Did Hospice rush your loved ones death?

Once upon a time I was opposed to hospice getting involved. That was because of a pushy woman at the hospital really acting against my Moms wishes and pushing hospice hard on Mom and myself. Ghoulish is how I would have described the whole thing....and very nasty.

When it was clear (a year later) that there was no help for the pain that Mom was in, I told her primary doc that he needed to prescribe hospice for her.

I agree, there seems to be a lot of one off posting here. Trolling.

Hospice was a very good thing for Mom. They were able to step in and control her pain. I am grateful. No one should die in agony.

What is interesting, and I have mentioned this before, those who are posting horror stories about Hospice have never been on this website forum until now. It is easy to check their past history of postings.

I get so tired of writing that the morphine given in Hospice is the same dosage as one would get after having major surgery. I've had two major surgeries, so I guess I am ghost writing.... [sigh].

Really wish the new writers would read some of the past 25 or more postings to gain a better understanding why certain things are done.... such as no food or water if the patient has an aspiration condition [which is common], or that the organs are shutting down so food would just lay in the stomach which would be painful.

Some times I feel we are being baited.

Alison I am in a mood too every time I read one of these posts.. Killing someone in 30 seconds I don't think so. It takes longer than that to kill a horse with a lethal injection when the animal is being euthanized.
Bad things may have happened in that rehab center I don't doubt that but killing someone in 30 seconds right in front of their family.
I did get yelled at in rehab the morning my infected wound burst and I refused to get dressed and go to the dining room. She said it was healing well and did not smell bad and I had to put my clothes on. Well I didn't and was back in the hospital in a few hours for revision surgery

So if you're not even sure if your mom is breathing, that would be the time to give her water??? You can find out if she's breathing when she aspirates it and chokes, I guess.

It seems to me this thread is fully hijacked by lunatics. No one wants to talk about their anti-Hospice position in a productive way, multiple 1 comment accounts dropping off super dramatic posts about Hospice killing their loved one...

Sorry, all. I've unfollowed this thread, will do it again.  Just happened to see the last couple of posts and I'm in a mood.  

Well They should inform the family in full detail what's happinin next because I left for a hour and my mom WAS BRAIN DEAD IT WAS SICK SHE JUST STARED AT ME AS THE NURSES KEPT SAYING SHES DIEING 5 DAYS OF WATCHING HER BREATH TO SEE IF SHE WAS DEAD I FREAKED OUT ... I SCREAMED SOMEONE GIVE HER SOME WATER YPUR KILLING HER IT WAS SICK ...

Yes absolutely! These people Kill. My mother who went into a respite care center was horrified at the treatment that she received, when the night nurse physically and emotionally abused her. I brushed it off,in a sense that my mother could get under your skin , but she truly was afraid. I am now investigating other circumstances and I am most certain they did do these horrific things to her. They actually killed her with an overdose of the heroin based medicine that they administered right before my eyes. A male nurse whom Ive never seen before comes into her room, we were there staying overnight as we had previously, and gives her the medication and she passed 30 seconds after the dose. I knew in my heart, as I reflect, that he killed her but after all she had been through, it seemed like a blessing. But after hearing about certain end of life care stories I really and Truly believe they purposefully killed her with a lethal dose of the opium based medicine. They are saying they give respite care but they actually are in the death business and I believe they truly Love and get off with the grief of the emotions of the family, the patient and the misery it all brings. Evil, Satanic, Luciferian practices I believe they are. Unfortunately it is after the fact, but yes they are in the business of Death, and they do control the patients death. Amen.

SueC1957

Thank you for your comments as well. Thankfully she had 3 insurances that paid for the bulk of the charges with only a few asking for the coinsurance. I read about cyanosis, which is why seeing the blue in her fingertips I made the decision regarding life support.

The doctor was not even her primary care, but the NH doc. She never saw or heard from her primary care doc the whole time. Ironically, she could have seen her since the Hospital claimed NH doctor care would end if she was not in the NH and her care would revert back to her primary care doctor.

Anyway, it is over and she is at peace and in a better place.

Ironically, since she has passed, the NH she was at and the hospital she was at has had a lot of turnover, and even one of the nurses at the hospital was let go and probably charged after using drugs.

BarbBrooklyn Thank you for your comments. It was the right thing to do taking mom off life support; her body could not fight the recurrence of Sepsis like it had before. It was God's will to bring her home. The ICU head did not even mention her being on Hospice. I found this out after the insurance statements came in.

