I thought I had resolved that question in my mind years ago. The last thing I did for my MIL, care-wise, was to give her some Ativan as prescribed by hospice. I know that I gave her the minimal amount. A little while later she had passed. Part of me wondered if giving her the Ativan triggered her death. I pushed that thought aside. Surely hospice wouldn't supply a med that ends life, would they?
A few years ago, a friend who was caring for a dying parent commented that her father died shortly after being given Ativan by the visiting nurse (who was actually there to explain to the family how to use the hospice kit). Of course, I wondered again if my actions caused MIL to die.
Last week my aunt died. My cousin said, "Mom had trouble breathing and was panicking, so I went to the refrigerator and got the Ativan for her. By the time I returned from putting the Ativan back in the refrigerator, mom was gone."
My husband will eventually be on hospice (shocked that he isn't already). We have a nearby hospice house that recently opened and I'm really wondering if it would be better for him to be there (NOT his wishes) where I won't feel the weight of responsibliity for his life and his death.
So, bottom line, my question is: Does hospice encourage us to use a medication that can cause death? I feel like this is the quesiton no one is supposed to ask. I'm asking.
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That would be murder. Murder is not legal in the US. Yet I'm amazed at how many people really believe that hospice killed their loved ones. HOSPICE DOESN'T KILL PEOPLE. THEY'RE IN HOSPICE BECAUSE THEY ARE ALREADY DYING.
graygrammie, you are fortunate to have a hospice house available for your husband. Have no hesitancy in choosing it if it would give you peace as you help your husband on his final journey. I have never heard a word of complaint about such places, and to my way of thinking, it's much better than having a loved one die where they live or in the home of a family member. Once a person dies in a private home, it no longer seems the same to family members. It's a death house. It's depressing. I know this from personal experience.
My father wanted to go home to die but my mother said No , she couldn’t handle him dying at home . Turned out for the best that he stayed in the nursing home .
When my grandfather was dying he came home from the hospital to be home for Christmas Day and we all went over to visit . Later that night he was getting short of breath so my father and uncle took him back to the hospital so he wouldn’t die at home . They thought that would be too traumatic for his wife( my grandmother ) . He slipped into a coma and died two days later .
What I DO know is that every single person I've know personally who did Hospice at home with their parent/spouse thought that they'd caused their death. My cousin blew his brains out about a year after his mother's very expectable death from heart failure. But you know....morphine killed her.
I have a friend whose elderly mothered is haunted by the final, regulated morphine dose. He died 10 minutes later. She thinks she killed him.
I think hospice is a great concept. But from my way of looking at it, there need to be medical professionals at end of life events.
I would not be involved with this at home. I was blessed when my mom was dying in a NH with hospice, the meds were ordered and the RNs administered them.
The Ativan didn’t cause your MIL’s death.
My mom had Parkinson’s disease and dementia. Her doctor prescribed Ativan and Seroquel to take. She started taking it long before she died and continued taking it until her death.
Please let go of second guessing yourself. This isn’t your burden to carry. It’s no one’s burden, your MIL was dying. You didn’t cause her death and you certainly couldn’t have prevented her death.
You gave her a drug, prescribed by her doctor, that is commonly used for hospice patients.
Your MIL would not want you to be concerned about how she died in your heart. She is at peace and she would want you to be at peace as well.
You are one of the kindest people on this forum. I have no doubt in my mind that you are an incredible advocate for your husband. Your compassion and understanding of a situation comes through loud and clear in all of your posts.
Sending hugs to you today and hoping that you can see from our posts that you did everything right in caring for your MIL and nothing was questionable about your actions.
As I always tell people, the person in hospice should be medicated to comfort level whether or not this speeds death by seconds, minutes, hours or even days.
The likelihood of ativan itself, if given to anyone not allergic to it, causing death? Nil.
So, no, ativan didn't cause death.
The dying process caused death.
Instead of calming and anxiety or agitation, one could allow the person suffering to continue in agitation and anxiety. The hormonal feed then of adrenalin would have surely prolonged life for a few more hours. To the expense of the tormented patient.
