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 went on Hospice when she was already actively dying. If she'd been compis mentis enough to ask for food or water, I would have gotten the Hospice workers to address her needs/wants. WERE you a disinterested bystander, or were you simply not involved until things got serious and then you showed up to object? I'm genuinely curious.
The two are one in the same.
Timeline:
hospicepatients.org/euthanasia-soc-of-america-to-natl-hosp-and-palliative-care-org
#minetoo #hospice #hospicemurder
And you would now try to insult me..saying it is my compulsion...actually...really.........and yes...he was..the nurse significantly increased the amount of morphine..Lorazepam on top of the Fentanyl..in a short time period....causing an overdose.....his jaw was locked..teeth clenched..pinpoint pupils..with a look of agony on his face...and the expression remained...though the nurse declared him dead...that is a state of overdose....and prior to this state of occurance...the minute the 75 Fentanyl patch was put on him on top of all the other meds all at once...in addition to the opioids...Lorazepam....caused a cascading effect..that would occur even in a relatively healthy person..even his doctor agreed with me...
And if you even read..what I have written...I never condemned the hospice nurse or nurses..but.....you have selective comprehension..focus....I wrote these things here to make others are aware...to pay attention..and to not accept without question what is being done...
The hospice nurse attitude I am referring to..is the attitude..comments..on this SITE..in past postings...that shoot down..are condescending....and arrogant...towards those that have posted their experiences...that they did not want to hear or acknowledge..that is what I am talking about..
And..no...I am not a hospice nurse...thankfully..and much more educated about things now...
And don't worry ...I have stated and made my point...and it is up to the individual to make sure their family members are getting the proper care..pay attention..read...watch etc..
So..I am done here..I am sure you are glad about that...
Wow, you're RUDE!
Yes, I vowed not to post on here anymore due to attitudes like yours. You've got it in for anyone related to hospice, don't you?
I'm not being a know it all nor am I having a "hospice nurse attitude", whatever that is.
All I wanted to do was answer Pamb's question. I think I'm qualified to do that since I AM a hospice nurse. Are you?
I am sorry that you believe your brother was killed by a hospice nurse. And I'm sorry he and your mother passed away. But don't come down on me because I answer a technical question for someone ELSE.
Maybe...one day...your anger will subside...and you won't find it necessary...a compulsion actually...to take it out on someone else.
I just hate some of the hospice Nurse attitude presented here...
Sometimes they do..sometimes they don't..and leave to us to record the meds given...and in handwriting format...from my one particular home hospice experience..can't say about how other company's..individuals..only my experience of course...and of course they should ...and do ... check with the doctor or nurse practitioner before changing meds..increasing meds...but you must still be vigilant ...watch..and consider what is being given and when...many of these meds do cause loss of appetite...and dehydration...and in increasing amounts..if not necessary...can have severe..outcomes..or side effects...
The home hospice nurse here...after tripling the meds..per the nurse practitioners instructions...caused my brother to overdose..in pain from the increased Lorazepam and morphine on top of Fentanyl patch..his e pression..frozen..portrayed this..and that was his end...she was shocked...but alert enough to take the sheet of the meds with her..and amount given...that morning...
I did not object as what had been done was done..and expected that she was taking the records for review..as she certainly didn't intend for his overdose...
For my mother..she was in Florida..terminal..stomach cancer..but not at a hospice since none was available.at the time...it was a recovery holding place...can't remember the name.it was in Titusville...and they had her on IV meds and fluids via IV...was in a nice room...tv..with couch and room for family to stay by her side...and nurses were very attentive..and nice..but it was not a hospice...toward the end she was in a constant state of daze...and did not seem to be in pain at that point..as the meds were given in IV form and constant ..or slowly increased...and they recorded everything...and she passed peacefully..that is what any could hope for and expect...and a very nice environment...
