When a person in a hospice starts taking morphine...
how long until they die, on average? I am going through this with a loved one right now.
Out of my three close relatives who died of cancer, about five days max.%0D\
And you HAVE to agitate at times to make sure the person has enough. If your relative seems uncomfortable, complain to the doctor. %0D\
With my relative, she was gone that night. %0D\
The hospice people said she had a couple days.%0D\
Just make sure the person is comfortable. We added some zanax as well. Also some breathing medication.The passing was peaceful. Thank God for hospice. Those people are fantastic human beings.
I agree with R1. My mom had about 3 days. That was also the end of her being lucid and able to have any sort of conversation or ability to make her needs know. Look at the non-verbal signs to assess if they are in pain (grimacing, posturing, etc). \
I''m sorry for what you and your loved one are going through.
My grandmother died of cervical cancer many years ago. Once they told her there was nothing more they could do they gave her 3 months. Tough little woman she was and she lasted 9 months. She was on a morphine drip the last several weeks of her life. She would be a millimeter from death one day and the next she''d be up and about laughing and talking. This went on for weeks until finally one night at 11pm she just woke up from a sound sleep, looked at my mother and smiled and closed her eyes and died.
It was less than 12 hours with my mom but she was already unconscious & had pneumonia.
As you can see, OP, it varies depending on dosage and the patient''s condition. But know that morphine is a godsend at the end of life, particularly if s/he is short of breath.\
Best wishes to both of you.
It depends on what is wrong with them. Is it cancer?
My grandmother was taking morphine for over three weeks, longest three weeks of my life. I ensured she was comfortable, when you take care of them at home you have control. It brings tears to my eyes even now after 13 years and I will never be the same mentally, so prepare yourself if you go that route.
[quote]And you HAVE to agitate at times to make sure the person has enough. If your relative seems uncomfortable, complain to the doctor. %0D\
If you''re doing hospice, you usually don''t have to agitate for morphine. Thank god for hospice. Our family''s experience with hospice death is that it is vastly preferable to hospital death.%0D\
My thoughts are with you, OP. How are YOU doing?
For a friend dying of kidney failure due to AIDS, two weeks. It probably depends somewhat on the patient''s overall physical condition, too. \
Hospice is indeed a blessing, although it''s better in some parts of the country than others. A friend''s mother in rural Georgia wound up having to be hospitalized for pain control when the hospice refused to approve injectable meds at home - crushing up pills in pudding won''t do much for someone who can''t swallow. \
What R9 said - how are YOU doing? Don''t feel guilty if you''re thinking that you wish your loved one would go ahead and go - that''s perfectly normal, and it''s not the same as wishing death on them.
The morphine really has nothing to do with it other than comfort measures. Some people need more to be comfortable.\
What you''re looking for is agonal breathing and, very near the end, a death rattle or Cheyne-Stokes. Look those terms up on YouTube for examples. The hospice workers should be well-acquainted with these patterns of breathing and will be able to inform you, though.\
Just be warned that people often seem to die when no one is around. It''s like some people want the family no where in view when they pass.
My sister died of breast cancer. She was in hospice care (at home), receiving morphine, for 8 days.
OP here. My grandfather is 95. I''m not sure what he''s dying of (besides old age), but it''s not cancer. He lives 4 hours away by car, so I probably won''t ever see him again, but I think about him every minute.
I think it depends on many things. My sister recently died of ovarian cancer. She was sent home to Hospice care on a morphine drip and was told it would be a week or so. She lived for 4 months on that drip. While it''s painless and comfortable for the person dying, it''s a horrible, draining experience for the caretakers. I wish you and yours the best.
They told us it would be four or five days for my mother but she lingered for seventeen days. %0D\
Best wishes, OP.
I forgot to add that the age and general health of the person (aside from the cancer) has a lot to do with how long they can last with the morphine.
[quote]If you''re doing hospice, you usually don''t have to agitate for morphine. Thank god for hospice. Our family''s experience with hospice death is that it is vastly preferable to hospital death.%0D\
I''m very glad that your experience worked out well. For one member of my family, the hospice experience was horrific--and these people came highly recommended.
It could be a couple of weeks. It will be quicker if you don''t stay with the patient night and day. If you go home, then they can die.