Yes, I did ask for one more day to see if her condition would improve, and can understand the doctor still seeing her and billing for the visit, but the GI doc. She was off of the feeding tube. There was no need for him to visit her, yet he did and of course billed for his services.

What I meant in the last statement, the Hospital did not list the discharge as death, so they sent this survey about how they did. It was marked, Deceased, don't contact her again and return to sender. I also called and made sure that she would not receive any more mailings from them. It was upsetting that they did this after she had passed.

PamB I am so sorry you had this kind of experience with hospice. My first experience with hospice was 17 yrs. ago with my dad who was dying from leukemia. There were few treatments at the time for the kind of leukemia he had and he had come to the point where his quality of life was being affected by the treatments that were not a cure but just basically kicking the can down the road because he was going to die, there was NO cure. Hospice helped me respect his wishes of not being in pain and to stay in his home with his books and dogs. His last night that he was conscious he was sitting in a chair,eating ice cream, watching tv, talking with my mom and husband, a pleasant evening and then he went to bed and never woke up, I suspect he had a intracranial bleed which with his type of leukemia was always a possibility. He was receiving oral morphine at the time. None of the hospice nurses giggled. If this is truly what happened to you, the nurse was extremely unprofessional and I hope you reported them to the corporate office and to their board of nursing of whichever state you were in. This is not the normal behavior of a hospice worker.Also if you as you say were present at your mom's bedside and told the nurse not to inject her and she did anyway, that is assault, you could have called the authorities. I just know I encountered none of this behavior with my hospice experience. I do agree not all hospice companies are equal. If you don't like their service, call your insurance co. that is paying them and complain and get another one.Educate yourself what hospice means. Traveling that last mile with a loved one ,knowing you can't cure them, that death comes to us all, this is the hardest journey.

My mother was on home hospice and I will always regret that decision. The agency promised me that mom would take all her regular heart meds. But when the hospice nurse arrived on her first visit, she went right to the box of narcotics and approached my mother with a syringe. My mother was lucid and was not complaining of pain. My mother, a retired RN, held up her hand and said, "NO." The nurse looked startled. After that experience, I made it clear that there would be no narcotics. Only her regular meds. Yet on my dear mother's last day on this earth, the hospice nurse rushed to her bedside and injected her with something. Why? She said my mother was agitated. What did my mother do? Well, the aide and I were changing her bed and mom said, "Please don't let me fall off the bed." She said it in her usual calm voice. Immediately thereafter, the hospice nurse rushed her bedside and injected her. I asked her why she did that and the nurse said it was because mom was agitated. Not so! Then minutes later, as my mother fell into a stupor, the nurse said, "your mother will probably die tonight." I told her that I could not believe it because she just ate ice cream. The nurse giggled and told me to go out and get a milkshake and celebrate. Yep, that's what she said! Celebrate! Mom never awoke and died that night.

How do you continue to "promote life", if your dying loved one On Hospice in your home can no longer drink from a cup, or suck from a straw? My FIL got to this point on the day before he passed away and my husband tried (in his scared and confused state), to drip a little water into his Dad's mouth, which only made him cough. It was at this point that I told my husband that this is the time that we continue to do everything possible to keep him comfortable, and swab his mouth with those little spongettes to keep his mouth moist. We continued to give him the liquid medications on a schedule, and he passed away comfortably the very next day.

There was going to be No IV fluids to prolong his life, as to do that would have been cruel, and not of the Hospice philosophy in the first place.

The dying process is difficult to watch, but we all die at some point, and it's our job, to make it as pain free and comfortable as we can make it.

I second your questions timbuktu.

Markmedsur1,and I am asking this politely. I believe you stated at one time you are a RN. Where did you go to nursing school and what degree did you obtain? I really am asking this respectfully, it would help me in understanding your posts.

I have said this before and again ---I have seen many people die on regular hospital floors and they got fluids in the veins and if they could eat they got food and they were turned and got bathed and not overdosed with mso4 or Ativan. In other words the promotion of life until God calls them home. Nobody but Our Lord knows when they are to go. Hospice kills and thou shall not kill. This is not some new loving organization that just popped up a few decades ago. As if they are so great. We've had people dying for thousands of years that had no hospice and they did just fine so don't go trying to promote this stuff because it doesn't work on me. My Grandmother died on a regular hospital floor and she died very peacefully. I'm very glad she was not pushed to death without food or fluids and shrank up like a raisin! I've seen that on Hospice floors, too. You don't hold back IV fluids. My God man. That's cruel and it dehydrates the person!

