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.
Three types of drug are commonly in use at the end stages of life.
Morphine is used to relieve severe pain (for example, in cancer), but it is also used to improve the quality of respiration (for example, in heart failure). The way this works can seem counterintuitive to the layman - it certainly did to me - but if you want to understand it, ask. Essentially it eases the breathing mechanism, reducing the heart's workload, and it also improves blood flow. It is NOT given to cause breathing to cease.
Hyoscine represses secretions. The purpose of giving it is to prevent patients' experiencing the terrifying sensation of drowning as their lungs fail. It causes drowsiness. I don't know, I haven't tried either, but I would guess that being too drowsy to talk to your children is probably preferable to nature's equivalent of waterboarding.
Sedatives are given to relieve the patient's anxiety and distress. The dying process can be terrifying; and the key point if that these drugs prevent *the patient* from enduring that terror. Of course it is hard for relatives not to feel that it is their own feelings that are being spared - that their loved ones are being doped to the eyeballs so that we won't have to watch their agony, or keep a prolonged vigil. But if it's hard to watch, just imagine what it's like to go through.
The key word, too, is *prevent*. Why was your loved one given these drugs when they weren't experiencing noticeable symptoms? Because, believe me, you didn't want those symptoms to become noticeable. You can't prevent something once it's already happened.
We tend to prefer natural processes such as birth, growth and death to take place naturally; but Nature is not always our friend. Medicine, from its beginnings, has developed as mankind's way of trying to protect ourselves against Nature's nastier, crueller moments.
Medicine is not perfect, not even close. But it is carried out by people who are doing their best to give their patients the best outcome possible in the circumstances. Some of those people will be better than others, just as some people in any walk of life are better than others. More patient, kinder, gentler, more perceptive, more empathetic, more intelligent, better at communicating... Which, unfortunately, means that some will be less so; and you will have to meet them half way by asking questions, expressing preferences and raising concerns.
If you really feel that one or more people on your hospice team are working to a schedule, or have become so hardened to death they have lost sight of their patients' humanity, or for some other reason are just definitely in the wrong job, then speak up, call another service provider, call your own doctor or your loved one's doctor for advice.
Remind the hospice team, if necessary, that this may be all in a day's work to them, but that for your loved one and your family and you it is a unique time that they need to stay sensitive to. If you have questions, they shouldn't be dismissed. If you want to know why a particular thing is being done, you have a right to ask and a right to expect a clear explanation.
But the best hospice professionals in the world can't prevent death from being a time of loss and grief. Your loved one, who was walking and talking and laughing, will be gone. Their role is to make that passing as peaceful and free of pain and fear as possible for their patient, but they can't save you from losing your loved one. Be fair in what you expect of them.
There a are stages to dying just as there are stages to birth. For some reason we know more about the joyous event of giving birth whereas death remains more of a mystery. I believe some cultures know far more about it than we in the Western world do.
You're right. What goes around comes around. Be very careful with what you wish for.
It sounds as though you did EVERYTHING right; you saw that there was no way around your mom's intractable pain and life-limiting diagnoses. You got her relief.
You could not 'save' her because death is ultimately part of life that we don't control. But you got her help with the pain.
Someone will be along shortly who can help you with the nightmares.
I will be thinking of you.
But it is hard, because she is gone. She hadn't been much of my mom for a couple of years, because of the dementia.
I've been mostly OK, because we did the best we could. But now I am having nightmares of her in agony, and when I wake up, she is still dead and I couldn't save her.
The murderers can not see cruelty because they see normal method of ending life, but no one can know or predict the time of anyone's life . how can they says their give comfort with all these narcotic. Just remember no body can take anybody's life, what goes around comes around.
My father's primary doctor, send hospice to my house on 02/28/2016. He stated that he have severe dementia, hospice nurse was pushing me to medicate my father with out having pain. I notice the she wants me to kill my father with those medications, my father started having a FOLICULITIS infection the nurse told me that they would not treat that, she said let him die, he is not have quality life. Hospice said to me don't call 911 don't take to the hospital. I took him to the hospital anyway and the doctor drained the DI skin obsess, give antibiotic and my father is recovering. I pray to God for guiding me and I found out the hospice is the trash can. Hospice selected few patient to cover the murders. They call graduated from hospice, that is a lie. If I listen this killer nurse, my father would be dead. I called the insurance to asks if is any cover limit for my father they told me no, I said that I am not satisfied with hospice that I would like to have another opinion. I took him to a doctor on May 11/2016 to help me to discontinue VNA & HOSPICE. My father is home safe. We don' have be silence about the way hospice terminate people's life.
I wrote something on this thread a while back, so it keeps coming up on my newsfeed. There is a lot of guilt that goes with the death of a loved one at times. It is easier for some people to deal with guilt by turning it into blame. We weren't there when the LO was passing, so we don't know things for sure. I just hope the people can find peace.
Everything I post to try and re-assure those contemplating hospice for their loved ones receives answers that I was part of the conspiracy.
You are correct, many people call on hospice at the 11th hour. We had patients die during admission or the same night. I was invited to keep off the thread if I didn't like what I was reading!
That said, I think it's true that being in a facility is less conducive to any kind if recovery than being home. At home, my mother gets constant attention, she can eat or sleep when she wants during the day. She gets hygiene care as needed throughout the day. She gets kisses all the time and I can give her homeopathic and naturepathic remedies as I ses fit. I am sure that she would have passed ages ago if she had gone to some facility. Hospice or not.
The only stories I have heard about Hospice taking the life of many people before their time has been on this forum thread, no place else. Of course, we don't have the whole medical story and we are not doctors to analyze each individual patient. All I know, I was so glad my Mom was on Hospice, her heart was giving out because of a serious head trauma, and she stopped eating before Hospice was called in, at least she wasn't in pain during that final journey.