OP, why don''t you try to arrange to visit him? Maybe on Saturday if he''s able to have company? If you''re thinking about him all the time then it''d be worth the time and distance to tell him so.
[quote]The morphine really has nothing to do with it other than comfort measures.\
It does suppress breathing function. It essentially induces a pain-free coma. This is far preferable to excruciating, lingering pain
OP, at the age of 95, he probably won''t linger too long on morphine, but anything can happen. Probably 3-4 days, but also depends somewhat on when he last ate or drank.\
R1, I''m sorry to her about your bad experience with hospice. It''s not supposed to happen that way.
Oh my gosh, OP, I''m so sorry for your relative ... it won''t be long, unfortunately. Make the last days count.
Have any of you been on morphine? If so, what is it like?
24 to 36 hours
R11 is correct about the morphine and the breathing. But even before that you will see the organs shutting down, primarily kidneys. Once the kidneys stop functioning and there''s no output, it''s a matter of hours. %0D\
The hospice people may check body temperature from time to time to gauge the process. A lot will depend on their overall condition and how weak they are to begin with, OP. So sorry.%0D\
The morphine keeps them peaceful and free of discomfort.
When they can''t drink anymore, it''s over.\
3 days tops.
Blessings on hospice care! Like the military, they should be funded and thanked with everything we can give them.
The insurance companies and Medicare both love hospice because it is a fraction of the cost of standard care.
Usually a few days. My thoughts are with you.
Like others have said, it depends on age, condition and illness.\
Honestly, it also depends on what it''s for. \
My father died in hospital on morphine. He had been on it for pain for about a week with no change in his vitals, but the last day they gave him a lethal dose (at my parents'' request, of course). \
This was in Canada many years ago. Nothing was ever explicit, but they will do it. I understand from talking to others that hospice is the same.\
Sending thoughts and condolences to you OP and all the others here who''ve been through it.
Why wouldn''t a person in that state not be able to drink water?
They have trouble coordinating the swallowing reflex, R31.
[quote]I''m very glad that your experience worked out well. For one member of my family, the hospice experience was horrific--and these people came highly recommended.\
I''m also sorry it was a bad experience for you, R1. Likely the hospice didn''t want to be accused of killing your relative by over-medicating. They walk a very fine legal line when treating with massive doses of morphine.
OP, and everyone else I am really sorry for your loss.\
About a year ago my dad was dying of pancreatic cancer and leukemia. We had morphine but he refused to take it. The day before and the day he died he was extremely agitated and the hospice nurse said just give it to him. There were a couple of gruesome episodes that led to this. He was dying, no question about it but it bought him, if not us, some peace.\
And I want to give a shout out to hospice nurses. Without them, I don''t think my mother and I would have survived. Professional, caring, and they listened to my father''s endless stories. At his memorial service we asked that in lieu of flowers donations be made to the hospice, and raised almost $4000.00 for them.\
I cannot sing their praise highly enough.
I can''t say enough good things about hospice. My mother, who had advanced breast cancer, had it in her assisted living facility for 9 months. She did have morphine at the end...about three days. But she had a great quality of life for 8 1/2 of those nine months. Remembering back to the AIDS crisis of the 1980s, my impression is that morphine starts shutting down the heart (depending on dose) and the max is about five or six days. Usually fewer.%0D\
So go now, OP, if you plan to. 95 is a great old age. Don''t regret if you want to make a last visit.
My father died last summer. We took care of him at home. We had the help of a hospice. The nurse was just amazing. Anything we needed we got within a few hours. There was 4 of us, pretty smart, very dedicated to the task of caring for him, but it was still difficult and a huge strain. I think we are still all abit shell shocked from the experience.%0D
He was given 3 to 6 months but died in about 2 months. %0D
They basically told us to give him as much morphine as he needed to be comfortable. Ativan was added because he was getting agitated. The last few days he was near comatose. He died peacefully on a Sunday morning with all of us there. I had never seen anyone die before.%0D
I took 30 mg of morphine and it was wonderful. It is like being in a cloud, physically and emotionally. Nothing bothers you, the world and life are wonderful and your body feels like cotton.%0D
Good thoughts, OP. One doesn't understand what grief really is until one loses a parent, spouse or child.%0D
It feels as though a piece of your soul is ripped from you.
