Hospice parent when you live out of state. Any advice?

I also went through my dads diagnosis and death from another state. It's easy to get twisted up focusing on being there when he passes but I just want to remind you it's the lifetime you spent with him that matters, not whether fate or luck allows you to be at his side when the end comes. It turns out many loved ones, my dad included, decline to die while family are around. Maybe they feel obligated to stay or just can't let go in front of their loved ones but I guess it's pretty common. I'm glad you're visiting as soon as you can, for the rest you just do your best.

Yes, I was at the end of my career 18 years ago when my Mom died. I could not tell how imminent death was and I had to return to try to figure out when to do family leave. She died two weeks after entering hospice. I would ask Hospice to be as honest with you as they can; no one can predict, but once there is no food or fluid intake things may progress quickly. I would counsel you not to worry so much about being there at the end because the dying are busy with their dying and will often begin to disengage from family which can be hurtful. Do it now if you are able. And return to work when you must, keeping contact as best you can. Our parents know we have gone on to lives of our own. It is what they wanted for us. Just stay in touch. I have a friend dying on Hospice 2 hours from me and I cannot get to her. But our contact by phone is touching and meaningful. You can only do the best you can. I am sorry for your coming loss and wish your Dad peace. Let him know you love him and will carry him with you while you live, because you WILL.

Facetime is your friend at this point. Go visit in person when you can, and try to Facetime every day if it's possible. Let him know you love him, and just be there in whatever way you can.

Hospice is for the entire family, so you should be able to talk with the social worker or nurse about his condition.

You dad isn't going to be the one to ask for morphine -- they'll give it to keep him comfortable. It doesn't knock him out cold -- it only stays in his system about two hours -- so I hope he isn't refusing it for the wrong reason.

Talk to the Hospice Nurse and get an idea what is actually going on.
If you have to go home the Hospice Team can keep you posted as to his condition.
Some Hospice have an App that can allow you to monitor what is happening.
Make sure that you are listed as a person that is able to get/give information.

If your father is having trouble swallowing, in reality, the end may be closer than you realize. Once such a situation occurs, things can go downhill rather quickly. Both of my parents were on hospice care; dad sort of 'gave up the fight' once he went onto hospice care; he was a warrior who was valiantly fighting to 'get better' from a brain tumor. Once it was deemed the tumor had grown & was causing his issues, then he gave up the fight, and passed away 19 days later.

My mother was doing well, with advanced dementia but socializing with her fellow residents in Memory Care, as usual. She had been on a steady decline for a solid year, however, and had started eating less & less and her shortness of breath was increasing dramatically. That to me was an indicator her CHF had exacerbated. She went into her bed one morning 'feeling tired' and never got back out again; she passed away 1 week later, never having regained full consciousness again; her heart had given out. Hospice did not see it coming, either. But I had a week to be with her and say my goodbyes; we all did, actually. Same with dad; he was in the active dying phase for a good week before he actually passed, so there was lots of advance warning.

I think hospice should let you know when it's imminent that dad is passing, so you can join him to be close by at the end. If not, you can spend as much time with him now and say what you need to say while he's still alert & cognizant, which is sometimes better, than waiting for the very end when he may be semi-comatose or fully comatose.

I know how hard this time of life is for you, and my heart goes out to you. Sending you a hug and a prayer that God has mercy on your dad, your mom and you, and makes his transition painless and you and mom's pain minimized watching him transition to a state of perfect peace.

You can never know how long it will take. With my dad, it was three or four months. With my mom, she was in and out of hospice care for 2.5 years. In your case, since you're working, there are reasons why you can't be there until the end. It might be best to go, stay whatever length of time you're able, and go back home. Modern technology makes it easy to stay in touch with video chats, phone calls to dad and phone support for mom. It's not the same as being there in person (which is hellacious, by the way), but at least you're THERE in real time and can take heart in participating. I'm so very sorry and hope he'll have a peaceful passing. Condolences.