As the doctor associated with our hospice told me "Hospice is rough business." Pretty strong words from a man on the payroll. But true.

My Dad was put on hospice when the medical community ran out of ideas. It was viewed as "palliative", and not necessarily "end of life"--but end of "valuable life" as viewed by society.

As the six months drew to a close, hospice dug their heels in and brought him to the end. No one in my family believed he wouldnt be around for Christmas--or NEXT Christmas. He had Parkinson's.

His death was systematic and ugly, ungraceful and uncaring. I will make it my mission to stop willowtreehospice from ruining more lives.

Those of you who sing the praises of hospice should count yourselves fortunate. I am certain that not all hospice is bad or wrongheaded or fraudulent, but willowtreehospice sure is.

PamB, here's a different way of viewing hospice services provided in a hospital.

The patient is already dying; why would anyone want to move someone in that condition to another facility? The EMS ride, the change in surroundings, the anxiety of going to an unfamiliar place - why put anyone through that?

My sister was in a hospital during her last week of life; when it became clear that she wouldn't recover, one of the doctors told us that they had a small hospice wing where she could be transferred, just the other side of the floor she was on.

We were so relieved that she could remain where she was without the ordeal of being moved, and she was relieved as well. The room was cozy and private, with a lounge next door for relief when we needed it.

I wish people would stop finding so much fault with hospice and think about how much it relieves people from lingering and suffering a slow, agonizing death.

Thinker1, one has to realize that when Hospice is called in, it is usually in the final week or two of a person's life. That person would have passed if Hospice was there for not.

It is a decision does the love one pass with peace and dignity, or thrashing about in unbearable pain. Which would you choose to do or what to remember of your love ones final hours?

PamB, please note when a patient is in the journey of their body shutting down, they CANNOT take water or food, it would be too painful for them because the stomach is no longer processing food/water, or the food/water would go directly into the person's lungs. 

Several times when my parents were in the hospital, we took turns being with them. We learned how important this is. There were times there was no cup. We would ask the attending nurse for one with water. Sometimes they bring a papercup and a pitcher of water. Usually, they will direct us to a separate room that has the paper cups, ice machine, even a vending machine. We also requested for those foam brushes to wet the lips with the water. We went through those too fast. I remembered going to the drugstore down the road and buying some. I think it was a quarter each. When mom needed turning, we just did it ourselves (when there was 2 of us) or reminded the nurse if we were by ourselves. We always asked the nurses if we can help. They were very grateful when they did accept our offer. Yes, it’s their job, but they have other patients, too. And in the end, it’s not about whose job it is - but the comfort of our parent.

I agree with you. For whatever reason, it does seem as though they go to unresponsive quickly and then to death quickly once they have been placed on hospice.

Mark I am sorry about your father dying but in reading your last post it sounded like your mother was exhausted and at wit’s end from taking care of her spouse who was terminally ill with lung cancer that had metastasized all over his body. Your mom needed help, and it was given to her by your dad’s doctor, who knew your father’s end was near and was gently guiding your mother to accept that and she & he agreed to admit your father to the hospice floor.

My view as a RN am thinking his CO2 levels were high from not being able to breath well enough to get enough oxygen in due to his lung cancer. As you may know now being a PA/RN or whatever title you have acquired, there is something triggered when end stage COPD pts or lung cancer called the hypoxic response. Those patients are so used to functioning at a certain level of O2/CO2 that once that condition changes their respiration’s decrease and they stop breathing.
This coupled with fatigue & all the other adverse conditions from his cancer caused his demise, not the actions of the hospice staff.

I say this respectfully but you may benefit from therapy for you to work out all this guilt or projection that you have for not being able to save your father. In your role now as a healthcare provider, you must realize that your personal feelings about a modality of treatment - Hospice - can not prohibit you from offering that service to others. You have a duty to provide your patients the right to decide on their own but you need to be able to give them that information with no personal bias.

Your mother did the best she could have done under those circumstances 20 yrs ago.

I am curious, Mark, what do you feel should have happened? What treatment would have given you a different outcome? Your father had lung cancer with metastasis. What could you have changed about that?

I hope you work out whatever negative feelings you have stored back in your psyche and are able to see both sides of this discussion. I certainly hope those issues a will not prohibit you from supporting any patients you have the honor of caring for if they choose Hospice.