R35, that''s not what really happens. Often hospices will give higher and higher doses until the patient''s breathing stops. It is an unsaid thing and is more common than people realize.%0D\
Morphine is actually a very safe drug for a patient to self-administer. They''ll never OD because they fall asleep way before that.
My father died in hospice after about 3 days, during which he was given fentanyl. He went into a semi-comatose state but came out of it when I arrived from out of town. The wonderful hospice nurses were shocked that he opened his eyes the instant he heard my voice. They said he was waiting for me. He was gone in about 5 hours.%0D\
I read on Wikipedia that fentanyl is 100x more powerful than morphine. Does anyone know why one is used over the other in some cases? %0D\
God bless hospice workers. They were truly amazing.
OP here. Thank you for all of your responses. I visited my grandfather back in 95. Things were just starting to get bad. He didn''t really speak to me. He was sitting in a wheelchair, watching tv, and I tried to talk to him, and he said,"I''m trying to watch this." Then, when I was leaving to say goodbye, I leaned down to kiss him, and he got really agitated and yelled,"None of that stuff!" %0D\
Even before he was sick, he was never an affectionate, warm man, but it was always interesting to listen to his stories and hear about family history. But that is all gone now.%0D\
I don''t think seeing him again will give me any kind of closure. As much as I love him, I''m not even sure that he even loves me. I had 3 grandparents who loved me, so 3 out of 4 is not bad. %0D\
I hope that when I die that we meet again.
I''ll tell a story to show how much it varies. Someone I worked with was a heavy smoker and drinker. In his late 50''s he got throat cancer. Went through chemo, radiation, and after getting extremely sick, he was told it was gone. He started smoking again and about a year later the cancer came back. He was too sick after awhile to continue the chemo and radiation. So, that was it and they put him in hospice. Three months later he started getting better. They tested him and he had gone into remission. He tested clean and got out of hospice. A year later, he was still clean. It probably won''t last, but all of us who worked with him were shocked. You just never can tell.
R40, I have a feeling the man you describe was not really in ''hospice''.%0D\
It sounds like he was in some other type of care.%0D\
I don''t think people stay in ''hospice'' for the long length that you describe - but I could be wrong.
People wait TOO long to apply for Hospice. Each state varies but a life expectancy of 6 months can qualify you. And the cancer guy above can get it again when the time comes.
When my uncle died they waited until all the family had gathered, gave them some time to be with him and then upped his morphine. He was in such pain that he needed it. He just slipped away after about half an hour. He died of cancer according to his death certificate.
Hospice keeps a special "dose" around. That''s when you pull that out R43. Euthanasia is alive (!) and well...
The night my mother died my brother and I had stayed in the hospital all day and most of that night. Finally my brother said we should go home for a few hours. A half hour later we got a call from the hospital saying she had died. My brother thinks she waited until we left, but I believe they turned up the morphine. Felt really guilty for leaving.
R45, please don''t feel guilty. I''m a hospice worker and can tell you that people often wait until their loved ones leave the room to die. There are many theories surrounding this. Among the ones I hear most often: 1) there are some things folks just need to do alone, and 2) they don''t want to upset their family members by dying in front of them. Who knows what the truth is, but it happens so often, there must be something to it.
I always wondered about the "special dose." My mother was in hospice for three days after a long battle with breast cancer that had gone on for seven years (she had a mastectomy, tamoxifen, radiation and chemo at various points in those years.) On the third day in hospice we were all there except one brother who had to put in time at work. We kept the (wonderful) hospice people informed that he wasn't there but should be called if needed. We called him to come to the hospital when the hospice workers noticed some changes in her breathing at around 11:45am. We kept telling my mother he was on his way and would be with us soon, even though she had already been unconscious for more than a day. My brother got there at 12 noon. We all held hands with my father and my older sister holding my mother's hands. She passed at 12:04. There was one hospice worker in the room with us who watched over the whole situation. It had been a sunny day, but right after my mother died there was a storm front that came through with a massive rainstorm, then it was clear and sunny again within about 15 minutes.
r45, I was the primary caregiver for my mother during her at-home hospice, and our hospice visiting nurse told us exactly the same thing about patients "waiting" to die until they''re alone. It''s odd how much control the dieing have over their deaths.%0D\
re: morphine, our hospice nurse gave me a talk about it, then left the dosing entirely up to me. We had total control over how much morphine she had and when it was administered. She wound up having her one and only dose the morning she died, which was when she began to exhibit respiratory distress. %0D\
We felt she had a "good" death: quiet, at home, with very little distress or discomfort, exactly as she wanted it. We would do hospice again in a heartbeat for any relative who wanted and needed it.%0D\
r46, you folks do fine work.
