Did Hospice rush your loved ones death?

Hi uninformed. I must say that I am a fan of hospice, having seen the wonderful home care that was afforded my Grandmother and my mother-in-law at the end of their lives. However, my recent experience with my Dad has left me feeling a bit confused and guilty, though my rationale side tries to dismiss the guilt. I have worked with many end-of-life specialists and I have produced programs on Compassionate Care, so I am familiar with the process involved, but when its your own loved one, especially a priceless parent, things can seem quite different. My Dad's cancer had seemed to be in remission and his sudden back pain, turned out to be metastatic. We were also told by his Oncologist and the Paliative Care team at his hospital that his prognosis was 3-9 months. The plan was to get him into hospice, get his pain meds working and get him home. Yet, several days later he was experiencing what others on this website called "terminal agitation" and we opted to sedate him as we feared he might hurt himself. He had been in quite a bit of pain and he was now resting quietly and hopefully comfortably. We were told that his extremities were showing signs of end-of-life, with discoloration. Within a few days he passed away peacefully. I was on my way to the airport when it happened, and my mom and sister held his hands and said it was very peaceful. So, in our case 3-9 months became 6 days. I have to say that i felt as if we robbed him of time on this earth by providing him comfort care. But, I think the reality is that we saved him from living through a torturous ending. These are not easy decisions to make, time is precious, I think I will always wonder "what if", but I also know that he was aware of his situation and although we all thought he had more time, he had indicated several times that he wanted pain control or comfort care to be the priority. I think that I was blessed that my brother, sister and mother all were in agreement with the course that was taken. I hope that you can find peace with your own family members. It is so difficult to lose a parent, but to lose the rest of your family seems to be unfair. Hopefully you can have discussions with accusing, to try to understand where they were coming from, and for them to understand your feelings as well. Your mom is gone, but the rest of your family will be with you and there is so much that you all share as family members, that it is worth the effort to resolve these issues. Good luck!

Thank you for your words of encouragement. I'm trying so hard not to allow whats happen settle hate in my heart. I find myself questioning my own core beliefs because of the acts my family and the service they received from Hospice. I loved my mom so much. I realize I cant bring her back , however I feel there has to be some justice . I'm not going to sit back and not push forward to get some things changed. I owe that to my mother. I feel weak right now due to the mourning of her death but I wont give up. I will find someone to hear me and understand HOSPICE has to adjust some of their policies. I cant tell you how much it means to me to find your comment. Believe it or not I needed it. You gave me the boost I needed to get up this evening. Thank you very much. My journey will continue.

I am so sorry for all of you pain and loss. You should read this article online if you can - Pulling the Plug, The Houston Press by Dianna Wray. The article says there is an ethics board in hospitals that decides who lives and dies. When my brother was dying, the hospital wanted me to find another place for him, insisting if I didn't they would leave him on a stretcher on the front lawn of my mother's house. They were asking about children and relatives from the first day he was in there. The morphine situation seems unethical - unless someone is with it enough to know they're in pain. We have to find a better way, but the hospice people need to be honest about what is going on too, so the loved ones can make a more informed choice and not feel like a deer caught in the headlights!

I think Hospice should use better discretion when it comes to administering death upon someone who isn't ready to die. Do they use their given authorization cruelly for the sake of the patient ? I cant help but feel the family members play a big role in it . 3 days ago my mother was put to sleep by my sisters, niece and brother inlaw and the help of hospice. It was done without my mother asking or knowing fully what they were going to do.Very few people knew including my brother and myself. It wasn't until after her death a friend had made a comment to the effect that they had no heart for killing your mom. I had been under so much stress and was detered from going to visit her by my sister saying not to worry if I couldn't go to help due to the fact I had my grand baby to take care of. My family no longer wanted to care for my mother. She would come to visit me and relate to me how rude they were to her and hated having to go home. She made me promise not to make a stink about it fear it would make things worst. Like an idiot I kept my mouth shut. My mother lived with cancer for 15 years and towards the end she related to me that she wasn't in anymore pain that she had been in before. She was still able to feed herself , get up to use the bathroom and was alert. Within 1 week after my sister got the green light ( the letter from the doctor ) that my mother was given 6 months she immediately got hospice involved and 5 days later my mom was dead. My sisters rushed to pick me up knowing they had administered the last dose. It was me who sat as she took her last breath and watched the vein on her neck stop pumping blood . They had the courage to give my mother that last dose but didn't have the courage to watch her die from it. They deceived me by not ever saying a word about what they were doing and used me to be the one to confirm she was not breathing. They stood in the back yard waiting . I didn't know that their hearts were so cold and a service such as hospice would support such actions. They should have confirmed that all siblings were informed. That is if they were as compassionate as they claim to be. MY MOTHER WAS NOT IN A CONDITION TO BE PUT TO SLEEP LIKE AN ANIMAL!

