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.
Taking my Mom [98] home wouldn't have extended her life at all, and I wasn't about to put my Dad [94] seeing my Mom thrashing about. When he visited her in long-term-care, he saw a peaceful person and that was the image I wanted him to remember her final days.
Hospice killed my aunt. Hospice did not "rush her death"; hospice put her down like a dog. He had had a heart attack and fallen on the floor, breaking her left shoulder, arm, hip and leg. She recovered from the heart attack and they set the hip. However, they told my cousins that they should put her in hospice in the hospital because at 94, her bones "would never heal." (Really?) So they moved her into a private hospital room with a nasty nurse, loaded her up with adivan (sp?) and morphine, and denied her water until 3 days later she died. She was parched, so I gave her water on a swab. The nurse to me not to because it would hurt her "since her organs are shutting down." How the **** were her organs "shutting down" from a few broken bones? A healthy person can only live 3 days without water, so you know when they stop giving the patient water, they're going to die within 3 days. How's that for predictive power? Then they load them up on drugs so they have no clue what's going on. When the kidneys start to fail from no water, they release a substance into the blood causing the person to fall into what they call a "peaceful coma. Yes, they kill people by denying them water when they can drink. I gave a friend of mine on hospice a bottle of water when she was dying of thirst. She was up and talking and drank half the bottle. I was scolded by the nurse for interfering. Now I know what she was talking about!!
That being said, my mother has Alzheimer's. If she reaches the terrible end stages of that disease, I will not hesitate to put her on hospice. At that point, it would be merciful. But I would only put someone on hospice if they are ready and I am ready for them to die in less than a week. That's what this post has taught me, and I thank you all for that.
Of course, the pcp was very aware if my mother's circumstances as he has been her pcp for over a decade.
When mom was dying, we couldn't get hospice service. And I can tell you all, that mom was suffering. Every time we tried to turn her, to change her pamper, she cringed in pain. Every morning, she was struggling to breathe. Because of Medicare protocol, in order to have hospice service, mom's doctor would have to see her and recommend it. But, her clinic/insurance does not allow home visits by the doctor. We would have had to put pain-ridden bedridden mom on an ambulance, travel over dirt road in order to get to the main road. and then back. We all decided that mom is so close to the end and we didn't want her to go through needless pain. Mom passed away in her sleep without hospice service.
I tell you this much, it was terrible. Terrible to hear mom every morning struggling to breathe. Terrible to change her clothes/pampers, and seeing her cringe in pain. I would have loved to have had hospice service - for mom. To ease her to a painless death. I still feel bad that we never got hospice service in time to make mom's last moments of life, to be painless. Yeah, I would have been gungho with the meds. Anything that would have made her last days as painless as possible.
Would I feel the same when it's dad's turn? He's not in pain. But if he's close to the end, yes, I would contact hospice service. So far, the home care nurses of Dad's clinic are very nice and friendly. I value their advice and feedbacks.
I am a retired hospice RN and my only goal was to bring comfort and peace at the end of life.
I know I wouldn't want to be that patient, who is in pain, who has no memory left, just a shell, let me go with dignity and comfort. Even if it was possible for me to live another month.... for what? The same discussion among the family would still be there.
But like everything else in the Universe, we each will cease to exist at some point. It's the tragedy of existance.
And I hope that Medicare eventually kicks someone all round the room.
I can't praise the people that cared for my grandmothers enough, but the hospice that provided care for my mother is criminal. First, they refused my repeated requests that my mother's own physician direct my mother's care, which according to medicare, is a patients right. The day my mother came home from the hospital, the hospice nurse to me to give my mother morphine every two hours, which I refused to do. I felt that giving it that often would prevent her from being aware of anything and hasten her death. She wasn't suffering a lot of pain for the most part. My mother had been on hospice for a month when she became severely constipated. The coordinating nurse came out Sunday night and administered 2 enemas. Monday I assumed the regular nurse would follow up because my mother had a bowel resection just before she was diagnosed terminal and constipation posed a particular threat to her. The nurse said she had been briefed and did nothing to address the issue. Wednesday I called to the hospice twice with my mother's screams in the background. A laxative was ordered and delivered by mail. Over Thursday and Friday a friend and I removed a MASSIVE bowel obstruction with q tips in shifts, according to my mother's tolerance. It was seven days between the nurse's visits and I was so angry that I told her "If I have another problem like this, I won't be the only one with a problem." It was a very unpleasant job, but I felt that if she were unwilling to do what was necessary, she should have at least advised me how to proceed since I am no trained medical professional and I could have hurt my mom in my ignorance. I also told her that if she hadn't recognized the seriousness of my mother's condition, she was not qualified for her position and if she had and ignored it, it was even worse. Hospice had attended my mother about two and a half hours weekly. At this point, hospice started providing about twenty minutes of care, consisting of taking my mother's vitals twice a week. I was so disgusted, I didn't care, and enlisted friends to help me provide for my mother's care. When my mother became agitated in the middle of the night and I couldn't keep her oxygen levels up, I called hospice @ 3am. When the nurse arrived @5:30 my mother experienced some sort of seizure. The nurse said she felt my mother might be in the process of dying, and left. I frantically tried to comfort my mother until @ 9 am when I called hospice and said if someone didn't come I was calling an ambulance. They showed up, gave my mother something and she never spoke or had a light of consciousness in her eyes again. As rotten as I felt their care was, I do not fault them for rushing my mother's end. I feel it was done to ease the inevitable. If you have any quality of care issues you want to report to medicare, I'm afraid they use the honor system to investigate complaints. It's been a year and I directed my energy into a more positive avenue by volunteering as a long term care ombudsman. Unfortunately, conflict of interest won't let me involve myself with that particular provider. Darn!