You''re welcome R49. Most of the people who work for hospice are there for all the right reasons. You can''t say that about many professions. The one I work for is a non-profit. We''re not paid much, but the work itself is very rewarding. Caretaking is extremely overwhelming-- having assistance from hospice allows families to have more quality time together in those last months.\
I''d like to concur with what R46 said re people waiting too long to involve hospice. They feel that if they involve us, it means there''s no hope left, that their loved one is going to die. Sometimes they wait so long, patients come into our facility from the hospital already non-responsive. It would be better for the family if they''d been able to have more time together in a home type of setting. If any of you are facing this, please think about contacting us sooner rather than later.
r48, who cares what the fucking weather was. OOOHHHH, it was your mom dying that caused the thunderstorm. Fucking idiot.
Trolldar reveals r51 to be a fascinating specimen.
In the animal kingdom, they go off to die alone. We are animals. It makes sense.%0D\
To the hospice workers, you truly are angels.. how you do what you do, I have no idea. I am truly grateful for people like you.
My dad called. It''s just a matter of hours now.
To be honest, I do not understand the ritual of everyone needing to be at the bedside holding hands when the person dies like R48 describes.%0D\
And some people feel guilty if they were not present.%0D\
It''s okay, but it just seems unnecessary and too ritualistically enforced. It seems to be something family members do just to impress people in society, the hospice workers, and their relatives.%0D\
People could have made peace over the phone with the dying person a week ahead of time when the dying person was still lucid and talkative. It is not necessary to make a big deal about being ''at the bedside'' at the dying moment or moments.%0D\
There is such a big deal in newspapers accounts when they say ''and the family was at the bedside''. It''s a bit mellow-dramatic.
[quote]Just be warned that people often seem to die when no one is around. It''s like some people want the family no where in view when they pass.\
My father took advantage of the break between one day''s visiting hours and the next''s, so that none of us family members were there when he died of lung cancer.\
But he had a nursing student in the palliative care unit with him, and she assured us that it was a good death, very peaceful and pretty quick.
[quote]And you HAVE to agitate at times to make sure the person has enough. If your relative seems uncomfortable, complain to the doctor. \
What does that mean, agitate what? The IV bag? The patient? In what way?
[quote]If you're doing hospice, you usually don't have to agitate for morphine.
We had to with my mother because it took the nurse 15-30 minutes to bring the morphine once asked.
Hospice was, for the most part, very good. However, the lazy nurse who took forever to get mom's morphine also was very unreasonable and unprofessional because mom was delusional after the cancer spread to her brain. Mom has been a nurse and had delusions of being at work and "making the rounds". The nurse was rude and thoughtless, although I specifically saw other nurses there who were respectful to other patients who had similar issues. A temp worker at Hospice also insisted on moving mom even when we told her not to because it caused mom excruciating pain. One day we heard mom screaming from half a building away, came running, found the temp aide had sneaked in and was moving mom. My partner almost punched her. And don't even get me started on the crazy guitar-playing nun who would sneak in and start playing hymns to my non-religious mother.
So be aware that even Hospice can have some problem employees and crazy volunteers, and learn to compensate for that. You have to be tough, rude, strong, self aware, and demanding sometimes. Don't ever feel guilty for it, not for a second.
[quote]Have any of you been on morphine? If so, what is it like?\
It''s like being wrapped in cotton wool, and being gently tucked in to a cosy matchbox.\
Like all opiates, it knocks all the hard edges off life, but it also makes you SLEEPY. \
I want something that makes me feel deliciously bouyantly ripped, and the world is your oyster, like when one is coming down from LSD, before you hit the hard buzzing earth. Whaddya suggest druggies?
