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.
Beers Criteria
Developed by an expert consensus panel, the Beers criteria is a list of potentially inappropriate medications for the elderly. The criteria have been revised several times to remain current. Using the Beers criteria, the 1996 Medical Expenditure Panel Survey found that 20% of 2,455 community-dwelling elderly persons in the United States were using at least one inappropriate drug. The survey data found even higher risks of hospitalization and death from inappropriately prescribed drugs among nursing home patients.
Your father was doing fairly well within a few days of his death. I think it is a blessing to go so quickly, rather than a long lingering period of the body shutting down. My husband ate scrambled eggs with cheese and salsa the morning he died. He was alert that day. He died while I was reading to him. I was very grateful that when it came, death came quickly.
Again, my condolences. I hope that looking at the medical records will provide the answers you need.
I do volunteer work for a non profit organization. I've had two patients pass way this month. I am not a medically trained person so I cannot disscus or debate care and meds. I simply do companionship and respite care visits.
I haven't contributed to this thread for a long time, but I started reading some of the more recent stories and comments today. My comments are not meant to criticize, but simply to add to the discussion.
What has been discussed very little on this thread (over 400 posts) is quality of life issues. There are many cases where terminally ill patients of sound mind choose to go into hospice. I have a patient currently like this. They have decided that the quality of life is not, or will not be worth continued treatments, tests and procedures and choose to face death on their own terms. I truly hope I am able to do this when I'm old and I'll.
For people who are not able to make their own decisions any longer, hospice is chosen for them by family, friends in conjunction with doctors and hopice organizations. When we make these decisions we are trying to do what's best to end the suffering of our loved ones. We are treating them the way we would want to be treated in the end. Many people have given us clear directives.
No one, or their families, are forced or coerced into accepting hospice. I don't second guess or question the validity of those who report bad experiences with hospice. But I feel there should be more thought and discussion given to quality of life issues. How much can it possibly matter that someone who is 98 or 103 years old have there life extended by a few hours or days? We should ask at that point, who are we fighting for? Our loved one who is dying or for the emotional needs of those still living.
Well, my last respite - Dad was brought into the unit. He was in good spirits, coherent, fed himself before going in, talked to me, etc. The staff was told by me and was noted in his file - NO HALDOL! Well, when my dad was brought back home after a few days, he was slumped over, could not talk, could not grasp a cup, could not open his eyes. When he heard me talk and knew he was home, tears started rolling down his face. I knew he was trying to talk to me. But he couldn't. I found out they were giving him haldol the whole time he was at the unit. He died that evening. So hard to believe that it will be a year October 15th that he died. His hospice nurse took a month leave from her job, and entered a facility for stress. She knew it was the haldol, but did not want me to think it was. It wasn't her fault. The doctor's, yes. While dad was dying, I know the critical care nurse expedited his death with morphine, and "turning him over". But in that case, it was merciful. It's the medications that some doctors don't want to educate themselves on, or learn about alternatives.