20 years is a long time to wrestle with the circumstances of your father’s death. I wish you peace.

Here is how hospitals play the Medicare hospice game. They can "discharge" a patient from the hospital and, under Medicare, "admit" the patient to the hospice wing. (The patient never "leaves" the hospital.) Hospice wings are very profitable.

I know two families who had a family member in a hospital hospice wing. And each said their family member was given NO food. Not even ice!

Markmedsur1 you are spot on. Hospice is BIG business and it will only get more profitable as the Baby Boomers age. Just look around at your local hospital. More and more of them are opening up hospice units. Our local hospital has been here for 100 years and its hospice wing is only two years old.

And once again Why are Hospices located on private floors? All nurses are qualified to deal with dying patients! It's because they know Hospice kills them off faster!  I know many nurses who will not work at a Hospice. They won't do Euthanasia.

Whoever told me "Since I was an RN I should have cancelled Hospice right away DOES NOT KNOW WHAT WE WENT THROUGH YOU FOOL. THIS WAS OVER 20 years ago and my Mom and I did not know what Hospice did to people then so shove it. We learned after my Dad died 24 hours after being admitted to the Hospice unite. He was fine at home. He ate well , he was alert and oriented times three. His problem was the lung cancer and the adenoma carcinoma throughout his body and on his heart! So he needed up with assistance and he had to have oxygen. But he wanted to live !!! He wanted to live ---do you get that ???? Darn death trap. He was on morphine ER 15 mg per day and that was it. That helped his anxiety from trouble breathing to where he was calm and he could breathe easy . The doctor tried Ativan once and he just went Loopy and said "no more " and my Mother said "you will never get out of Ativan again". Well my Mom was exhausted and I was very tired at that time,  too. So she got him admitted for Friday night at the hospice unit at the hospital ! The doctor had sympathy on her because he knew if she could not take care of him he would die,  so the doctor pulled a string and said We will take him here over the weekend and you can bring him home Monday.  Btw the Doctor was a Cancer specialist and liked my Dad and did all he could for him and said he was a remarkably strong Man.  Mom was relieved because she was getting physically exhausted from taking care of him and I was busy working and finishing my nursing school.  Well he was fine when we put him in the hospice unit and alert oriented times three they put oxygen on him and he said "I'll all be ok here go home and rest". So we went home. The next day we got a call from this hospice doctor stating that he believed that my dad was dying. My mother and I were in shock because he was just fine the night before! By the time we got up there his respirations were 10.  And he had not responded to them all night or all day. Mom looked at his chart and I did as well and we seen that they were giving him almost double the dose of morphine a day and they were giving him a 1 mg Ativan IV push BID!!  We were furious but yet saddened and in shock and we thought "my god what are we to think here? ". I suggested Narcan. Mom said that would probably work . . Well then they all got upset and the nurse told me and my Mom that "oh that will make him so disoriented coming out of this and upset and he's liable to start screaming and it will just create a terrible situation and it would be best to just let him die ". We told them WE WILL decide on our own and we will be back ". So Mom and I went downstairs into a quiet room in the hospital Chapel to converse privately about this. We called several relatives and conversed among ourselves. We were probably in this room for an hour hour-- about an hour. We were told that he would probably die within a few hours so "go talk." Well low and behold they sent a health care tech down to our area and she told us you'd better get upstairs now . We did and what did we find? He was within 5 minutes of death and respiratiins were 6! They lied to us all the way through this experience too. And we were considering suing them with a huge lawsuit but due to my mothers Christian values she said I just can't do it.  So you people that think hospice is so great don't you ever tell me that and don't you ever put words in my mouth and assume! Disgusting comments. YOU WERE NOT THERE!! And 40 years ago there were no hospices but people died on hospital floors with out hospice and nobody complained ! Including my grandmother and several older great aunts and Uncles. .... at that time they all got food they all got turned , they all got IV fluids , they all got attention and the medications they needed , and they were able to die with dignity and not be doped up with lethal amounts of morphine and Ativan ! Dr Death awaits you in Hospice. As I have posted on here several times before hospice is a big corporate money maker !

One of the most valuable things hospice gave me was stickers with their phone number to place on all my phones. I took advantage of that. It was a comfort to know I wasn't alone as I faced all the decisions I had to make. When I made the final call saying that my husband had just died it was also a comfort that that was the only call I had to make -- no coroner, not the funeral home, not the research center where he donated his brain -- hospice care of that, and I could focus on bringing my family together.

