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.
"Copyright © Ron Panzer 2011-2013 HTML/web version of.....etc.
Notice the date : 2011-2013....!!!! Now I wonder that the statements in that rendition were uttered prior to "Obama-Care" having taken effect..... Wonder what changes... hopefully IMPROVEMENTS Obama-care would or could bring .?????
A time for God
A time for Mama
and a time for you.
I think God sees that you are not really ready yet and leaves Mama in your wonderful loving care a little longer.
When the time is right it will be right for both of you and the angels will come and lift Mama up. You may even catch a glimpse of an angels wing. When the time gets close be sure and leave a window a crack open so her soul can rise. Even when her physical body has died her spirit may linger a short while just to reassure you
You can only pray that God will make the decision about what is right for you both. Do not be afraid Hope. God is with you
As far as comments about thepoor care from hospice nurses it just makes me cringe. I was a hospice nurse for ten years and could not have worked with a more careing and compassionate group of women. the slightest complaint about a nurses practice was treated like a cpital offence and our supervisor never ceased to fire people who she felt did not have the right attitude. We were a very small rural hospice a not for profit which does seem to make a great deal of difference in the standard of care from some of the for profit ones.
our phiosophy was to make the remaining time a patient had left as pleasant and painfree as possible. Yes we did use large doses of Morphine and Ativan but never with the object of ending their lives. Would you rather see your loved one resting peacefully or thrashing around in pain yelling for some one to please end this or lashing out at his nearest and dearest or chasing the nurse out of the house with an axe. We used what was prescribed in the quantities needed to relieve suffering.
morphine has such a bad rap because it is the drug most often used. the reason is that it comes in a liquid and can be dripped into the patients mouth with a dropper when they can no longer swallow. Do you want to watch your loved one suffer with a breathing tube and ventilator when you know they are dying. some nurses do not have a good bedside manner like some Drs and may not be in the right part of heathcare but it may not be possibel for them to work the hours needed in other field. i am not making excuses but just get upset by all the nurse bashing that goes on with hospice care. You may be loosing your loved one but it is very hard to nurse people you can do nothing for but give them a comfortable death. All your patients die from tiny babies to 100+ year olds you can not make any of them get better. Nurses and Drs are trained to get people well again. Do you ever wonder how many nurses go home in tears after attending a death and sharing in the patient's family grief. Wipe your eyes blow your nose and walk into the next house with a smile on your face appologising because your sinuses are acting up and you just came from a house full of cats. It is not an easy job and many burn out quickly. In a for profit hospice the work load is very high and the pay poor so corners get cut. the executives have to get their high pay and bonuses. By all means report the bad care that is the only way thing get changed but remember nurses are people too and have feelings.
When I first called their corporate office the woman tried to apologize, I said "don't, this can't be undone, no do overs. This isn't like a bad meal in a restaurant, this can't be fixed."
I'm glad to hear your mother is doing better.
They kept giving her the usual morphine atavin combo, ' to keep her comfortable' really it made her where she couldn't swallow or breathe and the meds kept her in that position TIL she passed away total of 15 hours in hospice.
If this is how hospice really works, why deceive the public, be honest and admit the combo of drugs actually hasten death.
I told the nurses when I was on my death bed. I was given morphine & it didn't kill my pain, they told me bc my mom was dying it's differevr, wtf I was on my death bed & lived These ppl are clueless since they never experience near dearh or death itself.
I'm pretty certain hospice nurses which are actually LPN's are brain washed about how the drugs really work.
I think I understand some people’s feelings on this subject matter. I too was temporarily concerned that we might have contributed in some way to Dad’s end given that we were consulted at each step of the way, everything explained to us in great detail and part of this process was the upping of medication. However, this was temporary.
It is difficult to try to be pragmatic, impossible perhaps for some individuals or at certain stages but eventually, we must try to be. In my case My father was a very intelligent man, aware of his circumstances and in the early weeks often spoke freely about it. Assured us not to fear, to not suffer and that any decision we made would be the right one. He remained that way all the way through, up to the point he became confused as a result of his illness and even then there were periods of clarity in which the realisation he had suffered delirium and that during these times he was agitated at times aggressive towards people like my Mother, who had been there every moment of every day was heart breaking and if anything even more painful for him. That is not what he wanted to do and certainly not who he wanted to be.
My Father and I didn’t really have any profound last discussions he/we just all spoke openly about what was going on. He did however have one last request of me and that was to get on with living my life. I believe that would not be possible if I spend from here to eternity questioning what ifs. He may well have lived a little longer, I really couldn’t say but I do know he was distressed, in pain and confused for a vile period of time and then he wasn’t, shortly after that he passed, peacefully.