I don't know about all hospice organizations but as soon as the one that we were using found out that Dad was not a cash crop for the doctors they rushed to get rid of him quickly. I was there and saw.

DebinHouston....I realize that Hospice is there for the end of life and to make the patient more comfortable while they are in their final days...But it should not be a rush to get rid of that person..Some things are wrong and the caring partner should not be the one to administer the morphine, no matter what..If that has to be then Hospice needs to be there and not leave the grieving partner feeling quilty for having to administer the final dose...So sorry about your sister but she is in a better place and in no pain..God bless the loved ones who are left behind to suffer until later..they surely had no clue about how they would feel maybe weeks or months after the fact...

My Dad died a year ago, today. He was under hospice and his last meal did not go down; he stopped swallowing. I should have administered the morphine, but instead early morning, nurse came by and she prescribed antibiotics and something stronger than morphine. We long ago said no feeding tube! ... I do not feel hospice rushed him. He was strong and ready to meet the Lord, and died sitting up with his O2 tubing in his hand. It is in the Lord's hands! Memory eternal, Dad. I will you!.

2015 Nightmare I feel your pain. I lost my brother to Hospice on December 30, 2011 and my sister to similar treatment, but not in Hospice on June 16, 2013. Both times we went to the same hospital. With my brother I was just innocent and didn't know what I was looking at enough to fight it. Family members thought I was rocking the boat. With my little sister, she was in the hospital for a week with a bad infection. When we picked her up on a Friday, the nurse was right there in the room but she never told me she was leaving against doctor's orders. A week later, my sister was back in the hospital and the infection was worse. Once she was stable, we all went to do some other things, so I went out of town to see my daughter who was away at college. My oldest brother went back to Dallas. The hospital contacted my mom, who they knew was extremely hard of hearing, and asked he if she didn't want to make Mary more comfortable. My mom truly didn't understand. She thought they were giving her extra blankets and moving her somewhere quieter. They unplugged her breathing machine and moved her to a different area. They tried to say she was out of it. I had gone to see her and asked her if she wanted me to get our mom from the waiting room. Because she had the tubes, I said blink twice if you want to see her. She blinked twice hard. A surgeon working with us had suggested I contact some of the burn units and ask if anyone would take her because she had a bad skin infection. I have been calling and emailing places, begging for them to help save her life. When we were back on deck - within hours, we demanded that the hospital put the life support back. We explained that our mom did not understand the question they had asked about making her comfortable. They refused to put her back on life support. Now, when I see places that offer lymphoma treatment I cringe inside. I had no knowledge and very little time to find out what was going on and what we could do. My sister was very private, so when she moved back down to care for my mother, she didn't tell us she was sick. If I had known, maybe I could have done something to help save her. I hate Memorial Hermann at Memorial City. I will never let anyone else I love go there. That is also where the hospice was. Maybe what we're experiencing is well-run hospice programs vs poorly run ones. Maybe they're only as good as who is providing the services. I know that terrible, helpless feeling of knowing something is not right about the care your loved one is receiving but not knowing what to do about it. We need a non-partial group to oversee these programs. And the representatives of the hospitals and programs need to tell the truth about what they are proposing when they suggest the hospice program as a solution.

