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 T-shirt use in hospice 
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Joined: Wed Oct 28, 2009 11:53 am
Posts: 969
Location: Ocala, FL
Post T-shirt use in hospice
The most practical covering for Dale in hospice care has been his old soft T-shirts. Someone posted cutting them open in the back. The hospice aide showed me how to do it. You leave the neckline intact. You do not cut it. It will easily go over the head - especially if the T-shirt is a V-neck or very old. The cut back of the shirt does not fray - even with several washings. It can lie open and there is no need for tucking the shirt down behind the patient.

We are not using diapers either. Instead, just a disposable pad works along with Dale's condom catheter. Since he is no longer eating, the waste production has ceased.

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Leone Carroll (75); wife of Dale (75) who passed away March 23, 2011


Sat Mar 19, 2011 12:12 pm
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Joined: Fri Aug 11, 2006 1:46 pm
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Location: SF Bay Area (Northern CA)
Post Re: T-shirt use in hospice
We did the t-shirt or long-sleeve shirt cut-open-in-the-back routine for awhile. Eventually we decided to only use hospital gowns because the thin cotton seemed to work out best.


Sat Mar 19, 2011 2:25 pm
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Joined: Wed Oct 28, 2009 11:53 am
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Location: Ocala, FL
Post Re: T-shirt use in hospice care AT HOME
Dale is at home in hospice care. Hospice has never offered me any hospital gowns for Dale. I should have been more specific.

I personally don't like hospital gowns. In Dale's case, the T-shirt is short enough to easily change his catheter. I don't know how long hospital gowns are ... but I'll bet they go almost to the knees.

The T-shirt is appropriate only for those who are bed-bound. Obviously, those who can still get up and walk around wouldn't want to be in a T-shirt cut open in the back.

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Leone Carroll (75); wife of Dale (75) who passed away March 23, 2011


Sat Mar 19, 2011 3:09 pm
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Joined: Fri Dec 31, 2010 3:07 pm
Posts: 1039
Location: Minnesota
Post Re: T-shirt use in hospice
Leone, I think this is a good tip to keep in mind for people who are bed-bound or with very limited mobility (perhaps to use a bedside commode), even if the situation is expected to be temporary while they recuperate and regain strength. T-shirts can be purchased very inexpensively, especially if durability is not a major concern. Leaving the neck band in place is clever. Coy has a large skull and neck so I'd probably probably cut the band and add some velcro, or make sure to only use v-necks. I'm tucking this idea away in case it ever comes in handy.

It is good to see you continue with practical problem-solving matters, as you prepare for the end of this part of the journey. Cutting t-shirts is an act of love!

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Jeanne, 68 cared for husband Coy, 86. RBD for 30+ years; LDB since 2003, Coy at home, in early stage, until death in 2012


Sat Mar 19, 2011 3:23 pm
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Joined: Sun Aug 29, 2010 5:46 pm
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Post Re: T-shirt use in hospice
Leone, you are right, hospital gowns are about knee length, or maybe longer depending on one's height. And I don't think they are anywhere near as comfortable as a T-shirt. Seems that you have found an ideal solution for Dale's situation, and it is a great practical tip that many of us might need eventually.

Julianne


Sat Mar 19, 2011 5:45 pm
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Location: Ocala, FL
Post Re: T-shirt use in hospice
robin wrote:
long-sleeve shirt cut-open-in-the-back
It occurs to me that a 'long-sleeve shirt' makes no sense at all. We live in Florida and Dale is warm most of the time.

The T-shirts I have cut open are really OLD. They are almost thread-bare. I'm sure some of the older women know what I mean. Old men wear them. They are a knitted fabric and far softer than any hospital gown I've ever seen.

We slip the T-shirt on one arm first. Then the neck band goes on the head and then the other arm goes in very easily because there is no fabric in the back to hold the shirt. It becomes very much like a kitchen apron and covers the front of him quite nicely.

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Leone Carroll (75); wife of Dale (75) who passed away March 23, 2011


Sat Mar 19, 2011 9:14 pm
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Joined: Fri Dec 31, 2010 3:07 pm
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Location: Minnesota
Post Re: T-shirt use in hospice
The basic idea would apply to any shirt that fits the environment, from a thick fleece sweatshirt to a skimpy thin muscle shirt.