Very little time goes by that I don’t think of him but I am trying to do as he asked and being pragmatic or at least trying to be is a part of that process. Having said all this of course no two of us are alike. We must deal with it in our own way.
Anyone who truly feels they or their loved ones have been wronged should speak up. I would only ask that you consider as many of the facts as you can, see beyond there here and now and all that that means, as difficult as that might seem. Terminal illness is just that… we are going to lose them… however hard we try to hold on. I know every last second is precious but in the end has it become more about you and what you want and need or them? If you still answer no I/we were wronged then I totally support your right to do so and encourage you to speak up.
Knowing that those IVs helped, made it necessary to decide on ER-visits... If one knows what can help, or one thinks the ER might have an answer and the patient does not say " I want to die", one has an obligation to follow one's concience of " what's right + what's wrong to do according also to one's religious convictions " to seek that help, or else you are guilty of murder ... Obviously not all cases are so clear to diagnose or not all folks know the medical intervention necessary to keep from being guilty of murder by neglect, and that does make THE difference - if you don't know - you have to trust the medical personnell to guide you... and you can only hope that they do not deliberately rush your loved one to the eventually inevitable death.
It's the eventual death every one accepts... it's the rushing it... which most folks object to.... I wish you all well.
He could neither talk or walk towards the end and lost half of his body weight.
I agree with jeanne, to throw around words like murder is just despicable for those of us dealing with end stage terminal disease.
My MIL (dementia) has been on hospice for 17 months. They are a big help to me and to her. They never force meds - it's all about her comfort. They provide much appreciated advice and send an aid to bathe her 3x/wk. That's a big deal to me as she is on this long, long, same, same pattern for now.
My wonderful husband was on hospice for 2 weeks before he died. In his case the cancer was causing excruciating pain..........unending pain. Hospice did medicate him in efforts to try to get him some relief. Unfortunately, his pain was relentless and nothing really helped. (His tumor had taken over his abdominal wall and was thickening so rapidly that his digestive system could not metabolize any pain meds). We had a port etc but it was a nightmare. Cancer pain was torturing my sweet husband and I had to watch :(
Hospice helped us as much as possible. Even placing an n/g tube which is not customary but it helped with the pressure because he was totally blocked. Hospice never abandoned us (like the medical community did). They stayed
with us till the end and I am grateful. Very grateful.
Back to my MIL's case...................she is still here after 18 months on hospice. She is comfortable (howbeit cantankerous) and I occasionally give her hospice prescribed meds when she gets agitated and frustrated. And it helps. I appreciate hospice. I really do.
It seems that the event of him losing control of his bowels was new? I apologize if that's not correct. From my experience with my dad, they lose all control of bodily functions at the end. The body more or less lets go/sets the soul free of your loved one.
One lorazepam or another won't make a difference either way. It's not cyanide. Get that idea out of your head, please. You did not kill your dad. The disease killed him. I have a FIL aged 84 with bone mets. It's progressive.
Please let the guilt go. You don't need forgiveness. You didn't do anything wrong, seriously. He was 90. The lorazepam didn't kill him, cancer did. Please allow yourself time to grieve without any blame.
Blessings
This thread is incredibly long and it has been hard to keep up. Some people have had great experiences with hospice. Others think that their loved ones were "over medicated" and that this overmedication is what caused their loved one's death. It really needs to be looked at on a case-by-case basis. In your case it's clear you did nothing to contribute to his death. Please be at peace.
I went back through the journal I had
Been keeping of her disease
(Glioblastoma),messages, emails and pictures,
I could then see how she was really suffering. In some of the messages I was praying for God to end her suffering. Even though I knew she was dying it was still very devastating when it actually happened. It doesn't matter now if hospice did
R did not hasten her death. She was pain free and comfortable until the end.
To qualify for hospice a patient must have a prognosis of dying within 6 months (not 2 weeks). No one can predict exactly when death will occur and many people are on hospice for longer.
Morphine and other drugs are available to keep the patient out of pain and severe anxiety. They are to make the patient comfortable, not to hasten death.
My husband was on hospice at home. I was given the drugs to administer as I saw fit. We didn't use the morphine at all, because my husband wasn't in pain. I did use pills for anxiety.
The nurse advised me not to "push" food, but to make food and beverage available if he wanted it. He ate a lot of popsicles! The day he died he had a normal breakfast and did not care to eat the rest of the day.
If the stories you were told are fully true, then I agree it is heartbreaking. And probably violates laws and care center regulations. This is why I wonder if your MIL might be mistaken about what she observed.