I agree, r27. My mom volunteers at a hospice. That has to be a draining experience but some of them are surprisingly upbeat (even a male teenager volunteers there and can handle it). I think it takes a certain type of person (not personality, some don''t have that "nursey" personality but you''d want them there with you or your family at the most difficult times).
R45, they likely didn''t "up" the morphine. As you already heard, patients often stay around for relatives when they can tell they''re in the room, but when left alone they drift away. My grandmother and mom both did exactly that, lingering until relatives left for a while and then passing away.\
R55 is strangely bitter and resentful, and also wrong. Mom was semi-responsive with hand squeezes and such until the very end, so she knew we were there with her, talking to her and holding her hand. It was important. And even if someone''s loved one is completely unresponsive, death is as much about the living as it is about the dying. If you want to be there with them, then do so, and don''t let the guilt-tripping of people like R55 dissuade you.
R55 There is a very big difference between dying and dead. If it''s the last chance to be with a loved one many are grateful for the opportunity. It has nothing to do with guilt or what others may think. It sounds as though you have "unfinished business" with your family. Did somebody hurt your feelings?%0D\
[quote]even a male teenager volunteers there and can handle it\
Do they screen for necrophiliacs? I''m not sure I wish to be fiddled with and spoofed over by pimply horndogs on nightshift.
It depends what type of cancer they have OP of course. My dad went within 2 weeks.
I am sorry Op I just read that it was not cancer your grandpa has.
My Mom died not even two weeks ago. I was with her when she passed and did not even notice that moment.%0D\
I have a question. She was semi-comatose. I kept constantly talking to her and holding her hand. Do you think she heard me or knew of my presence? TIA.
R66, I would ask a hospice person that question. They say they become aware right before the moment of death for a short while but ask someone who really know a lot about seeing people die. There are patterns apparently from what I was told.
My mother with cancer was on the morphine for about six weeks. We took her home at the end, and she was alert enough to enjoy it. Once home, she lived for another week. She, too, died when nobody was near her. I came back in the room, settled down, and just realized that I couldn''t hear her breathe anymore. It was peaceful.%0D\
With that said, having done hospice care for three relatives (in home, in hosptial, in nursing home) I will never do that again unless my relative is vegetative. I''ve never%0D\
had a good experience. The first time there was insufficient help and information (in home). The second time, watching a relative die from lack of feeding, was just too awful to watch again. The third time, in the nursing home, the doc fucked up her medication and cost her valuable time (we were on the point of pulling her out of hospice because she had been doing so well and wasn''t going to die soon. Medication error took care of that.)
I was on morphine for a few days following a round of seizures that are now ancient history for me. It did ease the pain, but mostly I simply didn't care about anything. Yes, it made me stoned, but I really didn't care much about that either. As it wore off, the pain was tremendous, so I REALLY wanted more. Luckily, I only needed it for about four days. %0D
When my partner was dying of AIDS I was giving him double and triple doses for the last few days. One of those days he was awake and alert, he even ate for the first time in months. When my mom was in the ICU dying of cancer, I knew how to pump up the morphine in her IV and the nurse just pretended there was something wrong with the IV, even though I had told him about my previous experience with my partner. The nurse knew what I did, but said nothing about it. My mom had some good moments(holding hands, smiling) right there at the end, too. In both situations I did what I felt was right and now live with no regrets or guilt. I just hope someone will do the same for me when my time comes.
I was on morphine for a couple of weeks following an emergency abdominal surgery. It kept me from going crazy, but did not take away all of the pain. Once, before some test or another, they gave me a bolus of morphine which put me over the allowable dose, but made the test bearable. It was the first time in days I wasn''t in pain and it was a miracle. That being said, once I didn''t need that and started with less serious medications, I didn''t miss it.\
Good luck to all of you with loved ones going through this.
R68, lack of feeding? What the hell was going on?
If you are really taking pain meds for pain...even if you take them for months...when the pain stops, you can stop the pain meds. I had no problem at all and I had taken them for a year. The pain stopped and there was no need for the medication. So, I''d just like to call Rush Limbaugh and the rest of the bullshitters on their bullshit.
The patient really wants to be alone so they can go on without feeling guilt, for leaving you. Believe me, your suffering loved one wants to leave their body but you whiners are there getting in their way.
