I also experienced severe intestinal obstruction and constipation and thus was inserted nasogastric tube too, to clear out my excreta. All these treatments were necessary and they were the last resort. However, at that crucial moment, what my mother needed was not "treatment" but care from her loved ones which included "spiritual care". The principal and essence of hospice care is: from cure to care.
I do not blindly oppose to intubation. My younger brother had a surgery before to remove one of his kidneys. The surgery had caused him severe intestinal obstruction and constipation. Thus, he was inserted a nasogastic tube for feeding. I also experienced severe intestinal obstruction and constipation and thus was inserted nasogastric tube too, to clear out my excreta. All these treatments were necessary and they were the last resort. However, at that crucial moment, what my mother needed was not "treatment" but care from her loved ones which included "spiritual care". The principal and essence of hospice care is: from cure to care.
临终病人只要插上了管子,不论是呼吸器或是鼻胃管等等,病人与家属的精力及关注点,就统统都围绕着“照顾那些管子里的东西进进出出”而搞得团团转,反而没有精神和余力真正好好地“陪伴”病人。更严重的情况是,当病人拖过了“人生的赏味期”,变成了“生命的延毕生”,多数的家属都无能为力而后悔莫及,有的甚至就把病人丢给医疗机构,自己躲得远远的,真正和病人常相左右的,其实是一堆无情的“医疗机器和管子”。
As long as the patient has been intubated, whether it is respirator or nasogastric tube and so on, the attention and focus of the patient and his family members will be on those tubes. They are left with no time to be spent with each other. In severe circumstances, when there is no hope for the patient to recover and he is simply being "extended" to continue his life, most of the family members are regretful, some even leave the patient with the medical staff. At the end of the day, what left with the patient is a bunch of ruthless tubes and medical machines.
As long as the patient has been intubated, whether it is respirator or nasogastric tube and so on, the attention and focus of the patient and his family members will be on those tubes. They are left with no time to be spent with each other. In severe circumstances, when there is no hope for the patient to recover and he is simply being "extended" to continue his life, most of the family members are regretful, some even leave the patient with the medical staff. At the end of the day, what left with the patient is a bunch of ruthless tubes and medical machines.
最后事实证明,妈妈靠着每天的两袋点滴及输液,维持了四十三天的生命,并没有“营养不良”或“饿死”的问题。在住院以及回家照顾的这段时间,妈妈陆陆续续将胃肠里的废物排泄得干干净净,得以身心清爽地在孙儿的佛号声中含笑舍报往生。
Finally, it turned out that my mother lived for another forty three days by dribbling, without any sign of malnutrition or starvation. During the period of hospitalization and being cared at home, she was able to have bowel movements. Thus, at the moment she was passing on, she was clean and peaceful.
在此与各位读者经验分享:要准备将临终的亲人从医院接回家中,除了医疗床,点滴,临时看护之外,氧气机,电子体温计,血压计。。。,都要事先搞定,才不致于亲人有状况时,左支右绌,不知如何是好。
I would like to share my experience with everyone here: If you are preparing to transfer your loved ones from hospital back to home, other than medical bed, drip and (part-time) private nurse, you need to get ready a oxygen tank, electronic thermometer, sphygmomanometer... This is to better "equip" yourself if anything happens to your loved ones.
我们很详尽地讨论了妈妈的后续关怀及后事处理事宜,并且达成了共识。因为妈妈生性朴实,低调,而且几乎不打扮,生平不喜歡交际应酬,所以我们兄弟决定秉持妈妈的一贯作风来处理后事:不发讣闻,不收奠仪,不看日子,不办公祭,而以追思会的方式怀念妈妈。因为不选日子,所以妈妈的遗体不进冰柜,直接入殓,然后火化。事后回想,还好我们家人及时会同讨论并且达成共识,让妈妈的后事处理非常顺畅圆满,否则很可能措手不及,慌乱一团。
We discussed about our mother's hospice care and after-life matters in details and came to a mutual consensus. Our mother is a low-key person, almost not dressing up all the time. She did not like to network and thus we decided to uphold her "style" while handling her funeral matters. We did not publish an obituary, no collection of condolence fund, no selection of "good date" and no public memorial. What we did for her is just a memorial. Due to the reason that we did not select "good date" for specific funeral "procedure", we did not need to send our mother's body to the mortuary cabinet but to the coffin and then followed by cremation. Whenever we recall the process, we are glad that we were just in time to discuss about our mother's after-life matters and came to an consensus, and thus manage to smoothly settle all funeral matters. Otherwise, we are very likely to be in a panic.
