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Lorraine12 Asked August 2019

Auntie is so very weak, refuses food liquid, moaning in pain, spits out everything I give her to try to help her. Any ideas?

 I feel useless. Eyes glazed. She is on hospice the nurse says give her the meds it will give her comfort but Auntie will not cooporate spits like a machine gun anything I put in her mouth. I give a bite then duck down ...I have mixed with applesauce that's the closest I get to getting anything in her. She bites down on the spoon then starts blowing it everywhere. Chocolate pudding was the worst! Looks like poop everywhere! lol!!


I know we are nearing the end of her journey. I knew the day she refused food but I just have so many questions and I've been through this before ...but still I am afraid. I really am afraid never felt this scared before, my dad had my mom in the NH the residents had their family now I am the only one. My family is here but Auntie never bonded with anybody in the family she refused to say anyones name except mine and my grandchild. What can I say to get Auntie to take her meds? What can l say to comfort her? Do I stay by her side all the time? I play her favorite music. ANY ideas HOW to get her medicines in her?? SHE WONT TAKE NOTHING KEEPS SPITTING ....if ANYBODY has any ideas PLEASE SEND ADVICE Thank you all

Lorraine12 Aug 2019
Ok so hope you all see this one I got the mouth swave like so many suggested (countrymouse) ect...and when I swaved her mouth at 4am this morning she bit down as I was taking swave out of her mouth and the pink end was stuck in her mouth!!!! I was freaking out !! How can she bite down so hard and not even be able to lift her arms!I woke my husband to get pliers to grab sponge cuz when I tried to put my fingers in her mouth she kept biteing me! Lil stinker!! Finally she nodded off and I was able to pry out of her mouth with the stick...
never used the pliers ..guess I wont be able to do the mouth swave thing unless she's kinda asleep.....I mean shes so weak I could not believe the strength she had to use to bite this thing so hard...SPITFIRE FIGHTING UNTIL the bitter end!!
Tothill Aug 2019
Perhaps a very wet wash cloth wrapped around a Popsicle stick will allow you to wipe out her mouth and keep your fingers at a safe distance?

Has your family told your Aunt that it is ok for her to die now? As well is there a significant date coming up? My step dad made it to 3 days past his birthday. My grandmother died shortly after midnight on her birthday. A friend's sister lived with 3 weeks until her son could be found and brought to see her in the hospital. During that time she had no food or water or other hydration.

It must be so painful for you to watch her dying process.
ArtistDaughter Aug 2019
Oh, Lorraine, thank you for posting what is going on with Auntie. She is so lucky to have you. And thank everyone else for the advice given. My mom's memory is worsening and I am so afraid of facing what comes next, but I must and I will. Take care.

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Countrymouse Aug 2019
Lorraine, don't forget you can get those little sponges for keeping patients' mouths clean and comfortable - they're on sticks, like cotton buds but made of sponge that won't disintegrate or leave lint.

Lorraine12 Aug 2019
THANK YOU ALL ; I'M HERE to update all of you Auntie still hanging in there now she is so weak even when she tries to spit she can't, she's forgetting how to swallow ,can not move arms or legs ,We have do everything for her she still gets mad when changing her ect...she can take VERY SMALL AMOUNTS OF water or at a time shes soooo tiny ...I feel very helpless poor little spitfire ,whitty, Auntie ....
againx100 Aug 2019
Sorry you're going through this. I think the end is near and I hope you can let her go peacefully. I'm not surprised you feel helpless - there really is nothing you can do.
MAYDAY Aug 2019
I should start out with, how is she? I have not been on here for while, in case she is still around, Have you tried Sorbet, something tart and icy kinda to numb the tongue? She may have a stronger reaction and hit the wall across the room...

I saw someone biking yesterday, and he had an orange and white outfit on. All I could think of was creamcicals. However you spell it... the frozen orange pop covering the ice cream on a stick ... thing.... :)

That is all I can think about. Going to store tomorrow to buy some for my aunt and me....

Isthisrealyreal Aug 2019
Lorraine, great big hug🤗🤗🤗🤗

Your little tiny aunt spitting like a machine gun made me laugh. You are doing an awesome thing for her. Laughter doeth good like a medicine. I am happy for you that you can see the humor it her spitfire ways, that alone cracks me up. Spitfire apple sauce.