Also..once your loved one has passed..all meds should be destroyed..and never..ever..accept any meds the nurse may offer you even with good intentions as one it is illegal..and two..you do not know what affect it will have on you..the nurse offered and left some Lorazepam for me..and I was repulsed since..I know it's affects..and can speculate what effect it would have on me..as I share...though with variations..the same genetics as my brother...and no way in hell was I going to take any med...even..especially..anti anxiety meds ..with known adverse side effects...though the home hospice nurse had good intentions regarding this...and I would never report her..
Private hire caregivers do not have this obligation but they usually creat a note book and write similar information. The hospice nurse will read these entries and write her own observations and instructions as the private hire does not have access to the hospice records. medications are usually dispensed in 1 - 2 weeks supply so it is easy to check the number remaining in the bottle if there is any doubt about their administration. Checking Roxanol (Liquid morphine) is much more difficult because the volume administered is .so tiny, for example 20mg is only 1cc given in a 1ml needless syringe. This is not usually abused but occasionally a family will claimed to have "spilled " a bottle
Yes, PamB 1972, we (the nurses) have to record every single medication, whether narcotic, anti anxiety, antihistamine or anything else, on the medication sheet and nurses notes. (At least at my hospice). Also any treatments given (oxygen, suctioning, etc.). We basically document everything we do to the patient and anything that is happening to the patient. Nurses are required to do this.
If you have a question about any medication given, it can be checked easily.
Hope this helps.
For example, give the Morphine 4 times per day AND As Needed. Then when asked, how will I know, they will give you suggestions of scenarios and tell you to give more pain med under those types of scenarios. I did note that our Nurse (in caring for my FIL at home until his death) did not want to lock us into a specific dosing regiment near the end, as she felt that we were well versed in the management of his pain, and that we were doing a good job, also that there was never a case of too much medicine dispensed, from her inventory of the amounts we always had on med ordering day, every week.
The process of documentation was At First, very important to me, with my medicine background, but soon, My day to day writings became routine, and my charting became very repetitive, and then I only documented things that occurred that were out of the norm, a any new med order changes, however my FIL lived for 9 weeks on Hospice, and sadly, many do not live that long. It was nice that our Nurses did appreciate my chart notes though, and it helped to establish a repor that we had a good handle on things.
and to all those that lost family members..Freinds..my condolences..it is never easy...and these services do help,us...and the family member...and as you say...things happen for a reason...hopefully for the best all around...as we never know what the alternate outcome would have been...and we as humans can only do ...within our ability...
"What's needed is dispassionate reporting of how these services operate on the ground. Very upset emotional relatives are in no state to do that. It is a job for standard-setters and regulators in government."
You do realize that these services do not fall under the same standards or regulations as hospitals..and that it is the fastest growing business..with now only a few major service providers ...since they have merged into just a few large dominant corporate providers..that have lobbyist...as the baby boomers reach that age..where they need these services...paid by the federal government...and a growing expense..regulators arentreally going to be interested..want to ...keep a certain age group around...realistically...just look at how SS and Medical care cost has changed for the worse for the elderly..and sick...sorry..yes...there has to be a good system in place...and I am glad the government sends out survey forms to those that have used these services...it became necessary after lawsuits of abuse...and a company telling their nurses that they had to speed up the death process...one of the nurses was appalled..horrified as what she was being told to do...and reported it...causing a major investigation...and watchdog created...people can discern in these questionnaires... from an overly irrational emotional person...from one being objective...with valid criticism....and I do have to say..over all...the service that was received...and all,those involved were really good hearted people with the intent to help in anyway ...within their ability...and certainly arranged to have anything needed delivered...
my only issue. ...concern...is the dosage...dosing...med combination...and making medical determinations in which they have no qualifications...or experience...at least the Nurse should call in the nurse practitioner to see the person...and..they should be better schooled in meds..ie..the nurse practitioner was doing a one to one of Fentanyl to morphine..opiate ..it is not a one to one conversion...anyway...at least I know..and can protect my family...
I would find it very sad and deplorable to think that there are hospice service providers who - how can I put this? - have either lost sight of or were never committed to the central mission of the hospice movement. But I don't find it impossible to believe; I wish I did.
