I have posted on here many times and answered questions every now and then. Dad passed away Oct 7th 2013 from Liver Cancer . He was in a hospice facility for 11 days until he died. The day before he was admitted he was in the hospital and was talking,eating and very clear headed but his ammonia levels were high and he had been very combative, not eating and wouldn't take his meds for 4 days at his nursing home. ( He was in for a Psych Evaluation.) The hospice worker talked to me about admitting him instead of returning to the nursing home. I agreed to this and arrangements were made. He was transferred later that day and was alert and in good spirits. The next morning he was unresponsive and stayed that way until he passed. They gave him morphine and ativan around the clock. He never got any water but they did cleanse his mouth and moisten it with swabs. It seemed like he could hear me the first few days because I would shake his shoulder and say "dad". His eyes seemed to be moving under his eyelids and his mouth would move slightly. I did ask about them lowering his dosages so he could wake up a little. The nurse said he was getting a very small dosage already. I just wonder if the drugs made him unresponsive and if less was used he could have ate and drank and lived longer. I know it was time for him to go but I'm kinda puzzled about his going from complete alertness and straight into unresponsiveness so quick. The nurses did a Great job. I myself don't know how they do it. They treated dad like he was their baby. So gentle and compassionate. I was just wondering if anyone else had the feeling that death felt a little rushed once their loved one was placed in Hospice.
I DO believe in assisted suicide, and I think it should be discussed and legalized in the US and abroad. BUT, what we currently have is SECRETLY assisted suicide, which is abhorrent to me. The patient and family MUST be involved. This is the problem. Until we talk about the fact that it should be an option, and until we involve the patients and family, it's not assisted suicide, it's negligent homicide.
Let me start by saying Hospice is a phenominal thing speaking as a patient and a Hospice nurse. Thank whoever you believe in for the narcotics and other medications for symptom management and a nurse who knows how to recognize these signs and symptoms and administers responsibly. So that loved ones dont cry out in pain, have the look of dicomfort, difficulty breathing because body system are shutting down and their lungs are filling up with fluid For there has been numerous studies and tons of evidence proving that these drugs do not cause death in the already dieing patient as the body metabolizes these drugs differently than a healthy person.
How selfish is it to want that last word and keep your loved one awake in a suffering state so that they can afirm your feelings of love. The thing with hospice is that many people really truely dont understand what it is all about. When I got this opportunity to be a Hospice nurse I was truely blessed to be able to affect so many lives. I can make a negative situation positive. You are supposed to treat the family aswell as the person latying in the bed.
I am sorry for those who had bad experiences with hospice because it was the failure of that nurse and social worker to explain and educate on the dying process. Death happens so differently for everyone no one death has been the same for me. I have had people how have taken upwards of 120mg of morphine an hour for days at a time, for the lay person that is a heck of alot and would kill me a healthy person. There are others who took 10mg an hour and lasted hours, so they are all different.
The fact is we love our people and want them arround for ever. We need to be realistic and not be selfish and make sure our loved ones pass in peace.
Best wishes.
Hospice is intended for end of life care and should also help loved ones cope with the loss. Hospice is often initiated by the Attending Physician by sending a consult to a hospice organization to see if they meet criteria and the family to should be involved in this decision.
Service are generally revoked when a loved one is taken to the hospital because it is considered an attempt to save or prolong their life when their diagnosis is such that they may be terminal and at the end of thier life. It often indicates that the individual and loved ones are not ready for the inevidable which possibly wasnt explained to you.
Not knowing his exact condition makes answering some of your questions difficult but for him to be admitted to Hospice his prognosis isnt or wasnt good. Lasix doesnt reduce fluids in the lungs it helps with generalised edema and blood pressure. In the end stages of dieing people tend to drink and eat less if at all. They make liquid stool softners but having a stool is the least of his worries. We often put in catheters so we can monitor urinary output. again not knowing specifics makes it hard to answer.
Sorry for your loss and horrible hospice. I would have gotten her the meds for pain and discomfort ASAP. I dispise nurses who wont medicate. All the signs and symptoms of discomfort I look for you explained.
As I already posted a few pages back I reported to the state the issues we had with the hospice my mother was in. It took a few months but the state did an unannounced onsite visit and found several violations .
Too late for our family, but if it helped other families going forward it was worth the effort.
So please don't say "hospice is what you need it to be", it certainly what my family needed it to be, and we're not alone.
I am sorry that you had a bad experience with your hospice. Alot of families just arent ready and certainly some hospices suck.
I remember weeks later a woman from their main office saying her sorry she was and that my story made her cry, I told her I don't want to hear it, I am not calling about a bad meal at a restaurant, there are no "do overs", no going back on this. Too little, too late.
I also told her my father is a very generous man when it comes to charitable donations(and he was) so you screwed yourselves, because he was going to donate money until we went through this horrific experience.
My father-in-law was in an assisted living, and we had home hospice for him. He started to have continuous seizures. Hospice gave some Dilantin, but he still had almost nonstop seizures. They said not to take him to the hospital. He eventually fell out of his wheelchair while having a seizure, hit his head, and had to go to the hospital. ER doctor told us about inpatient hospice across the street from the hospital. He was admitted to the hospital and transferred there and received wonderful care until he passed away. In both cases, home hospice caused more suffering rather than less. I do believe the role of home hospice is to hasten death.