DareDiffer Aug 2019
One other way - doctor or end of life team should be able to provide them - is small sponge on stick that can be dipped in water and used to wet the mouth. The end of life care team can help with care - mum hated being moved but looked a lot more comfortable afterwards. Small things like adjusting the pillow so supports the neck, they were very good.

Doctor only sent them for the last 2 days out of the week we knew mum was dying but they were very helpful all the same.

Mum bit Dad when he tried to remove her dentures- first reaction we had! At first she would suck the sponges but later we just would wipe around the inside of her mouth regularly.

Think the reaction is just, that a reaction to suddenly suddenly being disturbed with food or liquid. Not to be taken personally even though it’s a bit of a shock when they do. Partly as you can’t believe they still have the energy to react!

Hope you are looking after yourself too - tend to forget whilst focus is on a LO at that stage.

DareDiffer Aug 2019
i am so sorry to hear of your struggles. Sounds like she needs a further assessment - there’s liquid nutrients if she will still drink. My aunt wouldn’t eat and that’s what I used to ensure she had, as it provided all the essential nutrients needed.

Medication can also also be provided by IV pump if she can’t/ won’t take them orally now. The hospice staff or doctor should be able to advise if your aunt has reached a point where either a nutrient drink or stopping all bar water is appropriate for her. The same re IV pump for her medication.

I provided their favourite music and freesias, due to their aroma, but it depends whether your aunt likes them. Whether responsive or not, I’d chat to them normally about events past and present. Though that might be slightly harder if your aunt didn’t bond with family.

if you need a break, being human the answer is yes, put some music on for your aunt, and take one, or get another family member to sit in with her whilst you do.

Take care of yourself too, and remember to be kind to yourself at this difficult time.
Lorraine12 Aug 2019
Thank you for your response Auntie is still hanging in there ! She has pretty much stopped eating and can not even suck through a straw she has forgotten how ,the only food she even tolerates us to feed her is applesauce she has NO OUTPUT and she's so tiny and frail but still tries her hardest to Spit punch me or, bite me !!Haha Haha he he she's a spitfire! Not to be mean but i have to laugh or Ill cry. I appreciate everyones advice and Thank you all
MargaretMcKen Aug 2019
It sounds as though the food spitting really is last stage. The last time they encouraged my BIL to swallow food, it was followed by projectile vomiting. Cleaning up was very distressing to everyone, including him. Perhaps if you stop trying the food, her reactions will change. BIL liked having his lips painted with cold sweet liquid sorbet, and then he licked it off. Could you put a lot of sugar in the morphine and try that?

Lorraine12 Aug 2019
How long Do you think the patient can live when they no longer are eating ? She is agitated, mumbling senselessly, No consistant signs of blotches purple on legs the day before yesterday her feet were purple after 1/2 the day cleared up... but she looks grey, moans and screams in pain ,her oxygen is between 93& 97% p 69her BP FLuctuates between 100/50 & and 120 / 80 she has no other health problems except alzheimers /vascular dementia /osteoporosis/ scoliosis/ but nothing internal skin cancer she has had basel cells removed but that's it....Thank you all for your advice I do not feel as alone because of all of your support .

NeedHelpWithMom Aug 2019
God bless you, Lorraine

You have been so selfless in caring for your aunt. I agree that it would be helpful to contact hospice and tell them more help is needed. Take care, many hugs!
Lorraine12 Aug 2019
Thank you for your kind word's
staceyb2 Aug 2019
Do request the comfort care packet if you haven't already received it. There should be meds in it for her agitation and pain. I just recently did end of life Hospice care for my FIL in our home, and we had the liquid morphine which we delivered via the syringe into his cheek. I did not mix it with food, just pushed the dose into the inside of his cheek, and yes it tasted nasty but you could perhaps gently hold her mouth closed until it rolled back into her throat (it was only a few drops in my experience) or maybe gently tip her head back for a few moments for it to be absorbed and follow it with a drink. None of this is easy, especially when you have an uncooperative patient. Keep reassuring your Auntie that the medicine will soon work to ease her pain and suffering, and hopefully yours too!

I would definitely stay on your Hospice Nurses tail about getting educated about how to deal with all the issues that come up, as there are many and often. I know that there are other medications administration options, such as the patch or rectal suppository, and perhaps the pain patch might be best for your situation, but it sounds like you need to get this worked out ASAP for everyone's sake.