What's needed is dispassionate reporting of how these services operate on the ground. Very upset emotional relatives are in no state to do that. It is a job for standard-setters and regulators in government.
And..Again..the thread is DID HOSPICE RUSH YOUR LOVED ONES TO DEATH...not anything else..
I haven't seen condolences..sympathy..explanation..etc..to those posting their experiences that don't comply with your explanations..only condemnation and self glorifying...and frankly..I don't give a ###...to know how difficult your profession is..you chose it...and have a duty to thempatient to the best of your ability..
I have a government survey form..that I am slowly filling out..and I will use that to express my experience...again..I have had wonderful people and care given to family members......but in .some things where life is concerned..meds.....understanding their state...was very unacceptable...which should not be occurring..as example..like putting on a 75 mg Fentanyl patch on someone and giving them a bunch of meds all at the same time...into their system...causing their system to go crazy...when you never give higher dosages to start with..especially while talking other opines..and say..oh..we give this to everyone....just one example....but you are so hung up on seeing..reading...and not understanding...as if defense for those thatnerrredmis necessary rather to take note...and perhaps explain..because you know death...and we do not..but that hospice nurse here...did not know death...I dont hate her..I know she did not do it intentionally...and was shocked...at the results..but she was adamant that she knew what to do...and took control in those moments...rushed into the moment..when it was not necessary...and completely ignored what I had been saying many times over to her and the Nurse practioner...she was a good person..not mean...just lacking in knowledge and training...but..per your attitude.. I am the bad ignorant one...because I didn't ...don't..have a basic training in Nursing..and because...the profession should be above criticism..
Yes..so challenging..and busy..they had lots of time to walk through my home..admire the things..and tell me about the things their hospice patients gave them as gifts...
I wish the people who are condemning hospice and medical professionals would take a course in basic nursing, and read the curriculum of required courses. The courses are very challenging, and very extensive, as are the requirements, especially at some of the hospitals in Michigan.
I wonder how many people who criticize nurses, especially hospice nurses, have any idea how challenging it is to work not only in a medical profession but one which deals with perhaps the most emotional aspect of living, i.e., the opposite.
To malign the profession does not reflect an accurate assessment of the requirements or performance. Nor does nonmedical interpretation of intricate processes offer an understanding of what happens as death approaches and occurs.
I really take issue with that comment...and your attitude..it is insulting....we unfortunately have a certain amount of misguided trust in the care takers then..it seems...the question of this post is..Do you think Hospice rushed your loved ones to Death...rather than reading..hearing..what people are saying..you become defensive..and insulting to those of us who lost our loved ones...I know this group.page is run by nursing..Hospice service...so hopefully..they will...HEAR..understand what can go wrong..what does wrong..and that at times..poor training..or lack of training ..understanding..can affect an outcome..no one said the nurses were evil..that it was with evil intent...but training should be improved as well as having the proper tools...and...and not rush to medical conclusions about a patient...but I suspect that you may have some hidden guilt in mistakes that you have made in your career to be so defensive on this matter...
We expect the Nurse..or Nurse practicer..taking care of the family member to have a certain amount of knowledge and ability...and know..understand...how lethal these medications can be...and how to introduce the into an ill person without causing the person to go into shock...and have the proper equipment on hand...I shouldn't have to get a doctors or nursing degree myself...to counter the nurses..Nurse practitioners actions...but it seems that I do...and it on,y takes one second for a nurse to deliver these meds..once done...it's done..