busterboy, I agree with you regarding hospice, and the process of our loved one's dying. The night my Dad died, I still didn't believe he was going to die that night. But it was happening, and I was a little taken aback by the nurse telling me to administer the morphine. Am I understanding you correctly, that you did that as well? I understood that I was 'helping' him - relieving his pain. And having been his only caregiver for five years, I was used to giving him medicine, but surprised the hospice nurse asked me to give it to him. So essentially, when morphine is being administered at end of life stage, it's essentially allowing them to die more quickly so they don't suffer. Yes, hospice is good for the patient, but business as usual with the loved one losing their parent, family member. Dad's been gone now just a year and a half, and I still re-live those last hours, holding him, with the nurse sitting at a little desk in his room waiting for her patient to expire and go on to the next. But really, I imagine they get so conditioned to it, and of course it's not their loved one. I'm grateful though that I was there with Dad when he died. You were there with your loved one at the end of their life, and I'm sure they are looking at you lovingly from the spirit world, and thanking you for your help and love.

I also think the Dr. do not really know what time you have left..They give you hope so that you will fight with every being you have left in you..I know Hospice is there to give you comfort, but at the same time you are grieving of losing a loved one and do not want them to be in pain. The guild comes after you come to your senses and realize that what happened is actually what you were responsible for..The death of a loved one even though they tell you what is actually happening...Hospice has a way to go to help the ones left behind with the guilt..It has taken a toll on me and I will never be the same..Maybe it is just me but I know I am not alone. It is good in a way that Hospice is there for the dying but sad that the one administering the morphine to have live with helping them pass on peacefully. I know I will get some flack from this but this is my thoughts only on something so devastating to me. God help me.

Commodore, Drs in general and Oncologists in particular are notorious for over estimating the time a patient has to live. I don't know why they do it, maybe because loosing a patient makes them feel they have failed or perhaps they are too chicken to give the family a true answer so leave it to someone else to break the news.. This false hope can be very damaging because the patient and family have many final things they wish to do.
Do not feel in any way that you "moved him along". He was given the medications that he desperately needed at the time. He was suffering from what is known as 'terminal agitation" he would not have come out of it on his own. As far as pain is concerned that also had to be controlled and right at the end the patient may require increasing amounts of medications to achieve that goal. There is no easy way out the meds either have to be used or you have to watch your loved one screaming in agony and out of his mind in fear. Doesn't matter what combination of meds the Dr chooses to use, the side effects are similar as are the end results which is a calm pain free patient allowed to drift to his final destination.
The longest you could have hoped for would have been a few more days so try and comfort yourself with the fact that we live in a society where the meds are available to ease the suffering of the dying.
I know for a fact that Hospice nurses in Malawi do not have these drugs available and many patient's dying from AIDS do so in absolute agony. We live in a far from perfect society so it is very important to separate the bad from the good and be thankful that you followed your loved ones wishes and made it possible for him to die in peace and your mother can move on and accept the fact that he had some very good years that many people are deprived of. Blessings for you and your mother and the rest of the family. iI is always hard to loose a loved one especially the head of the family who seem invincible.

I'm glad that I found this thread and so many people are feeling the grief, wondering the same things that I have wondered and also feeling guilty about participating in and possibly speeding up the death of a loved one. I lost my father to cancer in January. He had been having back pain for several months and we only learned in mid January that the cause of his pain was metastatic cancer in his lymph nodes. He had fought prostate, bladder and kidney cancer over 15 years or so, quite successfully, so I think we all believed that he was invincible. He and my Mom lived in Florida and the rest of the family was scattered around the country.