Lastly I would like to say that we had the most amazing experience with our Hospice provider, establishing good communication is essential and keeping good records saved my bacon as I was so busy and so tired that it was easy to forget things, I also kept a list of questions so I wouldn't forget to ask them.

You are doing great, this is such a difficult job and people don't realize just how hard it is on the Caregiver. You are an Angel for taking this on. I hope you soon get your medicine issues solved and that your Auntie's end of life journey is swift and peaceful for the both of you. Take Care!
Lorraine12 Aug 2019
Thank you for your well thought out advice
Countrymouse Aug 2019
It makes me cross on your behalf that the nurse tells you to give your aunt morphine but doesn't tell you how. I agree with BB that you should ask the hospice team to show you the right technique.

I'm sorry that your aunt is struggling and in pain; but it may be that battling with her is more distressing *to* *her* than leaving it and trying again later. How aware is she? If possible, offer her food, drink and medication and let her choose. Don't try to force anything.

I don't think anyone can judge better than you whether it's best to sit by her or to let her have privacy; but certainly if you need a break then take it, and ask a family member to listen in - you can use a baby monitor for this - and call you if she needs help.

You are a brave and strong person to stand by your aunt through this. I hope your family can support you even if they're not close to her.
Lorraine12 Aug 2019
I want to send my appreciation to your help Thank you
AlvaDeer Aug 2019
Food now will prolong her suffering. Just a little food can keep someone going for much much longer. So see if food can be avoided. Speak with hospice about your inability to get in the medication and have them show you how to do it. Often medication can be shot in with a little syringe without a needle and is put on the buccal membranes, under tongue, side of cheek, and absorbed without need to swallow. There are also patches which would mean that your Aunt doesn't have to swallow at all. The most important thing now is that she is medicated to a point of comfort. She is likely taking no nourishment now and will pass soon, and nourishment would in fact prolong this agony. Dying is not an easy thing, and there are some three days in which agitation, picking, confusion can be very acute with lots of restlessness. Hospice was ever so much better in my day with more support at the bedside or with the senior in hospice facility. Speak with them about how to give the meds, about the agitation, about how long you can expect it, about what to watch for when death is more eminent (mottling and cooling in extremities, and etc). Do know that your presence and your attempts now is all that you can provide. I am sorry for all you are going to and please throw yourself upon hospice folks with desperation so they give you all they got to help now.
Lorraine12 Aug 2019
Thank you for your advice .So you think the food is only going to pile up inside her and make her uncomfortable?I try not to be pushy Applesauce is the
only thing I can get her to take I think its the consistency like liquid but still thick .I will stay on the hospice people I already text the nurse about the pain and her spitting out meds TY for encouragement !!
BarbBrooklyn Aug 2019
When my mom was on hospice, the nurses used a long syringe type of dropper that they were able to shoot the liquid morphine into the back of her throat. Ask for the hospice nurse to come out and demonstrate the best way to do this.

Lorraine12 Aug 2019
Thank you yes I can get liquid morphine but they never give comfort packs anymore so we have to wait until it is delivered in the mail... I was still kinda leary about morphine and distributing it she's still going to spit it everywhere .....
AlvaDeer Aug 2019
I am so sorry that hospice is not now what it was designed to be and what it once was. It is now a business. It once had Social Workers, RNs and CNAs coming to you on a daily basis, or in facility, to give care and to teach and to help families come to peace and comfort. I have never heard anything so insane as hospice by mail. I keep telling people how much it has changed since first it started.
MAYDAY Aug 2019
dont they have morphine patches or pain relaxing patches? HOw about that medical marijuana stuff? Maybe they can make an insence and she can just breathe it in? Or make tea out of it... marijuan patches...

BarbBrooklyn Aug 2019
Call the hospice line now and tell them what you've told us here. You may need to use a suppository or some other method for getting pain meds in.

Do you have liquid morphine that you can give with an eye dropper in the side of her mouth?

((((((Hugs))))))
AlvaDeer Aug 2019
Yes, exactly what she needs, will be absorbed even if she spits, as a small amount, and goes right into the membranes. Hospice is getting to be so bad now. Not at all what it started out with, with good personnel at the bedside, especially trained, and teaching. I never heard of hospice by mail. Sounds ludicrous to this old nurse.

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