我交代Yani每一小时记录一次妈妈的血压,脉搏,体温,最后一笔记录是在二十四日晚上七点二十分,也就是在妈妈舍报往生前一小时,她的血压103/54,脉搏60,体温36.8度。这些数据显示,妈妈不但没有拖到体力精神都衰竭耗尽的情况,而是保有足够的精神和体力,所以才能在孙儿的佛号声中,含笑舍报往生,这也是我们兄弟至感安慰之处。
I asked Yani to record my mother's blood pressure, pulse and body temperature once hourly. The last record was on the 24th (date) 7:20pm, which was one hour before my mother passed on. Her blood pressure was 103/54, pulse 60, body temperature 36.80. This record shown that my mother was still in healthy state while passing on. We all were glad about this.
Finally, it turned out that my mother lived for another forty three days by dribbling, without any sign of malnutrition or starvation. During the period of hospitalization and being cared at home, she was able to have bowel movements. Thus, at the moment she was passing on, she was clean and peaceful.
在此与各位读者经验分享:要准备将临终的亲人从医院接回家中,除了医疗床,点滴,临时看护之外,氧气机,电子体温计,血压计。。。,都要事先搞定,才不致于亲人有状况时,左支右绌,不知如何是好。
I would like to share my experience with everyone here: If you are preparing to transfer your loved ones from hospital back to home, other than medical bed, drip and (part-time) private nurse, you need to get ready a oxygen tank, electronic thermometer, sphygmomanometer... This is to better "equip" yourself if anything happens to your loved ones.
我们很详尽地讨论了妈妈的后续关怀及后事处理事宜,并且达成了共识。因为妈妈生性朴实,低调,而且几乎不打扮,生平不喜歡交际应酬,所以我们兄弟决定秉持妈妈的一贯作风来处理后事:不发讣闻,不收奠仪,不看日子,不办公祭,而以追思会的方式怀念妈妈。因为不选日子,所以妈妈的遗体不进冰柜,直接入殓,然后火化。事后回想,还好我们家人及时会同讨论并且达成共识,让妈妈的后事处理非常顺畅圆满,否则很可能措手不及,慌乱一团。
We discussed about our mother's hospice care and after-life matters in details and came to a mutual consensus. Our mother is a low-key person, almost not dressing up all the time. She did not like to network and thus we decided to uphold her "style" while handling her funeral matters. We did not publish an obituary, no collection of condolence fund, no selection of "good date" and no public memorial. What we did for her is just a memorial. Due to the reason that we did not select "good date" for specific funeral "procedure", we did not need to send our mother's body to the mortuary cabinet but to the coffin and then followed by cremation. Whenever we recall the process, we are glad that we were just in time to discuss about our mother's after-life matters and came to an consensus, and thus manage to smoothly settle all funeral matters. Otherwise, we are very likely to be in a panic.
我交代Yani每一小时记录一次妈妈的血压,脉搏,体温,最后一笔记录是在二十四日晚上七点二十分,也就是在妈妈舍报往生前一小时,她的血压103/54,脉搏60,体温36.8度。这些数据显示,妈妈不但没有拖到体力精神都衰竭耗尽的情况,而是保有足够的精神和体力,所以才能在孙儿的佛号声中,含笑舍报往生,这也是我们兄弟至感安慰之处。
I asked Yani to record my mother's blood pressure, pulse and body temperature once hourly. The last record was on the 24th (date) 7:20pm, which was one hour before my mother passed on. Her blood pressure was 103/54, pulse 60, body temperature 36.80. This record shown that my mother was still in healthy state while passing on. We all were glad about this.
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