Covering conveys some dignity, even if it isn't necessary for temperature comfort. I'm reminded of seeing my preemie nephews (less than 2 pounds each) in the neonatal unit. The nurses had given them tiny doll-sized hats that somehow seemed to personalize them. These tiny beings were definitely not specimens, they were people. Dressing them, even in a small way. helped make that real.

Unless it was likely to be uncomfortable for him, I'm sure I'd rather see Coy in a real piece of clothing than in nothing or even in a hospital gown.

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Jeanne, 68 cared for husband Coy, 86. RBD for 30+ years; LDB since 2003, Coy at home, in early stage, until death in 2012


Sat Mar 19, 2011 10:48 pm
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Joined: Fri Jan 15, 2010 9:33 pm
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Location: Vermont
Post Re: T-shirt use in hospice
The hospice nurse was the person, I think, who suggested I cut my dad's tee shirts down the back. He was almost always cold, had been that way for several years. Even in the hot MD summer and fall he was cold, so I'd bought him a bunch of Land's End long sleeved tee shirts. They were soft and comfortable and he loved them. He could not handle having anything put over his head in his last weeks. It was painful for him to even have someone pick up his arms to put in the sleeves. Putting even a neck band over his head would have been excruciating.
I agree that having them look more "dressed" is a dignity issue. Hospital gowns are so impersonal and institutional, plus they don't have long sleeved ones, so I'm glad I'd bought the LE for my dad and cut those up. I'd get on their "sale" site online and order whatever colors they had on sale. My dad was very colorblind, so bright colors were the only ones he could really see. The bright and odd colors were the ones that were on sale, so he had lime green, orange, royal purple, etc. and he thought they were great. He would ask for his favorites and he seemed to feel better when his CGs would dress him in the orange or purple one. His visitors probably wondered why he always had such outlandish colored tee shirts on! :lol: Lynn

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Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Sun Mar 20, 2011 10:53 pm
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Post Re: T-shirt use in hospice
LTCVT wrote:
The hospice nurse was the person, I think, who suggested I cut my dad's tee shirts down the back.

He could not handle having anything put over his head in his last weeks. It was painful for him to even have someone pick up his arms to put in the sleeves. Putting even a neck band over his head would have been excruciating.
These two portions of your post, Lynn, apply to Dale as well. It was the hospice aide who first asked if Dale's T-shirt could be cut. And yes, when Dale could still express himself, he cried out when his head was moved and he fought putting his arms into the sleeves. However, his whole body was aching and he couldn't even stand to have me hold his hand. Since the regular doses Morphine have become routine, that intense pain is probably gone.

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Leone Carroll (75); wife of Dale (75) who passed away March 23, 2011


Mon Mar 21, 2011 4:47 am
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Location: Vermont
Post Re: T-shirt use in hospice
My dad couldn't stand for me or anyone to hold his hand or touch him either his last few weeks. That's when I begged and pleaded that he be given morphine regularly not just "as needed". Who was determining when he "needed it"? And how? He needed it all the time - he was in terrible pain all the time but they didn't want to "overdo it". OMG - he was dying and in awful pain. How can you "overdo it" under those circumstances? Lynn

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Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Mon Mar 21, 2011 11:12 pm
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Location: Ocala, FL
Post Re: T-shirt use in hospice at home and the pain involved
Re pain, Lynn: It is slightly off the subject of this thread, but Dale is now on both Morphine and liquid Methadone. The nurse explained that the real effect of Morphine is only two hours AND the patient becomes immune to the effect after a while. The liquid Methadone 10 mg is to be given twice a day.

Dale can no longer express himself ... but I know when I touch him and it hurts! He took his bath yesterday quite well in comparison with previous days... but there was a point (and there always is) when he becomes terrified at being moved to wash his back. Oddly, it was a very touching moment for me because I held him with his arms sort of around my body. That may be the last hug I get from him. He was quiet and I think he was aware.

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Leone Carroll (75); wife of Dale (75) who passed away March 23, 2011


Tue Mar 22, 2011 6:07 am
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Joined: Fri Jan 15, 2010 9:33 pm
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Location: Vermont
Post Re: T-shirt use in hospice
Interesting about the pain drugs. No one ever mentioned the methodone option, and yes, I noticed the morphine wearing off after a few hours. Of course we were having to deal with the CNP who was in charge of whatever my dad was or wasn't being given, and her skills and personality left a lot to be desired.
Sending you lots of big hugs today Leone. I hope Dale will not have to suffer any longer. Lynn

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Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Tue Mar 22, 2011 10:01 am
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