Audrey Wuerl

Caring.com Expert

About

Audrey Wuerl, RN, BSN, CHPN, is education coordinator for Hospice of San Joaquin in California, which serves San Joaquin County and its surrounding areas. This nonprofit agency has provided compassionate care for patients facing life-limiting illnesses for more than 25 years. She has received national certification in hospice and palliative care nursing. She is also a geriatric trainer for the End-of-Life Nursing Education Consortium (ELNEC), which promotes education in geriatric nursing and end-of-life care. She holds national certification in hospice and palliative care. In her current capacity she works with physicians, nurses, and social services to facilitate patient referral and ensure continuity of care. Additionally, she collaborates with other community educators to promote end-of-life awareness regarding treatment options and pain management.

During her career, Wuerl has held positions in psychiatric, medical-surgical and operating room nursing. She is also a public health nurse. She received her bachelor's degree in nursing from California State University, Stanislaus.

Recently Published on Caring.com

  1. Tuesday September 20, 2011

    1. We are considering bringing mom home with help from hospice, any suggestions?

      Answer - Hospice is truly about providing a peaceful life closure, usually in the home setting. It sounds like your mother has been through quite a lot. And, often times the hospital will send a patient to a nursing home after an acute admission for various therapies. If you feel you can now care for your mother in your home, then definitely consider hospice...

  2. Friday July 22, 2011

    1. How do I convince my Dad that our family will be alright after he dies?

      Answer - Talking openly and honestly about end-of-life concerns can be difficult even for close families. The inevitably of the situation can make “finding the right words” impossible. Much of what is going on now for you, your family, and your Dad is what we call anticipatory grief, or grieving in advanceance of the event...

  3. Friday July 15, 2011

    1. Is my grandmother going through a phase or is this really the end?

      Answer - Your grandmother has been diagnosed with two diseases that affect both her heart and her lungs. Both conditions are using up her energy by making breathing, which we take for granted, extremely difficult for her. She needs to sleep more just to restore her body...

    2. Can hospice step in if an Alzheimer's patient no longer wants to be hospitalized?

      Answer - The Hospice Benefit requires that patients have a prognosis, or life expectancy, of 6 months or less as determined by their doctor. This is really an end-of-life benefit when cure is no longer an option and all therapies have been complet...

  4. Friday July 08, 2011

    1. How can I reasure my mother that it's ok to pass away with our her getting offended?

      Answer - Caring for a loved one can be overwhelming—especially when there seems to be no relief from the day-in, day-out role of providing for another person. But, let’s stand back and analyze what we can do to help.

  5. Wednesday June 29, 2011

    1. How much can I expect to pay for hospice in a nursing home?

      Answer - Care giving can be a daunting experience, especially is you have young children who require your attention as well. And, it sounds like you and your siblings are trying to do all you can to make your mother comfortable. I have a few suggestions for you:

  6. Wednesday June 15, 2011

    1. We want to place mom in hospice care but were denied, what should we do?

      Answer - First, your mom is under the care of her primary physician. He or she is the one to consult regarding a referral to hospice. From your description, your mom would benefit greatly from hospice in that her pain and symptoms would be managed, as “curative” treatments are no longer an op...

    2. Is it possible the nursing home made my mother's Alzheimer's worse?

      Answer - You are to be commended for caring for your mom for as long as you did. But, I would not feel bad for placing her in a nursing and think they may have made her “Alzheimer’s worse.”

    3. Mom has inconsistent eating behaviors, what is causing this behavior?

      Answer - It’s hard to know what is going on with your step-mom because you did not state her diagnosis. But, one thing is clear—families are distressed when their loved ones no longer want to eat.

  7. Thursday June 09, 2011

    1. How can I deal with my personal grief around the failing health of my client?

      Answer - Being a caregiver is one of the most difficult, and most rewarding, jobs you may ever have. It takes a very special person to do what you are doing, so first let’s realize that fact and work on ways to help you, the caregiver, deal with these unfolding events.

    2. How can we find hospice care in our area?

      Answer - It certainly seems like you have your hands full! Caring for your mom, as well as your dad, would be overwhelming for anyone. I am not sure you can find a hospice near you, but I have included a website at the end of my post whose specific purpose is finding hospices.

