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.
Your father was a wonderful person in the way he selflessly bore his illness and pain. he deserved his peace. May you find comfort.
He went into semi-unconsciousness that afternoon and complete unconsciousness that night. He passed the next afternoon. I know we did everything we knew to do. I know I couldn't watch him suffer anymore. I also questioned whether the morphine hastened his death. But what I want to share after all of this is that death was in process already. To withhold the morphine would have kept him in pain and worsening delirium. Though I questioned if it slowed his breathing, the truth is, the death process was already irreversible. I thank the nurses for keeping him comforted in the final hours of his life. To understand, the death process of someone with disease doesn't happen in a day or two (unless an acute occurrence like an embolysm or stroke or heart attack).... the body starts shutting down over a period of weeks. Nothing was going to stop his death, so I'm glad he was comforted after 6 excruciating months of cancer treatment. And who knows how long before that he had it and lived with the pain before he was diagnosed. I am thankful the medication was available. Please don't second guess your choices with loved ones. They know you did your best. You have to know you did your best, too, with the knowledge you had. Thank you for posting this. I was concerned, too, tonight that our decisions hastened death. But after reading all of the responses, I know that is a response to the grief I am feeling tonight. I miss my dad. I miss him and cry a little every day. But I know death was imminent and we did our very best. May you find peace. May you know that your loved one understands you did your best, and they are at peace. God Bless you.
My dad could not speak, swallow, or shuffle for a year after his several strokes and was trapped in his body by his wife who refused to "give up." If I had been in that situation, I would have preferred to be let go than to be miserably treated for a year with a ng tube down my nose, my diaper changed in front of my child, and all the other indignities of being incapacitated and unable to communicate. It is good that your dad is loved, but give him peace and permission to leave.
The reason no food or water is given is because when the body starts to shut down prior to the start of morphine, the stomach can no longer process food or water. Or food/water is going into the lungs and that would be very painful for your Dad.
Please please note, your Dad's timetable for passing would be the same whether Hospice was there or not. With Hospice, you know your Dad is relatively pain free.
I'm assuming you are asking me the question, since I debunked your "mercy killing" theory in the Bible. What's with pointing the finger about mercy killing anyway?
It is illegal and immoral in our society. There are some states in the U.S. and some countries that allow terminally ill people to end their own lives, but none that allow homicide.
We've gone over and over about the doses of Morphine, Ativan, nausea meds, etc. that hospice nurses give their patients. None of the quantities given comes anywhere near lethal doses.
I do not believe in mercy killing, I have never assisted or done that and never plan to. For me, I cannot do God's job. What I can do is relieve as much pain and suffering by administering medications and other pain relieving treatments. Now do you see the difference?
He was up during the night...talking and walking.
In the morning I found him cold..in bed.
I have seen a dramatic change in just hours. No morphine or hospice was involved.
Sometimes it just is what it is
Please note that people who will be passing shortly sometimes get a short time frame where they appear to be improving... thus talking, eating, laughing, and everyone feels there has been this turn around in the person's heath. This phase doesn't last long, then the patient goes into the next step.
Depending on the Hospice group used, some groups have a very informative notebook that explain all the steps involved, and what will happen when. And there have been cases where a person had improved so much that they were taken off of Hospice and lived many more months or a year or two.
Where the question shows at top of this page there is a "Following+" label, select it and you will not be following it any longer.
I'm gathering from your position that you are for mercy killing and that you believe it is the right thing to do?
First off, because he isn't licensed to administer meds or even IV saline solution to his own father is illegal! Secondly, giving and even forcing IV fluids to him, when his damaged kidneys are no longer working is just plain cruel, because his kidneys aren't working to capacity, he cannot process the fluids, which is why they are giving him only limited fluids by mouth or even food, as his poor body cannot process very much.
As mentioned above, I would most definitely report your Nephew to the Hospice Nurse and Dr, and sadly, he might well be banned from being alone in the same room as him, or worse, banned altogether, and hopefully not reported to the police!
As for him being asleep, or out of it, this is to be expected, being that his kidneys Are shutting down, the chemical buildup of BUN & CREATININE from his failing kidneys, do make the patient extremely sleepy and loopy if conscious, and even make them feel euphoric. The small amounts of Narcotics, are not enough to put a healthy person asleep, but a very ill person, may very likely be deeply asleep. However, the Narcotics will not hasten his death, but keep him comfortably in his decline.
The reason I know this as it happened to my own Mom, while on Hospice, and actively dying. The Dr's explained that when the body is shutting down, and the organs are no longer working properly, and it becomes dificult and even painful for them to process food and fluids, and it's best to discontinue them.
Yes, they are often unconscious, but it's much better than bring awake and uncomfortable, or in pain. Still, they may be just "under the surface", and still able to hear you, so talk to him, play music during your visits, enjoy conversationsome with others in his presence, as this too, may bring him comfort, just knowing that you are there!
It's terribly sad, that you are losing your Brother, and I am so sorry! Use this time to be near him, speaking to him, sharing and remembering all the wonderful things you enjoyed about your shared memories.
I'll be keeping you in my prayers!
Your brother is - and I'm sorry to be this blunt but you seem very matter-of-fact yourself so I hope you'll forgive me - dying of renal failure. There comes a point in kidney disease where dialysis, which is uncomfortable and risky in itself, is not enough to keep the patient going. So there is no point in continuing it, because it will not allow him to recover and improve, but only prolong his severe suffering.
Your brother and sister in law are both fortunate that you are a sensitive person, able to recognise that acting rashly in this difficult situation might end up making things worse for them to no purpose. Many people in your shoes would kick up a fuss whatever the consequences of it. Well done to you that you genuinely are putting your brother's and SIL's peace of mind first.
