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 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.
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!
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.
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?
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.
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.
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
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.
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.
Wolf, I am so sorry for your loss.
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.
My Mom wasn’t in hospice.She died in the nursing home she had been living in for the last 15 years.
The nurse who gave my Mom the 2 injections was a nurse who wasn’t working at the home full time, she just worked during some nights per week.
This leads me to believe she wasn’ capable to make the right decision about the morphine.
Yes, I know my Mom was going to die anyway, I just know that she would have lived more days without the meds.
She was totally awake and alert.
The nurse should have told me that there was no way we could ”change” my Mom’s rapid breathing, this breathing was just a normal phase in the dying process and nothing that had to be corrected.
As for morphine overdosing, it would take one dose of 200mg for that to happen. It would be impossible for anyone to get their hands on such a huge amount. Hospice uses between 5mg and 15mg to make a patient comfortable.
There are patients who "graduate" from Hospice, and continue to live productive lives. That was the case of that 13 year old boy from Texas, who's mother was starving him to death [she was charged with attempted murder], which resulted in the child having a life-threatening blood infection. Thankfully he pulled through. Note that not everyone passes away in Hospice.