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.
My mom died while in hospice. I too kept a vigil at her bedside.
My mom didn’t pass away because of hospice. My mother passed away because she had a stroke (her second in 3 weeks). I knew clinically that she was dying.
Our loved ones are in hospice because they have a disease that was going to take their life sooner, not later. There was absolutely nothing that I could have done to change that fact.
In situations like this, we have no control over the flow of events. We can’t predict when someone will die, just that they are on the path.
I would have done anything to have stopped my mother’s demise. Just to let you know, during those final 4 hours prior to her leaving me, the hospice nurse came in and assessed my mother didn’t need any additional medications at that time. I say this to try to help you to realize that hospice staff will not use additional medications if they don’t feel it is warranted.
Yes we trust strangers (hospice staff) to help assist our loved ones pass gently. I understand how vulnerable we are under those circumstances. But we don’t know physiologically what the dying person’s status is. In reality the death of our loved ones is not caused by that dose of morphine, seraquel or whatever, it’s caused by the terminal condition that qualified them for hospice which is having a disease they will not recover from within 6 months among other factors.
Please find a way to work through your guilt. I’ll admit I did feel somewhat guilty but only for a short time as I knew my mother would have not had it any other way. She was 89, all her sisters were gone, my dad too, and she was tired.
I knew after her first stroke 6 weeks prior that it wasn’t looking hopeful. Watching her not be able to communicate, develop the beginnings of pressure ulcers on her heals, etc was horrible.
Thus when the second occurred it was time to let her go.
I don’t think any of you hastened your mother’s death by what you did or did not do in those final days. Nothing. Neither do I feel actions of hospice staff did as well. It was our loved one’s time to leave.
I hope it gets better for you because life is for the living. Your parents wouldn’t want you to be sad or guilty and let those feelings consume your life. Please try to let it go and live your life in honor of your parent.
Wolf, I am so sorry for your loss.
From what I have read [I am not a doctor] seroquil looks like a positive drug, it can decrease hallucinations and improve a patient's concentration.... it can help a patient to think more clearly, feel less nervous. This is a common used drug for dementia. My Mom was on seroquil when she was in long term care, as she was trying to climb out of her bed forgetting she could no longer walk or stand. It was months before her organs were starting to shut down and Hospice was called in, and then weeks before she passed.
As for Morphine, it is used to help with pain. I was given morphine for pain control after having several surgeries plus when I broke my arm.
Just now I saw the warning about giving seroquil to patients who have dementia when I searched on-line.... but that warning was for patients who have dementia related "psychosis" and are already on an antipsycophantic drug.
You can still contact the Hospice Group that was used and asked to talk to someone about the medicine, the pro and cons to get a better understanding about the uses. Keep the conversation on calm terms. This isn't Hospice's first rodeo, they have been on thousands, but it was your first rodeo thus there is so much to learn.
Try to let your mind switch over to the fact that you were making your Mom comfortable on her final days. Mom would have passed the same day with or without the meds given by Hospice. You can be comfortable knowing your Mom had a very peaceful death with no pain.
I have read that sometimes a double dose is enough to ”kill” a weak and dying patient.
My mom got this double dose.
First 7,5 mg morphine+5 mg sedatives and about 30 min the same amount.
I think this caused her to stop breathing.
You are right I feel very bad for leaving her bedside, but most of all I feel terrible for letting the nurse give her that second injection despite that I saw tgat Mom tried to signal no.
She knew she wouldn’t make it if she got it.
I have been seing a therapist and I will do it again.
This guilt is making me feel just terrible.
Thanks a lot for sharing your stories.Hugs
You did the right thing asking for more morphine which would have been between 5mg and 15mg depending on the pain. No one wants to see their love one in such pain. So, unless you got your hands on 200mg of morphine, which would have been impossible to do, you didn't advance your Mom's passing. No way, no how.
I have a feeling that you are hurt that you weren't there when your Mom passed, correct? A lot depends on the parent... my Mom passed when I was in the room with her right after viewing her all time favorite movie at 3 in the morning.
On the other hand, my Dad waited a couple hours after I had left the building as he knew having me see him pass would greatly upset me. And he was right.
The hospital said my Dad's passing would be within days, so then I got Dad back to his Assisted Living room and Hospice was brought in. Dad passed a couple days later, he would have with or without Hospice, but I have comfort knowing his passing was very peaceful.
I highly recommend talk therapy with a therapist who deals with passing of love ones. Chances are that therapist would be saying the same as what Barb and I have said, but at least you would have a third opinion.
Thank you for sharing your experience.
You seem to have a clear understanding of what your Mom went through, maybe I don’t have that.
I thought I was helping her, as in to continue living, and as it turned out to be the oppsite I was in a state of shock.
Today I am so sorry I wasn’t there and that I couldn’t accept what was happening.
I asked for a second dose, just like you did. To make my mom comfotable. Don't feel so unique in your panic at the time of your mothers death. Many, many of us want our parents to be comfortable. I didn't think of comfort as being something evil. Why do you?
I didn´t know this then, the nurse said she was going to give her a small amount the sec time....For an opioid naive this is too much I have learnt.
And my Mom wasn´t gasping for air, she had a rapid and noisy tachypnea and was never in a coma.
This is all why I feel she died in advance and it was my fault.
I also went to bed and left her with a girl who worked there, I left her full of hope because tomorrow was another day and we had agreed with the doctor and nurse to try and save her.So while I was walking away with that feeling, My Mom knew this was the end after me causing it!