I agree with letting them have whatever food and water they can tolerate. To feel like you are denying someone a drink of water...don''t do that.
I agree with R73 mostly.%0D\
The second after death (or second of death), the loved one has no knowledge and no recollection that anyone was at the bedside.%0D\
The loved one falls into eternal nothingness for eternity (or whatever you believe) and it is just as if you were never at the bedside at all.%0D\
So it is all an illusion that it is somehow meaningful. For those relativea who want to be present at the moment of death and it is meaningful to them, fine. But some relatives can talk to the dying a week before death or a few days while the dying person is still talkative and lucid and say what one would like to say.%0D\
I do not understand not giving water or liquids to a dying person. And the dying person not eating at all - not even an Ensure shake - is hard to understand too. But I can understand the not eating much more than the not giving the dying person water - I do not understand that.
R71, apparently many dying patients refuse to eat the last week of their life. (or at least for several days)%0D\
The not eating is an indication that they want to die, and they refuse food.%0D\
My father and my grandfather both refused food so that they would die. Neither wanted to live any longer.%0D\
My mother did not eat at the end either. She had cancer and either could not get the food down her throat or didn''t eat to speed up the dying process.%0D\
Apparently in nursing homes, this is quite commom. My father and grandfather were both in nursing homes when this happened. My mother was at home in her apt under hospice care.%0D\
I would be interested in others comments on this.%0D\
[quote]I can understand the not eating much more than the not giving the dying person water - I do not understand that.%0D\
Dying people lose the ability to swallow. The water just comes pouring back out. It''s a sign that the end is near when that happens. Hospitals have little spongy swabs they call lollipops that you can dip in water and use to moisturize a person''s lips and mouth.
R76 here. I meant to mention that my father in a nursing home decided that he did not want to live any longer and absolutely refused to eat food.%0D\
The not eating was not because he couldn''t get food down his throat - he could have - the eating was because he wanted to die and was adamant about it.%0D\
His wife (my mother) of 62 years had died two or three months earlier, and he did not want to live without her - he would rather be dead than live without her.%0D\
So the nursing home just followed his wishes and let him basically starve to death. (although I don''t think nursing homes or the medical profession consider it starving to death)%0D\
I guess it is quite common.%0D\
I would like to hear comments from the medical profession, nursing home workers, or hospice workers on this.
One of the side effects of opiates is appetite suppression, so that is a factor also.
I had a morphine drip following major surgeryand it made me very high and sleepy. In my foggy stupor I mentioned something to a friend who was visiting. This friend asked my nurse if it was normal to feel as though I was itching on the inside while on morphine. That drip was gone within two minutes. Severe allergy! Vicodin shots just weren''t the same. Hopefully I never get cancer since I can''t have morphine.
R68 here. I just wanted to clarify the not eating thing.%0D
My great uncle in his eighties had a stroke at some point. They told us later that it was in a part of the brain where it couldn't be easily detected so nobody knew about the stroke, not even the family physician who had checked him out. He just gradually got weaker and weaker and less responsive. He was given the last rites at home and then taken to the ER.%0D
In the hospital, they found that he couldn't swallow. The family was able to coax a little water down his throat, but the hospital staff couldn't get anything to go down. For the first time the docs started talking that maybe he had Parkinsons on top of the stroke, but that was the first time Parkinsons was brought up.%0D
He was put into the hospital's hospice program. The docs said he wouldn't recover, but there was an option to put in a feeding tube. We had unfortunate experience with feeding tubes before with another relative, so the family said no tube. They did give him fluids through a tube and plenty of pain medication. To be fair, the staff were friendly and helpful, although a little overenthusiastic about encouraging him to walk into the light.%0D
He couldn't communicate although at times he opened his eyes. I always had the feeling that there were times that he knew what was going on and hated it. He was a devout catholic who would have wanted every measure taken... but he never made a living will. I thought I saw him mouth the word for water, but it might have been my guilty imagination.%0D
He lingered for about a week and visiting him was just horrible. Maybe it was the best thing to not put him on the feeding tube and let him die, but I could never do it again. The feeding tubes are going in unless there is a living will saying otherwise.%0D
NOBODY''S GONNA GIVE BIG DADDY A HYPO!!!!
