Grand­daugh­ter: Bar­bara Bush is ‘a fighter,’ in good spir­its

Austin American-Statesman - - NATION & WORLD - By Michael Graczyk

For­mer first lady Bar­bara Bush, who was re­ported to be in fail­ing health over the week­end, is in “great spir­its,” and the fam­ily is grate­ful for “ev­ery­body’s prayers and thoughts,” her grand­daugh­ter said Mon­day.

Bush fam­ily spokesman Jim McGrath said in a news re­lease Sun­day that “Mrs. Bush, now age 92, has de­cided not to seek ad­di­tional med­i­cal treat­ment and will in­stead fo­cus on com­fort care” at home in Hous­ton af­ter con­sul­ta­tions with her doc­tors and fam­ily.

McGrath did not elab­o­rate on the na­ture of Bush’s health prob­lems but on Mon­day said she’s suf­fered in re­cent years from con­ges­tive heart fail­ure and chronic ob­struc­tive pul­monary dis­ease. She also has been treated for decades for Graves’ dis­ease, which is a thy­roid con­di­tion, had heart surgery in 2009 for a se­vere nar­row­ing of her main heart valve and was hos­pi­tal­ized a year be­fore that for surgery on a per­fo­rated ul­cer.

Jenna Bush Hager, an an­chor on NBC’s “To­day” show, said Mon­day morn­ing that Bush is rest­ing com­fort- ably with fam­ily.

“She’s a fighter. She’s an en­forcer,” Hager said, us­ing the fam­ily’s nick­name for her grand­mother. “We’re grate­ful for her, for ev­ery­body’s prayers and thoughts, and just know the world is bet­ter be­cause she is in it.”

Hager said for­mer Pres­i­dent Ge­orge H.W. Bush “still says, ‘I love you, Bar­bie’ ev­ery night,” and de­scribed her grand­par­ents’ close re­la­tion­ship as “re­mark­able.”

Pres­i­dent Don­ald Trump’s press sec­re­tary, Sarah Huck­abee San­ders, said in a state­ment Sun­day evening that “the pres­i­dent’s and first lady’s prayers are with all of the Bush fam­ily dur­ing this time.”

Peo­ple who opt for com­fort care re­ceive treat­ment only for their symp­toms, such as short­ness of breath or pain, rather than try­ing to pro­long life or cure the un­der­ly­ing health prob­lem, said Tim Simp­son, a cer­ti­fied hos­pice and pal­lia­tive nurse for al­most 28 years.

For ex­am­ple, pa­tients hav­ing trouble breath­ing might re­ceive oxy­gen or steroids, or if they have fluid in their legs be­cause of a bad heart, they might re­ceive di­uret­ics.

“With com­fort mea­sures, there are no un­nec­es­sary tests ex­cept those needed to re­lieve a pa­tient’s symp­toms,” said Simp­son, chief nurs­ing of­fi­cer at Sea­sons Hos­pice in Illi­nois.

Hos­pice care has some tech­ni­cal dif­fer­ences. It’s for pa­tients who are not ex­pected to live more than six months, Simp­son said. They sign a waiver of­fi­cially say­ing they want only treat­ment for their symp­toms that does not pro­long life, he said.

Com­fort care is more of a ver­bal un­der­stand­ing be­tween a doc­tor and a pa­tient, Simp­son said.

Heart fail­ure is one of the top rea­sons older peo­ple are hos­pi­tal­ized and is a lead­ing cause of death. It de­vel­ops when the heart mus­cle weak­ens over time and can no longer pump ef­fec­tively, some­times be­cause of dam­age from a heart at­tack. Fluid can back up into the lungs and leave peo­ple gasp­ing for breath.

Many peo­ple have both heart and lung prob­lems, said Dr. Kyle Hog­a­rth, a pul­mo­nolo­gist and as­so­ciate pro­fes­sor in pul­monary and crit­i­cal care at the Univer­sity of Chicago Medicine.

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