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.
It is a decision does the love one pass with peace and dignity, or thrashing about in unbearable pain. Which would you choose to do or what to remember of your love ones final hours?
PamB, please note when a patient is in the journey of their body shutting down, they CANNOT take water or food, it would be too painful for them because the stomach is no longer processing food/water, or the food/water would go directly into the person's lungs.
The patient is already dying; why would anyone want to move someone in that condition to another facility? The EMS ride, the change in surroundings, the anxiety of going to an unfamiliar place - why put anyone through that?
My sister was in a hospital during her last week of life; when it became clear that she wouldn't recover, one of the doctors told us that they had a small hospice wing where she could be transferred, just the other side of the floor she was on.
We were so relieved that she could remain where she was without the ordeal of being moved, and she was relieved as well. The room was cozy and private, with a lounge next door for relief when we needed it.
I wish people would stop finding so much fault with hospice and think about how much it relieves people from lingering and suffering a slow, agonizing death.
My Dad was put on hospice when the medical community ran out of ideas. It was viewed as "palliative", and not necessarily "end of life"--but end of "valuable life" as viewed by society.
As the six months drew to a close, hospice dug their heels in and brought him to the end. No one in my family believed he wouldnt be around for Christmas--or NEXT Christmas. He had Parkinson's.
His death was systematic and ugly, ungraceful and uncaring. I will make it my mission to stop willowtreehospice from ruining more lives.
Those of you who sing the praises of hospice should count yourselves fortunate. I am certain that not all hospice is bad or wrongheaded or fraudulent, but willowtreehospice sure is.
There was going to be No IV fluids to prolong his life, as to do that would have been cruel, and not of the Hospice philosophy in the first place.
The dying process is difficult to watch, but we all die at some point, and it's our job, to make it as pain free and comfortable as we can make it.
Yes, I did ask for one more day to see if her condition would improve, and can understand the doctor still seeing her and billing for the visit, but the GI doc. She was off of the feeding tube. There was no need for him to visit her, yet he did and of course billed for his services.
What I meant in the last statement, the Hospital did not list the discharge as death, so they sent this survey about how they did. It was marked, Deceased, don't contact her again and return to sender. I also called and made sure that she would not receive any more mailings from them. It was upsetting that they did this after she had passed.
Thank you for your comments as well. Thankfully she had 3 insurances that paid for the bulk of the charges with only a few asking for the coinsurance. I read about cyanosis, which is why seeing the blue in her fingertips I made the decision regarding life support.
The doctor was not even her primary care, but the NH doc. She never saw or heard from her primary care doc the whole time. Ironically, she could have seen her since the Hospital claimed NH doctor care would end if she was not in the NH and her care would revert back to her primary care doctor.
Anyway, it is over and she is at peace and in a better place.
Ironically, since she has passed, the NH she was at and the hospital she was at has had a lot of turnover, and even one of the nurses at the hospital was let go and probably charged after using drugs.
It seems to me this thread is fully hijacked by lunatics. No one wants to talk about their anti-Hospice position in a productive way, multiple 1 comment accounts dropping off super dramatic posts about Hospice killing their loved one...
Sorry, all. I've unfollowed this thread, will do it again. Just happened to see the last couple of posts and I'm in a mood.
Bad things may have happened in that rehab center I don't doubt that but killing someone in 30 seconds right in front of their family.
I did get yelled at in rehab the morning my infected wound burst and I refused to get dressed and go to the dining room. She said it was healing well and did not smell bad and I had to put my clothes on. Well I didn't and was back in the hospital in a few hours for revision surgery
I get so tired of writing that the morphine given in Hospice is the same dosage as one would get after having major surgery. I've had two major surgeries, so I guess I am ghost writing.... [sigh].
Really wish the new writers would read some of the past 25 or more postings to gain a better understanding why certain things are done.... such as no food or water if the patient has an aspiration condition [which is common], or that the organs are shutting down so food would just lay in the stomach which would be painful.
Some times I feel we are being baited.
When it was clear (a year later) that there was no help for the pain that Mom was in, I told her primary doc that he needed to prescribe hospice for her.
I agree, there seems to be a lot of one off posting here. Trolling.
Hospice was a very good thing for Mom. They were able to step in and control her pain. I am grateful. No one should die in agony.
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.
...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..
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.
(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.)
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...
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.
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...