Markmedsur1, since you are a RN, you would know that you can cancel Hospice at any time.  Why didn't you?

It's not unusual for a pt to just become unresponsive when the ammonia levels get that high. I've taken care of several patients with increasing ammonia levels and most of them did not even require any meds and they passed in the same manner as the ones that required meds for comfort. It's not unusual to see the periods of combativeness, then the very hyper alert mode prior to the pt going unresponsive. This happens with or without the meds. Hope this helps

Everyone has a right to voice their opinion. But, doctors have to write an order that reflects they think the person has 6 months or so to qualify for Hospice.
Hospice patients are terminally ill; the expectation is they will die soon. Every family should realize that fact.
Do patients rally & come off hospice? Yes, they do.
The person isn’t penalized for getting better.
I too am a RN. I had my mother enrolled in Hospice twice while she was in a NH.
The first time, she got better, substantially so, & was discharged from hospice.
One year later my mom had a stroke, & we called Hospice again. They came back in &  provided services to her.

I think she was on Hospice for one or two months prior to her death.

During her final hours the nurse came in to assess my mom and stated she was going to give her morphine but felt my mom was in no pain, this withheld the morphine.

Thus to believe hospice over medicates willingly is just not true.

I would think that being a Hospice nice is a hard job but in my conversations over the years with hospice nurses, all of them tell me that they loved their job - that they were honored and privileged in their role to provide support to the patient and their families during the end of a person’s life.

I asked if it was depressing having to take care of dying patients and actually not one of them said it was depressing- heart wrenching, sad, & hard work physically but not depressing. I am sure there are hospice staff that do get depressed from their job, but enlightening to me that many of them loved what they did.

We don’t know what expectations the anti-hospice posters were of the hospice team; were they unreasonable expectations? Maybe.

Hospice staff are not miracle workers, after all. They are human too.

To me while this thread asked if hospice rushed their loved one’s death, of course there will be those who have a negative view, but the majority of people that replied were very pleased with the hospice team’s performance in providing comfort to a dying person & if that meant giving more medication to that person, so be it.

No one can say they know how the body metabolizes narcotics and the person in hospice is usually quite ill meaning many organs are not capable of functioning as they should. I don’t believe any hospice nurse willingly over medicates the person to the point of respiratory depression and death. That provider uses their professional assessment skills to administer the appropriate dose the nurse feels will achieve the goal of comfort.

Families angry their loved one wasn’t turned every hour, lips moistened when they became dry all the time is an unrealistic expectation of hospice staff, and in this situation the family should be there to assure that person is turned and their lips moistened, as well as other comfort measures. 

That was MY job as I kept vigil with my mom in the last hours of her life.

Perhaps hiring 24/7 caregivers would have assured the hospice patient’s needs were being met because it is truly unrealistic to believe any health care provider will be available every minute of their shift to assure those needs were met.

An RN or PA with hospital experience surely is aware of this as well.

For those families reading the negative opinions on this forum, please don’t be frightened to where you will not choose Hospice to take care of your dying loved one.

My experience in the two times I utilized hospice were very satisfying, under the circumstances.

I will share one interaction with our hospice nurse Holly.

I lived 200 miles from my mom. I had spoken to the hospice nurse, Holly, every week prior to my mother’s passing. On our last conversation I discussed the distance & time I lived from my mother, & asked her to please notify me if she assessed that my mother’s death was imminent. Holly called my home @ 8:30am the morning of my mom’s passing and told me that today might be the day.
I thanked her & headed north on 95. I was able to get to my mom’s bedside by 3pm. My mother died 12 hours later at 3am. I was with her.

Moral of this story is that Holly, who was probably very busy, recognized the signs of approaching death and remembered what we had spoken about, as she called me & I was able to be with my mom when she passed.

Long post, I know! But please keep an open mind about using hospice. Hospice will assure the dying person’s comfort and needs are being met.

I’ve been a RN for 37 yrs & have never heard of any family complain that hospice didn’t do their job in past experiences. 

Don’t let the negativity of a few cloud your judgement. 

Perhaps we should insist that to be a hospice nurse you have to be terrified of the dying process and utterly unable to support families through it. Substitute hand-wringing and raging against the dying of the light for practical symptom relief and a reassuring presence. That should help.

Now, that's ridiculous.