And how is a Nurse given ability to declare death when she..he..has never seen death before?...especially after it occurs right after administering morphine and Ativan in higher dosages...and declare them dead..while their pupils are constricted!!! Not dialated..and...their jaw...teeth..clamped..locked..not relaxed...and their face frozen in agony...knocking off the nostril air tube with the back of her hand. Then..afterwards say she has never seen a dead person before...and quickly grabs all the documentation of meds and dosage used...No..her intent was not to kill him...she was going into I am in control mode now..and was shocked at the outcome...but..from all I have read...researched..he was still alive.in a state of overdose...Doctors do not declare a patient dead..if they consumed lage amounts of opiod meds and lorazepam....and their eyes pupils constricted..until there is no brain activity..and you are to be kept on oxygen..as the heart rate and breathing drop to almost undetectable levels....and lock in syndrome can occur ..until help..or breathing restarts...as this can occur...once stabilized or the meds wear offf...so basically I sent my brother to the morgue...while he was still alive! Because a home hospice nurse declared him dead...and I..the only caretaker..exhausted..lack,of sleep..and stress..didn't register what was occurring...but asked..are you sure he is dead...I don't deal with the dead..and sick......I have to trust what a nurse is saying...just to find out...she has never seen a dead person before..because of that statement...and his facial expression..I researched this...I now how to live with knowledge..
No the nurses are not evil..except on rare occasions...and he had some wonderful caring nurses...who were attentive...and listened...and a couple who were controllers...and the Nurse practioner...didn't even know what SNPs were when I stated genetic SNPs reading showed he was unable to met certain meds..and showed the list...per pharma studies....it didn't register with him... and still wanted him on the meds..because they give it to everyone....but just because you are in hospice..doesn't mean you should be killed by the meds...I can understand...a person in pain...coming to the very end ...wanting the meds...but just dumping them into a person showing no pain..in higher dosages..knowing they are sensitive to the meds..is just wrong...as well as not calling someone else to confirm desth...if they have never seen death before!
And yes..probably trying to revive him at that point...may have been futile...and accomplish little ....but at least he would not have been put in a body bag in a couscous state...
(Uh...if someone has a pulse, they don't need CPR. If your loved one is enrolled in hospice to die as peacefully as possible and have their pain managed, don't start CPR if they become pulseless.)
When a suction catheter is stuck down anyone's throat, they are going to gag whether their eyes are open or not. Google: gag reflex. Stick your finger down your throat and find out. Performing deep suctioning on a dying person, which makes them gag and possibly vomit, is cruel.
Family members are enrolled in hospice to die a peaceful, pain-free death. If you want your terminally-ill family member to die while receiving CONTINUOUSLY PAINFUL procedures, take them back to the hospital or to a different hospital than where they were previously discharged.
...he declined so fast once accepting hospice and their meds..while he was still active prior.so.. yes...some hospices do intentionally..or unintentionally..rush your loved ones to death..through ignorance..lack of knowledge..or set in their protocols ..and med cocktails..without waiver...they can be very nice..or irritating...and you have to be attentive..some of the nurses that came were great..really wanted to help him..others..not so great ..(he developed bed sores once on their knock out meds..and became dehydrated..and harder to get back to his previous state)so they came a bit more often afterwards..... and.educational level and training were very lacking..especially when it comes to dosage levels..determined by a nurse practitioner..and introducing various drugs all at once..for the first time...into a person...not factoring potential side affects..which can manifest in delirium..Nausea ..lack of coordination..coherence..anxiety...lack of appetite..and inability to drink..comatose for days...after they placed a Fentanyl patch on him..leaving the care taker ...me..to try and sort out what is causing the effects..and seeing improvement while off some of the meds..while hospice keeps trying to keep him on those meds...saying they give them to everyone as standard..and immediately introduces them back in the first chance they get...so..some are fortunate in their care..others are not..though they can have nice concerned people taking care of them..just..not educated..or understanding that not everyone metabolizes meds ..and dosage..the same..
One thing is clear to me as well, that in some cases the proper questions weren't asked before hospice was brought in, during the dying process, and at the time of death.
It's easy to make accusations but harder to do so when someone takes the time to inform oneself of the process, meet with the staff, and understand what will happen.
And it's not atypical for someone to become emotional and accusatory if that person doesn't understand the dynamics of dying and the hospice role.
I still would ask these people why their loved ones were in hospice in the first place, and if prolonging a life of suffering, lack of consciousness and whatever degenerative issues existed at that time is something they would have preferred to happen.
I would agree the thread has been hijacked, but I would think perhaps by people who as I wrote haven't completely understood either the purpose of hospice or the dying process.
I also think it's time to close this thread to any further responses.