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.
With Mom's condition [head injury due to a fall], both my Dad and I were sad but relieved when she did pass. Would I wanted her to live another week or two being in a coma state? Why? For what purpose? Her quality of life was gone. She passed peacefully but waited until her favorite all time movie on TV had ended.
In my case, dad was not yet on hospice when they administered the narcotics that I feel eventually hastened his death. Once given, his vitals crashed precipitously. However, I have to support what windytown and others have said: no one can say for certain how much longer they would have had without the medication. My dad's own oncologist gave me an outside range of a "few weeks" when I asked him, point blank. He was gone less than 15 hours later, and no one was more surprised than his medical team when they got their report the next morning. If you knew for sure that your mom's life would have lasted a few more weeks, but she would be in unbearable pain (which neither you, nor I nor anyone else can even imagine), would you want that for her? Or rather, would you want her to have a peaceful passing, surrounded by the best care she could get. Everyone has to think about this.
In my case, even though I feel I would have had my dad a bit longer and perhaps could have told him I loved him one more time, in the end, I knew that he knew that, and he was able to go peacefully. That is my last memory of him, and one I know he would be OK with, so as much as I miss him, I am at peace now these few weeks later knowing he did not have to suffer needlessly for my own conscious.
One point to underscore here, and I find I am evangelizing with each retelling of my dad's story: Make absolute sure that your family's wishes are codified in a Healthcare POA and discussed beforehand!! This, for me, made the hardest decision of my life one of the easiest to live with. Also, it goes without saying, please do not wait until the last minute to say you love your dear ones. You never know when their time will come. That would be a true regret.
I wish you and the other peace in your mind when this issue has come up.
Please don't feel guilty about what you could've done to gain time with your mom. A doctor's guess, is just that, a guess. Cancer and other horrible diseases have their own timeline, which is why doctors just generalize a life expectancy. Each person is different and the degree and extent of their illness is so variable. My dad's doc said he would live 3 to 6 months with his brain cancer. He died in 2 1/2 months. I don't blame hospice. They kept him as comfortable as they could during those short months. Cancer killed him.
I think fewer people would be so devastated and guilty-feeling if they read the hospice agreement and knew to protocol going in.
For example, it is standard procedure to remove all drugs except those used for comfort. Lortabs (I think) might come under comfort care, but it is possible they couldn't be given in addition to the stronger pain medication they administered. As I understand it, Lortabs are to eliminate pain; they do not extend life. I don't think that even if you fought to have her take them (and won) it would have extended her life span.
Hospice took my husband off almost all of his pills. They added two back in when I reported he was agitated without them. There goal is to keep patients calm and pain-free. They are not unreasonable about following their "rules" if those rules are not meeting that goal. My husband was not in pain. I did not give him morphine or ativan. Hospice did absolutely nothing that could have hastened his death. But he died earlier than we expected anyway. The hospice nurse was surprised when I called her. His autopsy revealed an extremely severe case of LBD and also that his heart disease would have taken him very soon anyway -- the doctor remarked he was surprised he hadn't died of that earlier.
Sometimes the actual causes of death is not so apparent on the outside. Even the experienced professionals are very often wrong in predicting life expectancy. Just because her doctor thought she might have had 2 months left doesn't mean she wouldn't live 5 months or she wouldn't die in 3 days. Nobody can say that with certainty.
Please, please Sadgirl, do not torture yourself with "what ifs." Do not feel guilty. Your mother was dying when she entered hospice. There was nothing you could have done to change that fact. The timing of death is out of our hands, or hospice's hands. Your mother and my husband died when it was their time.
Sheila
Sheila
She passed that night but as she had an obstruction and internal bleeding she would have died that night anyway, but was able to do it painlessly at the hospice.
I feel for everybody affected by all this but it is making me keep going over last years events in my head and I just hope our uk hospices are run differently. I went to see a counsellor at the hospice and we talked about all this and she said doctors were able to be incredibly accurate these days and you had to trust them ... She said maybe 10/15 years ago accidental overdoses may have occurred but would never have been deliberate as that is illegal. But these days they are able to be very accurate with their dosage.
Death of a loved one is traumatic enough to cope with, having these thoughts is just too much.
I believe 100% that hospice rushes death. My mother had a kidney that was nicked during a biopsy. She was bleeding internally. The bleeding had stopped at the hospital, and she had been given 10 pints of blood. However, the internal bleeding pooled in-between her cavities and organs. We did a cat scan 7 days into the hospital and it had started to shrink. However, she got a case of ild pneumonia , and had been struggling with congestive heart failure, and myleolukemia for about a year. She had just come to visit me out of state the month before the biopsy, and was getting around just fine. So the blood cancer was not affecting her that badly yet. She had 3 heart attacks over the years, but was one tough cookie. As I said, she had just visited me a month prior to the biopsy. At the hospital, she was in so much pain, that the doctor had a meeting with all the family. We just wanted her out of the pain from the biopsy, and more comfortable while she could get a chance for her body to fight the kidney healing on its own. The pneumonia was mild as I said. We had no idea that when she was taken to hospice to get more "comfortable" that she would not be speaking anymore as of that night. She had been waking up off and on just fine in the hospital, but in pain. The night before transfer to hospice, my son had stayed in her room with her joking all night when she'd wake up. She was in high spirits, but when the pain kicked in, it was horrible. We opted for the hospice, thinking it would focus on her pain, and with the pain relived a bit, along with the stress that comes with that, her body might start to heal. No. First night, she was out on the meds. When I told the nurse around 4 A.M the next morning that I was in shock that the meds were so heavy she could not talk anymore, she said they were making her "comfortable". I went outside to grieve. The nurse came out and said (coincidence) she's awake come talk to her. When I did, my mother knew, and said this was it, and that it was so hard. We got about one hour, that I will forever be grateful for to talk, then they came in and gave her the meds. She was out. She died the next morning. She never woke up again. My daughter jumped a plane, that is only a one hour flight, and I could tell she wouldn't even be able to talk to her grandmother again. My mother couldn't talk, but they said she could hear, so I put the phone to my moms ear as my daughter was boarding her plane. She died 20 seconds later. This all happened over a day and a half. I'm heartbroken. Hospice nursing staff were exceptional to her, but yes, they take them down, and fast.