u/swunderball

I don’t know about you guys but we have a very aggressive nutritionist team - recommending megace and PPN left and right for cancer cachexia, generally frail elderly unfixable patients, etc

they are not recommending PEG tubes, thankfully but I didn’t train in a system that ever used PPN and here, the culture is to use it like a supplemental protein shake w brunch. it’s crazy.

I’m wondering how you guys intervene on the chronic multisystem multifactorial beast that is the malnourished elderly?

What do you use for appetite stimulation, if anything, ever? This question is posed to me by our nutrition team multiple times per day - are they appropriate for an appetite stimulant? and I often spiral trying to understand what they mean and what the point would be.

Am i insane? It is day 7. I could be insane.

when pt is dying from the disease process that put him on hospice in the first place
pls

update: turns out yall were right, it was a combination of inadequately controlled symptoms and family panic. thanks for all of the helpful insights; i learned a lot from this post!