We had a good visit for Thanksgiving and he had been complaining a little about his back and was seeing a chiropractor and a spine specialist. He regularly had check ups on his bladder and kidney, so we all assumed that the cancer was in remission. In late December, he started to have bad reactions to the pain medicines, hallucinations, etc. which caused my mother and my sister quite a bit of anxiety and resulted in a couple of ER visits via ambulance. I live in NJ and I came down to visit after his second episode to see if I could push the doctors to find out what was at the route of his pain and to see if they could get a better handle on his pain management. While i was with him, he was not eating much. I would sneak out and try to bring him appetizing meals, but he ate very little do to the pain. One morning he phone us at 4am to tell us he was in pain and the nurses would not give him any more medicine. I drove to the hospital to see what I could do and then received a call from my mom, who had a history of minor strokes, that her blood pressure was through the roof. I actually thought I as going to lose them both at the same time. After a lot of prodding on our part, we finally had a biopsy performed on his lymph nodes and discovered that he had a form of metastatic cancer that was aggressive and ultimately untreatable. So, we had discussions with a wonderful nurse from the palliative care office and made the decision to move him into hospice for a few days, in order to get his pain meds under control, and then allow him to move home with home hospice care.

The prognosis was that he would live for 3 months to 9 months and he had a lot of things that he hoped to do during that precious time. He moved into hospice on a Wednesday and had a few days with some ups and downs. My mom spent the nights with him, which may have been a mistake in hindsight. We were told that the nurses spend more time with other patients, when family member stay overnight, assuming the family members are caring for them. On one night, he became very agitated and it was very stressful for him and my mother. My mother was in a panic over the fear that they would be sending him home and that he might fall and hurt himself if he was as agitated as he was the night before. The following day we spoke with the hospice physician, who said he had to give an enormous amount of medication to sedate my father the previous night. The social worker told us that he saw signs of end of life, relating to discoloration in the extremities. We decided to keep him in comfort care and of course he was not eating and within a few days he passed away.

So, the 3 to 9 month window that had been estimated by my Dad's Oncologist, became 7 days. I continue to wonder if the there was a better cocktail of meds that he could have received...and of course, I feel like we cheated him out of those extra months that he might have had. I know, at the time, I was also concerned about the impact that his health was having on my mother, both physically and psychologically. There is some guilt that we "moved him along" to help her keep her sanity and health. I'm happy to say that she is doing quite well 3 months out. But still, there are moments where I feel that i participated in cheating him out of those last precious weeks or months. Of course the rationale side tells me that those weeks or months might have been shear hell for him...and his wish was for comfort care and hospice. Still there are those moments where rationalizing doesn't quite work.

My Father wasn't in any pain either but they said he was and put in on morphine and Ativan. When he did not have any signs of dying and they knew I was up-set I believe that they over dosed him that night after I left him and the next morning he was dead. The night I left him I wet a cloth and he would suck the water out of it. They were not giving him food and water and did not even want me to do that. Don't know what else to say.

PCVS, My father in now at home hospice, He is not in pain and has no need of any pain killers. The nurse wants to medicate him with morphine and lorazepam. Her concern was the my father that's not have quality life. She don't have compasion neither for patient or families. I am happy that she is not my father's case manager. In hospice there is good nurses and bed nurses. I understand hospice is not prolonged life, but they explained to me that my father can be in the program short term or long term. They shouldn't rush people to death, but some nurses do.

Pasalire, you clearly have very little knowledge if how a good hospice works. My mother is receiving at home hospice. She is not in pain and has no need of any pain killers and so is not receiving any. Hospice is covered by medicare and possibly some insurance companies. You need to recognize that hospice is palliative care and does not seek to prolong life. It is end of life care.

That said, I believe that yhere can be some unscrupulous people who run their hospice as a business with less concern for their clients. In general, however, I do not think Hospice rushes people's death. They just don't try to prolong it.

rosie123
Did Hospice rush your loved ones death?
Yes, I strongly believe that hospice rush your loved ones death, the morphin and Lorazepam is a very strong narcotic, has opium. Can kill anybody. If everybody know the politic and the law of hospice. No one will trust hospice! The insurance pay for the three months if your loved ones die in two weeks they make money, they will not return any payment to insurance. If your loved ones live longer they have to expand money in medicines, diapers, whipes, gloves, ...plus staff who come to visit or attended in the facility.

