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.
The nurse will be here twice a week going forward. On her first two visits, she never mentioned the eye drops. She explained the box contained, morphine, Adivan, oral and rectal anti nausea meds.
I bet she didn't want to say that in front of Mom, who was already weepy and softly crying. (She feels better finally)
I meant to ask her, but the first week has been a head spinning flurry of activity. Thank you Stace.... you're awesome *as usual*👍🌹
Thankfully, we never had to use them, but I would definitely recommend that you speak with your Hospice Nurse, and review All of the medications, and their usages, should you ever need to use them.
I believe that the Nurses are wanting to to medicate your Mom around the clock, so the meds don't wear of, and she then has break-through pain, and I tend to agree with them. 5mg of Morphine every 4-6 hours should not be enough to make her "out of it", but only enough to keep some of the pain at bay. At some point, it may be necessary to give her even more pain meds, but that will become evident as time goes by.
Having gone through the Hospice experience with 2 of our parents, my Mom, and more recently my FIL, whom my husband and I did the Hospice care in our home, for the final 9 weeks of his life, and he passed here with us, last September.
Towards his final 2 weeks, our Hospice Dr gave us orders to give him more and more pain meds until they were as needed, along with meds for agitation too, as he had a lung (cancer) mass, and metastases to his rib bones, very painful!
I really would not worry about her being sleepy or asleep, it definitely beats her being in pain, and it allows you to have some rest from the exhausting work that it takes to care for someone 24/7, and who is in so much pain.
Remember, some Cancers can spread really fast, the patient often Is so tired, so leave them to rest. There is So much to do in caring for someone on Hospice. The meal preparations and serving, making sure they are drinking enough, bathing, laundry, entertaining, visitors, medical staff visits, CHARTING!!!, my Least favorite thing to do!
Do what you can to rest as often as possible, it's exhaustive work! If you can, enlist others to help, like grocery shopping, patient care and entertaining, tidying your home, dishes, laundry, some meal prep, but do be careful to have your Mom's meds put away in a safe place, even the emergency med pack that Hospice gives you, as you don't want those high powered meds to get into the wrong hands, especially children! You've got to rest wherever you can!
Near the end, you might need someone to stay with you some nights, if your Mom is anything like mine, who needed things during the night time.
I hope that things go go smoothly for you, but too often, unexpected things do come up, that throw you for a loop, bowel problems were a big issue for both of our parents, and you need to be flexible and calm. Remember, your Mom is now nearing the end of her life, and You need to keep a cool head. More then anything, she doesn't want you to be frazzled, so You take care!
Is mom on hospice? Can you call the 24 hour hospice line and talk to a nurse about your concerns?
What kind of cancer does mom have? Did they tell you what stage, and where it's spread to?
Are the meds for pain? Cancer pain, especially the cancer has spread to the bones, is excruciating. Morphine will help control the pain.
You're not killing your mom, the dosages are not high enough for that. The morphine is for pain relief and to ease breathing difficulties.
There really was nothing that could have been done to stop the bleeding but she could have been sedated if she and the family wished.
When admitted to hospice the caregivers are instructed to call the hospice nurse first and not take the patient to the ER.
That being said the RN may decide that the patient should go to the hospital for many reasons but not for life saving measures.
I agree with your description of the negligence of the staff assigned to your sister, there is no excuse for that kind of behavior and you should write a letter of complaint to the Board of Directors of that hospice. In the hospice i worked for that would have been a fireing situation. No notice no nothing just get your stuff and get out.
Don't know if they were overworked, underfunded or short staffed or anything else.
As a side note hospice nurses earn roughly 1/2 the salary of their counterparts. not that matters to you.
Be at peace you have lost your dear sister so do your grieving and remember anger is part of the grieving process
The last 10 or more posters who opposed Hospice were one time posters and never posted again and had no history which made them look suspiciously fake I suspected your post was another fake post hence my rude reply.
I looked up your profile and could not find any information about you on this site.
You didn't say if you took care of anyone.
You only have 3 answers which are hidden.
Just wondering how you suddenly found and appeared on this particular tread.
Regarding your sister, why didn't you take her to ER right away? If someone was bleeding to death, you were supposed to take that person to ER or call 911, not beg and wait a day for non emergency service to give you permission to act. Why would you need Hospice's permission?
The same amount of morphine that was used is the same that one gets when you have major surgery. I have had several major surgeries and each time had morphine for pain.
The amount of morphine given is 5mg to 15mg.... in order for morphine to kill someone the amount would need to 200mg. Since morphine is a highly regulated drug that is closely watched, no way would any doctor or nurse give a patient 200 mg.
I'm still not understanding; was your dad under Hospice care? Are you saying that Hospice CAUSED his decline?
I think many of us are confused by your posts.