  8. Friday June 03, 2011

    1. How do you accept the decline of dementia patient even though you know it was coming?

      Answer - Living with dementia can be very difficult for families. You want to do everything you can for your mom, but accepting her decline—which is part of the disease process—can be physically and emotionally taxing. And, it is the behavioral changes, like needing help with dressing, toileting, and eatinating...

    2. Dad is refusing to eat after his surgery, is this typical for recovery or is he giving up?

      Answer - Sometimes people, like your father, who are facing a life-limiting disease appear to be “giving up” when the family sees a decline. Realize that your father has gone through a lot up to this point. He broke his hip, required surgery, and now resides in a nursing ...

  9. Thursday May 12, 2011

    1. How will I ever get over the guilt I feel for placing my mother in a nursing home?

      Answer - I am assuming you placed your mother in the nursing home because you could no longer care for her at home. Possibly, she was living in her own home, and now needs more assistance. Either way, you are overwhelmed by feelings of guilt.

  10. Thursday May 05, 2011

    1. How do I stop feeling guilty about suggesting to put Mom in hospice?

      Answer - This is a situation in which communication with the Case Manager would be helpful. Call the hospice treating your mother and speak to the Case Manager or the Social Worker. Express your concerns; and you’ll, also be able to get current, first-hand information on what is really happening in her disisease process...

  11. Wednesday April 20, 2011

    1. Can hopsice resuscitate a patient?

      Answer - I am sorry to hear that your sister suffered. From you discription, I believe your sister received what we call "palliative controlled sedation" in the hospital. This is pain control for those patients who have intractable pain, or pain that is so severe only specific medications can begin to manage it...

  12. Tuesday April 19, 2011

    1. Can hopsice resuscitate a patient?

      Answer - Patients do not have to be a “do not resuscitate” to elect hospice services. They can still be a “full code”. Generally, patients and their families come to understand that resuscitation efforts become futile when faced with terminal or life-limiting i...

  13. Thursday February 10, 2011

    1. My mom is has end stage COPD, I have to put her in a home but what should I expect?

      Answer - COPD, chronic obstructive pulmonary disease, develops over time and includes several diseases such as chronic bronchitis and emphysema. As the disease progresses, the patient has difficulty getting air into (and out of) their lungs. Sadly, smoking only makes the situation worse. You have seen this first hand...

    2. Can mom be catheterized while in hospice to make it easier on me?

      Answer - Indwelling catheters are an option when the patient is unable to ambulate to the bathroom, or is currently wearing briefs. This is an invasive treatment, requires a physician order, and is not pleasant for the patient. There is always a risk of infection; families need to be educated on good catheter care, and what to do if the catheter becomes plugged...

  14. Tuesday January 11, 2011

    1. Is it normal for hospice to stop all medications?

      Answer - Thank you for asking this question. It allows me to clarify what our goals are when a patient comes onto our service.

  15. Thursday January 06, 2011

    1. How will accepting hospice care affect my job?

      Answer - You should consider hospice when your husband, 1) has completed all his therapies, such as radiation, chemotherapy, blood transfusions, or other therapies and, 2) when his physician can state he/she estimates his life expectancy at 6 months or less, should his disease run its normal course.

    2. Is this hospice nurse getting to personal with my widowed mother?

      Answer - From your description, it sounds like your mother could use some support from you. It is not the normal “follow up” for any hospice to keep in contact with the family of the deceased in the way you describe. Hospice offers bereavement follow up care for up to one year to support families during thg...

    3. Can I talk to my sister's hospice caregivers in another state?

      Answer - I would suggest you contact the hospice that is caring for your sister, directly, and explain your concerns. As a family member you may be able to talk to the caregivers your sister has. This is not a “given” though. If your sister has stated she only wants to speak to her guardian, for example, le...

  16. Tuesday December 14, 2010

    1. My mother-in-law is under Hospice care and her husband is denying her pain medication!

      Answer - I’m sorry to hear your mother-in-law could be facing a painful life closure. The one thing you could do at this point is contact her case manager. This is the hospice registered nurse who oversees her physical care and well being.

  17. Friday November 19, 2010

    1. Did I do the right thing in Grandpa's final hours?

      Answer - From your account of how your grandfather died, I think you did wonderfully. It is not easy to know the "right" things to say to someone who is dying--especially someone we love deeply.