I agree with badboyz1. My Dad was also on morphine and Ativan and was 90 years old. I believe that he was starved to death and intentionally dehydrated by hospice. Some how they paralyzed him so he could not even move his legs. It took him 10 days to die. Said he could not eat or drink and the morphine and Ativan would help his breathing. He could not even talk but sometimes a tear went down his cheek when they administered the medicine. One Doctor said Oh just let him die he lived long enough. (He said this in front of Dad by the way) I believe that my Father could hear till the end. I will not post anymore on this subject because I am afraid that someone will put a hit list out on me. I have trouble sleeping at night because of this and am taking care of my husband who is sick with pancreatic cancer so I can not afford to die.

For starters you don't know my moms condition in the days before her death, and she was not miserable and even smiling at times. they gave my mom morphine to supposedly help her breathing due to pneumonia that she was recovering from, however morphine can actually make it harder to breath, especially mixed with ativan . They took my mom 2 days before her 90th birthday, she was doing ok and had all good vitals in the morning and dead two hours after the morphine was administered. And yes I can afford 800.00 for an autopsy , my mom is worth way more than that. However the Dept of health is looking into this case for me. There was just another morphine death two days ago here in northern Mn that they found morphine actually was the cause of the mans death. People are being murdered in tons of nursing homes across the USA, by these drugs and even starvation at close to death, but the sad part of it is, because they are old no one give a toot and has the attitude like yours, well they are gonna die anyways. It needs to stop and I'm going to do my part it trying to stop it.

badboyz1, I am sorry that your mother's death was especially stressful to you.

Have you ever looked at it this way? Your mother's body was approaching death. In fact, she was just hours away from leaving this life, although it might not have been apparent looking at her from the outside. She was miserable -- in distress and pain. Hospice gave her morphine to ease that distress. In other words, she was very close to death and so hospice gave her morphine. Not the other way around -- they didn't give her morphine and then she got close to death.

Your mother had a terminal condition. That is what she died from.

I'm sorry that you did not have an autopsy -- it may have eased your mind. Who discouraged you from doing that? In this area they are around $800. Could you have afforded that?

Why don't you look up morphine, and see what the lethal dose is? Then compare it to the amount she was given. This might ease your mind, too.

The death of a mother is a huge, huge loss. My condolences.

my mom was given morphine and was dead less than two hours later. She had ativan the night before. I defiantly believe these drugs killed my mom, she had all normal stats before these were administered. I asked for an autopsy but everyone thot , why, shes old. it still bothers me terribly.

Rosie 123 You will never know if your Dad was rushed into his death..Just remember that he was on Hospice and that they did what had to be done to make him comfortable in his passing..That is the main thing..We are all going to be there and I just hope that I will pass in comfort if there is no hope for living a normal productive life...So sorry about your loss..Just think of the good times and all the memories you have of him..I lost my husband in 2013 of cancer. When he was in stage 4 after all the chemo and radiation that did not help I can say that I would not go through what he endured..Hospice did what they could but you will always wonder if things went the way they should..Meanwhile, your father would have wanted you to go on and live your life as my husband would have wanted for me..But it is so dang hard to just go on but you must for the sake of the ones that you have living around you..I could go on and on but you have to grieve in your own way..Just hope that you know that you are not alone in this ....

My mother had end stage COPD. If it wasn't for the morphine she received under palliative care in the hospital, she would have died an agonizing death from air hunger. She was taken off the ventilator, given morphine and allowed to die naturally with comfort and dignity.

I have to admit the thing that worries me the most about allowing my mother to remain home until her death is the fact that all the responsibility will rest solely on my shoulders. Most of us have never sat a death vigil before, and certainly not one where we are totally alone and unsupported. Yes, there are aides and nurses, but they come and go. There is often no one immediately at hand to hold your hand, to give us the benefit of their experience, to let us know what is normal and expected.

when my FIL was put in hospital HOSPICE he lasted ONE (1) hour I do believe they overdosed him to end his suffering because he had been in ICU for 4 days before that on a BiPap machine however he knew what was happening and rushed everyone out of the room literally 5 minutes before he took his last breath.

busterboy my husband was on hospice in our home, too. I was given the complete kit of medications he might possibly use, including the morphine. I think that is pretty standard practice for in-home hospice. The nurse was typically there two or three times a week ... and there was no way of predicting when hubby would need meds.