R66, your Mom was aware you were there. The hearing is the last thing to go. I've often had supposedly non-responsive patients squeeze my hand or react in various ways to questions etc.
R68, hospital and hospice workers see plenty of terminally ill people suffer because someone in the family wants them to hang on a bit longer, hence their aversion to "heroic" measures like feeding tubes. It's pretty cruel to do that to a loved one. To be eligible for hospice, your diagnosis has to be terminal (usually 6 months or less), you have to have a DNR order, and the patient has the right to refuse food, meds, etc if they so choose. I've seen patients refuse pain meds until the very end, and that's incredibly hard to watch.
That said, we "graduate" quite a few patients every year. They respond well to the one-on-one care, beautiful surroundings, kind staff, and good food. At that point, their diagnosis is either no longer terminal, or they have much longer to live.
R78, a nursing home or hospital can't force-feed patients. Patients have rights, and that's illegal. It's also illegal to withhold food and water from a patient who wants it. The last week or so of life, very few people want it though. Their bodies are shutting down. Food is no longer a priority at that point, and swallowing can be very difficult.
R46, Hospice Worker
[italic]Everything was OK until they called 911.
Last summer, Collena Ridler and her sister sat peacefully with their terminally ill mother as she passed away in her Winnipeg (Manitoba, Canada) home.
Within an hour of her passing, Ridler's sister called the St. Boniface General Hospital, where the woman had been staying as a palliative cancer patient. The family had her out on a pass, and although a gentle passing at home was what everyone wanted, they didn't know who to tell or what to do next.
The desk clerk at the hospital advised her to call 911.
When the paramedics arrived, they were forced to attempt resuscitation on the woman, as per their policy.
"I was horrified," Ridler said. "The paramedics were sickened by it. They were apologizing to us."
What Ridler didn't know is that such a scene could have been avoided had her mother's doctor or other hospital staff informed her family about proper process - calling 911 isn't necessary, for example - and documents that would have permitted paramedics to avoid a revival attempt.
The College of Physicians and Surgeons of Manitoba has a guideline in place governing such situations.
In fact, college registrar Bill Pope said the guideline was created after a similar situation occurred in the late 1990s.
The guideline advises doctors how to handle anticipated death at home, including the process for providing patients and their families with documents that give paramedics orders to not resuscitate a patient.
Ridler said when she discovered the proper process, her sister asked their mother's doctor what happened.
"He said 'It's been a learning experience for all of us. I've never had a patient pass away at home before.' "
Pope said he's surprised and "a little disappointed" no one mentioned the process or documents to the family, but said the doctor cannot be disciplined because the guideline is only recommended practice as it involves some responsibilities that fall to the hospital and are out of the doctor's hands.
Ridler is now working with Pope, hospital authorities and the St. Boniface General Hospital ethics committee in an attempt to improve the policy or at least ensure staff are reminded of the protocol.
"I just don't want it to get missed for another family," she said.[/italic]
My grandfather passed away this morning. He was on morphine the last six days of his life. His funeral is on Saturday.
I''m sorry for your loss, OP
I am very sorry, OP.
Thank you, R86. He was 95 and ready to go. He was my last living grandparent.
[quote]One of the side effects of opiates is appetite suppression, so that is a factor also.\
Chemo and other cancer treatments also change the taste of food - either it has no taste or it is unpalatable
I am sorry OP. RIP OP''s grandpa.
Thank you, Josh. %0D\
Grandpa has Aspergers and was a germaphobe. He was a big believer in vitamins. He didn''t like physical contact at all, and he couldn''t carry a conversation. He spoke in monologues. He graduated from law school at 16 and was a certified genius, but he had no social skills whatsoever. %0D\
It sounds so trite to say this, but 9/11 really made me reevaluate things, and I decided to build as close as a relationship to my grandfather as I possibly could. So I visited him every 3 or 4 months and wrote him letters every week. I mailed one off yesterday before I found out he died. I am so glad that I spent as much time with him and stayed in contact as much as I could. He wasn''t a perfect man and certainly not easy to love, but I''m not perfect either, and I did love him. I always will. Sorry for blogging. I have put on a brave face all day, and I''m tired.