You are in a very challenging position. You are correct that it is professionally (never mind anything else) inappropriate for your nephew to be administering treatment to his father, unless this has also been agreed by the patient, his doctor and the hospice team. Whereas it sounds as though nephew is muscling in and making it hard for the hospice nurse to challenge him without upsetting the patient.
As a side issue: be careful how you judge your nephew. People who say what he said, and perhaps felt what he felt when he said that, often experience terrible guilt and shame about it later on when what they "wished for" is coming true. It seems more likely that his feelings towards his father are extremely complicated: if he truly, simply hated him it would be easier and more final to stay away and deny him any chance of leave-taking. Anyway.
In your position, I think if I could I would call the GP and report my concerns. The GP may be able to liaise with hospice to ensure that only authorised staff have any hands-on involvement in nursing or medical care. If you decide to try this, keep strictly to the facts; and if you must comment on your nephew say only that he is too emotionally involved to give appropriate care. Good luck, and please let us know how you and your family are getting on.
Please check out the New International Version (NIV) of the Bible. It is in modern day language and is so much easier to understand than the King James version.
I would like to dissect the verses you printed from your Bible and get to the meaning of the story. The man who came to David was probably not who he said he was, an Amalekite from King Saul's camp. Since he had Saul's crown with him, an item that the Philistines would not have left in the battlefield, we can assume that the Philistine's hadn't arrived yet and that he was a scavenger, pilfering the battlefield for treasure AFTER Saul had been killed. (See 1 Samuel 31:3-4)
Since the Amalekites had been in battle with the Israelites since the time of Moses, and David had just destroyed a group of them who had burned his city and kidnapped the women and children (1 Samuel 30:1-20), obviously this man was unaware of David's hatred of them. He thought he would be pleasing David to tell him of Saul's death but his lie wound up costing him his life.
What I am trying to get across is that, because the man was lying, and he did not kill Saul, you can not use this story to show "mercy killing". The man never committed Saul's murder to ease his anticipated (perceived) pain of dying at the hand of the enemy.
I am not saying that, in history, mercy killings have never happened. I'm just saying, in this instance, that it wasn't the case.
You have every right not to opt for hospice care for a dying loved one. As a hospice nurse, I have seen people in extreme pain at the end of their life. If you can live with denying them pain medicine and can put up with their moaning, screaming, gasping, writhing, etc., until the good Lord takes them, then you are a tougher cookie than I am. I wonder if that's what your family member would want.
I've seen it, and observed one who chose to end his own life with grace and dignity, utilizing his option of Death With Dignity. A very brave thing to do.
No, a sad and painful death, I wouldn't wish on my worst enemy, but it happens, a lot! And thank God we have the wonderful option of Hospice Care, to help in the aid of comfort for our Loved ones, and now even Death with Dignity, in some states.
When your body is broke down, and death is in sight, please, take the option of Hospice Care. They are not hastening your death, they are a saving grace, helping you to live out your days with as much comfort as is possible. And they definitely don't set out to kill you or shorten your life!
If you would rather, do not choose Hospice, tough it out of on your own, but it won't be pretty. It will be Awful, difficult, and painful, and you can't pray that away.
2 It came even to pass on the third day, that, behold, a man came out of the camp from Saul with his clothes rent, and earth upon his head: and so it was, when he came to David, that he fell to the earth, and did obeisance.
3 And David said unto him, From whence comest thou? And he said unto him, Out of the camp of Israel am I escaped.
4 And David said unto him, How went the matter? I pray thee, tell me. And he answered, That the people are fled from the battle, and many of the people also are fallen and dead; and Saul and Jonathan his son are dead also.
5 And David said unto the young man that told him, How knowest thou that Saul and Jonathan his son be dead?
6 And the young man that told him said, As I happened by chance upon mount Gilboa, behold, Saul leaned upon his spear; and, lo, the chariots and horsemen followed hard after him.
7 And when he looked behind him, he saw me, and called unto me. And I answered, Here am I.
8 And he said unto me, Who art thou? And I answered him, I am an Amalekite.
9 He said unto me again, Stand, I pray thee, upon me, and slay me: for anguish is come upon me, because my life is yet whole in me.
10 So I stood upon him, and slew him, because I was sure that he could not live after that he was fallen: and I took the crown that was upon his head, and the bracelet that was on his arm, and have brought them hither unto my lord.
11 Then David took hold on his clothes, and rent them; and likewise all the men that were with him:
12 And they mourned, and wept, and fasted until even, for Saul, and for Jonathan his son, and for the people of the LORD, and for the house of Israel; because they were fallen by the sword.
13 And David said unto the young man that told him, Whence art thou? And he answered, I am the son of a stranger, an Amalekite.
14 And David said unto him, How wast thou not afraid to stretch forth thine hand to destroy the LORD'S anointed?
15 And David called one of the young men, and said, Go near, and fall upon him. And he smote him that he died.
16 And David said unto him, Thy blood be upon thy head; for thy mouth hath testified against thee, saying, I have slain the LORD'S anointed.
So called mercy killing in the Bible.
Making money? On average Hospice gets $150 per day from Medicare for each patient. That $150 also has to cover the cost of the rental of the hospital bed, rental of oxygen tanks, and a long list of medical supplies.
Oh, let's not forget the payroll for the Board-Certified palliative medicine Physicians.... the Hospice trained RN's.... the Hospice trained Aides,.... the Clinical Social Worker for the patient..... the interfaith Chaplain..... the Bereavement Coordinator, etc. that commute to where ever the patient may be, at all hours of the day, in all kinds of weather.
By the way, morphine is a Controlled Substance.
Another thing you need to take away form this story: Hospice is a business. Its goal like many businesses is to keep costs low and make money. You see how the CEO of this business was calling the shots? He has no medical training or degree and he is the boss. That's how it works. Also note the cap.