(Hospice does not service a person who lives alone in their own home. They have to have someone with them to handle the meds and other cares. They could go into a nursing home and have hospice there.)

By agreeing to stay with your husband and provide his day-to-day cares until he died you performed a wonderful service to him. Many of us fear dying alone, or dying in pain. It is a terrible and also awesome responsibility. It is part of what I meant (without understanding it at the time) by "in sickness and in health."

My husband passed away three years ago, too, on home hospice, with me responsible for his drugs. It was scary but I have no regrets and certainly no guilt. It was a privilege to take his journey with him to the very end.

I'm quite sure you will never "get over" your husband's death. I won't. But I sincerely hope you can get over the guilt. You did not cause his cancer. You did not cause his death. You did the absolute best you could with the resources available to you. You have reason to be proud and glad of your role.

My husband had stage 4 cancer and Hospice came to the house to take over his care...BUT I was given the duty to administer his morphine and it made me very uncomfortable but I did not know this was not the norm..He passed away and now I have guilt because I had to administer this morphine..Shouldn't this have been done by the Hospice nurse???? It has been 3 yrs and this still haunts me...I think the nurse should have done this and not me...Please advise..

I think that most of us have no idea what a natural death looks like, our whole experience is often based on the death scenes in the movies or television. Or we may have kept vigil before with a loved one, but that only tells us one story, and every story is different. I think the reality is that dying is seldom as peaceful as we hope it should be, just as birth is loud and messy and fraught with emotion so too is dying, unless we are fortunate enough to slip away in our sleep.
There are professionals who have seen death and dying many times, and we need to let go and trust what they are telling us, they really have no motive to steer us wrong.

Luvya771010, hospice nurses sometimes can tell when the end is very near. My mother's hospice nurse won't give a timeline because my mother, though declining, is at a stage where she could just not wake up or go on for some more months. Or longer.

She is off her meds. Sleeping a lot. But her blood pressure is better than it has been since she started hospice. Of course, this just means that what I am doing is making her comfortable.

You are not rushing anything. You are grieving. It's hard.

My mother has just been put in comfort care only - basically hospice here in Canada. Some of her meds have been discontinued. She is still eating and communicating though not as well as earlier. She is not in pain or agitated so there is no morphine or Ativan administered at present, but I have been assured it will be available of needed. Her body is slowly declining through disease - vascular dementia. Nothing can stop that or treat her disease so that she gets better.

I just looked up some literature on hospice/palliative care/comfort care and saw this statement which is meaningful to me,

"Hospice palliative care aims to relieve suffering and improve the quality of living and dying."

Meds at this point treat the symptoms of pain, agitation etc. that can accompany dying. The choice is to treat or not to treat, as Jeanne pointed out. Improving the quality of the dying process is valid to me. The doctor has assessed my mother as in the dying process, due to her disease. She shows the symptoms of last stage dementia. The recommendations made by the doctor are in line with that. They have removed meds that are not helping her and are prepared to add meds to treat any pain or anxiety. As I have mentioned before on this site, I had a friend whose dying process was not helped. She was aware and talking to the end - begging for help as she gasped for air. I would not want that for a loved one -or anyone.

Experiencing a parent or any loved one at this stage of their life is very difficult and painful. No one likes losing anyone or seeing them in them in final days, but it is a reality most of us have to go through.

I agree that you. luvya, are not killing him but treating him for the things that are causing him pain and distress in the final days of his life. I am thankful that there is treatment for such things.

luvya771010, what do you think might be a better choice? Allow him to be in horrid pain for the next few weeks? Have you talked to the nurse about something for the agitation?

You are not killing him. The disease that put him on hospice is causing his death.

I know that no generalization applies universally, but as Americans we have a strong belief in progress, in our ability to control things, in "get 'er done." And when we are faced with a situation that his declining instead of progressing, that we can't control, and that is going to conclude contrary to our wishes, we not only feel sad, we tend to feel guilty.

Death is outside of your control. Alleviating pain (or not) is within your control.

This is a sad time. I hope you can focus your energy on loving Dad and mourning his loss and give up the unproductive (and unearned) guilt.