It is not unusual for a patient to have what is called a rally, where the patient will wake up, start talking, wanting to eat, etc. Then return back into a coma state. This is normal, with or without Hospice.
Also note, the amount of morphine given is no different than the morphine given to someone after they had major surgery. I got the morphine after numerous surgeries.... I am still here.
Do you feel bad for not allowing your mom to face death gasping and in writhing pain? I wasn't willing to go that route with my mom. I'm sorry if people think that makes me a bad person. I think it shows that I was a compassionate daughter who honored my mom's wishes.
I started another thread here where I expressed my concerns that my Mom got too much morphine and sedatives and died in advance.
Now I know it is true and it was my fault. MY FAULT!!!
Everyone seems to know how dangerous these meds are when combined, everyone I read about are careful so their loved one doesn’t get too much.
Except me!! My Mom had been living in a nursing home for the last 15 years paralysed from strokes sitting in a wheelchair.
Now she was dying from Pneumonia.
We couln’t believe it, she was in her bed and looked the same as she always did, awake but during some nights the breathing was strange.
We talked to the nurse and doctor and asked if they couldn’t try once more to save our beloved Mom who now had been without food or water for three days.
They accepted to try( later they admitted that they didn’t believe in it..)
Anyways, the last night I was sitting by her bedside and she had been breathing really fast for about 6 hours when I rang the nurse and she came and said my Mom needed some meds( morphine and sedatives), I think that eased her intense breathing a little but not much, the rate was still the same, about 50/min.
This stressed me out, I panicked and rang again, thinking what am I doing, it has only been 30 min since the first injection.
Someone told me it had to be 4 hours between the doses.
The nurse came and I said that I didn’t think it helped, and couldn’t she get some more, just a little? I CAN’T BELIEVE HOW I COULD DO THAT, I truly thought I was helping her!:( But it turned out to be the other way around..
I saw that it made it harde to breathe after this second injection, just the opposite to what I thought!
But I was in such denial, the girl from the nursing home came into the room and asked if I wanted to get some sleep and I said yes and said Goodnight mama, I love you, I hope you can get some rest now, and off to bed I went.
My mom passed away an hour later.
I feel so much guilt. It’s almost 5 years ago and it gets worse the more I understand that because of me my Mom died days in advance, totally awake and alerte and rhe worst thing is that she tried to show me she didn’t want that second injection.
But I was so used to taking decicions for her through the years and she often had that look on her face when I tried to help her, but this time it turned out to be she was right.
And it feels like I killed my Mom! The one person I had been taking care of and loved more than my own life.
I am totally devestaded.
I know that the nurse has the ultimate decision and if she said my Mom could have some more I trusted that she would benefit from it, be able to rest, not die!!
I don’t think there is anyone else in this world who made such a mistake.
I thought I was helping her..
For all of you who regretted hospice for their parents (etc.), it was absolutely AWFUL to hear mom struggling to breathe that single breathe for hours. To clean her, change bedridden mom’s pamper by turning left/right - and seeing her Cringe in pain was Awful. Sometimes, when I read here, I have to force myself not to hope that one day you will Understand what pain is like when you’re dying. I do not want to wish this on anyone after seeing my mom go through this for about 2 weeks.
You all need to look deep inside yourself and be honest. Stop the blame game. What’s done is done. When my mom died without hospice, yes, I blamed her social worker who avoided our calls and voicemails (but had no problem calling me after mom died to offer her condolences.) I blame the insurance company who refused to allow this one time for mom’s doctor to do housecalls to just Evaluate mom. But I also accepted partial blame by relying on sis to keep me updated on mom losing hospice service 4 months earlier. Sis knew but didn’t say anything {her usual MO}.
Is there a problem with helping people die in peace, rather that having them die gasping for breath?
My mom had CHF and chronic pleural effussions. When my dad was diagnosed with Chronic Leukemia, she asked his doctor very specifically what kind of death that would lead to. He assured her that something else would kill him, and renal failure did.
My mom asked us all to make sure that she didn't die in pain, or gasping for breath. She was very aware, before her stroke, of what death from CHF looked like, as her sister had recently passed, on Hospice, at home, with her son administering the morphine. She wanted to spare us that.
My mom was hospice eligible for two years before we signed on. She was actively dying when we got Hospice in and they were able to give her small doses of morphine that eased her breathing, and anaxiolitics that kept her anxiety in check. Without Hospice, would she have lived another hour, week? I don't really know.
I just know that the only thing I ever promised my mom is that I wouldn't let her die in pain.
To me, having hospice for a longer period of time would have meant more aide hours, more nursing and more help with getting things put right at the facility. But it was not meant to be. It was only when mom appeared to be in intractable pain ( psychic or physical) that my brother relented and agreed to hospice so she could be given morphine, which eased her breathing.
Did the morphine hasten her death by a few minutes or hours? Maybe? Did I promise my mother that she wouldn't die in pain? Yes, yes I did. I kept that promise.
If you haven't found it yet, please check out the Hospice Patients Alliance website
hospicepatients.org
It was started by a former hospice nurse, turned whistleblower. It is filled with facts and first hand accounts.
Also, we have many groups on Facebook. Please look for them and join our discussions. Search key words on Facebook, such as "Murdered by Hospice".
There are also some radio shows dedicated to exposing this and informing the public. One is The Vicky Travis Show.
The other two are on blogtalkradio:
Search for the Marti Oakley Show
And Hidden Truth Revealed.
For every one person you tell 100 people learn the truth. Keep telling what you witnessed. Let no one silence or shame you. You know what you saw. You were there.