I know for CERTAIN that if you discuss this with ANYONE from Hospice or any MD you will be reassured. So do that.
What many don't know is that even quite large amounts of valium will not kill us. Not that alone. I know a friend who took a MESS of it, went to Pt Reye's State Park and made herself comfortable in the beauty of the Oceanside Park. She awoke that night with a horrific sunburn, and quite groggy, but there she was.
The MAiD laws, which I am quite familiar with and very happy with, will allow us that last cocktail and you would be amazed all what is in it. It takes quite a lot. Morphine, Digoxin, amitriptylline and phenobarbital in VERY LARGE DOSES is what they give you. Now THAT will kill you!
Of course so will deadly mushrooms, tylenol and a whole bunch of other stuff, but it is very painful and will take your liver before you are gone and give you quite the stomach ache. Generally that sort of suicide attempt, when it is not reversible, they will put you in a coma for relief as you go.
"However , the alternative was to not give him meds and he continue to be in severe pain , mental distress , and in respiratory distress."
If your dh is suffering, you would want his suffering eased. That's the bottom line.
Also, Lily's post about over-dose dosage. As a person who has known you for 20 years from another forum, I KNOW that that would be the LAST thing you would be doing.
My DH was concerned about the Morphine depressing FIL’s respirations.
I told him that his father is absolutely miserable in pain , severe anxiety and short of breath . Let him have the morphine he’s asking for .
People in hospice are dying. Sometimes a dose of medicine is given just before the person dies and those present assume the med killed them. It did not.
In trying to research this I found stories of people who intentionally overdosed on Ativan, taking 28mg or more orally, and did not die. In a hospice setting they are probably giving 1-2mg doses.
I hope this eases your concern.
If they are close to the end , anything can tip them to cross over. If someone is close to death , I personally don’t see what difference it makes if they die soon after a dose of med or an hour or two later .
If you are uncomfortable with that, you have to decide if you want to be in control of the meds he gets or do you want nurses to handle his meds. Only you can answer that question .
My FIL died last month on hospice the day they started the meds in the comfort pack. My DH has expressed to me a number of times how he didn’t’t think his Dad would go so fast . He spoke with him only hours before he died . The man was in CHF, had COPD and was ill with COVID . He was also in a lot of pain from spontaneous vertebrae fractures from severe osteoporosis . He was very anxious from pain and shortness of breath . I told DH , his breathing was so compromised that I am not surprised he went quickly . However , the alternative was to not give him effective meds and he continue to be in severe pain , mental distress , and in respiratory distress for perhaps a little longer before he died . At least he was calm and comfortable .
I should also note that the man had been declining with cachexia for months prior as well . He also had been given Lasix for the CHF which initially gave some relief of shortness of breath for a few days . He was on hospice about 3-4 days total and was given Oxy for pain initially with some relief for a couple of days . Then FIL was worse. Pain , short of breath and very anxious .
FIL had asked for Morphine a few days before he died , and decided to go on hospice and stay in his AL . But they did try the OXY first before giving morphine and Ativan . The last day he really needed both the Morphine and Ativan started .
Every case is different though. I know others have been upset and shocked when death did not seem imminent to them yet LO died soon after a dose of med .
I can appreciate how this is a tough decision for you . Either way , you will do the best that you can , just as you have been doing all along.
(((Hugs)))
Did I give my Husband more Morphine than I should have?
Why didn't I get up right away when I heard him rather than fall back to sleep?
Was there something I did...
Was there something I should have done that I didn't do....
What I do know is that I cared for him the best that I could.
He was cared for, he was loved, he was not in pain.
I have told people that if you do the absolute best that you can given the knowledge that you have that is all you can ask of yourself and you can lay your head on the pillow at night and sleep well knowing you have done your best.
I think I did that.
Reading your comments and replies to people over these years...you have also done your best.
Don't doubt what you did.
I am sure even if you did give MIL a bit more than was prescribed a bit more would not have hastened her death.
What you did do is allow her to die with little or no pain, at home in a loving, dignified way.
🙏