OP, kudos to you for taking the time and effort to keep up with you grandfather. He sounds like he was a complicated and interesting man. I''m sorry for your loss.\
Working for hospice has been tremendously helpful in my own life, and helps keep things in perspective. You really get the chance to see families take what is a sad and negative time, and make the choice to heal and grow stronger. Conversely, we certainly see our share of estrangements and familial resentment. The thing that''s kind of stunning to me is when family members refuse to put aside their gripes and grievances during the death process. I even witnessed a fistfight in a patient''s room once.\
Everybody has at least one of those stereotypical histrionic and egotistical relatives... the ones that always make every single effin'' thing about THEM. That''s the single most toxic element I run into in dealing with the psycho-social aspect of families. Thank god for our social workers.
OP..Sorry for your loss.....and I have to add my praise to the Hospice of the Valley in the Phoenix area. My father died three years ago and went in/out of hospice over a two week period. I spent the night on a cot next to his bed the last three nights he was alive. I was able to bring our family dog to the hospice and all of the staff there were wonderful people. My family also had all memorial funds be directed to the hospice. My dad was on morphine and went in/out of consciousness until his last 12 hours..but I don''t think I would have been able to experience his passing in the sad/emotional but positive way I did without the hospice staff around our family.
I''m sorry for your loss, OP.
Speeding up a person''s death with morphine is basically euthanasia.\
My question is: do we have the right to play God with someone''s life?\
About 6 years ago my mother was becoming progressing worse from the symptoms of Parkinson''s disease and my family decided that rather than see her body beginning to shut down (losing a muscle control), it was decided to start a morphine drip, she died in about 5 days.\
I was a against but my father and the rest of the family believed it was the best thing to do.
[quote]Speeding up a person''s death with morphine is basically euthanasia. My question is: do we have the right to play God with someone''s life?%0D\
Yes, we do. When someone has terminal cancer, God has already thrown the dice. I''ve watched my mother, father, and aunt die from cancer. These deaths ranged from agonizing to awful, even with morphine. I can''t imagine how horrible their agony would have been without drugs.%0D\
The flip slide to your question: Is it moral to deny someone relative freedom from pain in order to satisfy your own little philosophical qualms?%0D\
(The answer is no, by the way.)%0D
My thoughts are with you, OP.
Sorry for your loss, OP
r96, you have no right to toy with God''s plans.
R-96, who''s to say that having a friend or relative up the morphine dose isn''t "God''s plan"?%0D\
Keeping someone in pain for no good reason, when it could be relieved somehow, is torture.%0D\
I think it should be illegal for people to die prolonged painful deaths. Why make the last chapter of someone''s life horrible?
I''m against all forms of murder, r101 - whether euthanasia, death penalty, abortion, what have you. I understand your point and while I would find your choice to kill your loved one against what I stand for I would not prevent you from doing it. Killing is just not for me.
R102-- additional morphine is given to lessen pain, NOT to kill the patient. The reality is that the very end of life can be excruciatingly painful. Another reality of life is that as the body grows weaker, but the pain grows stronger, giving that additional much-needed morphine means that death happens to arrive faster than it would if you just let them lie there in bed screaming. Hospices do NOT euthanize patients.
Thanks for sharing this OP. We''re dealing with this right now with my 92yo grandmother. Saw her today and she was comfortable and alert but very, very tired.
Actually, additional morphine is, at times, given to hasten death. No one has exact figures. But, if you talk with medical professionals, they''ll cop to it. Morphine suppresses respiration. Calvary Hospital in the Bronx is well-known as ''morphine central'' and staff there discourages autopsies for that reason.
[quote]I''m against all forms of murder, [R101] - whether euthanasia, death penalty, abortion, what have you. I understand your point and while I would find your choice to kill your loved one against what I stand for I would not prevent you from doing it. Killing is just not for me.%0D\
Come back with your juvenile conceits when you''ve watched someone you adore writhing in hideous pain on their death bed.%0D\
It''s not juvenile to honor and respect life, r106. Sad that that needs to be explained to you.
For the sake of argument, R107, would you ever have a pet put to sleep if it were in horrible pain and there was no hope of recovery? Or does that come under the heading of disrespecting life?
Absolutey not, r108. I have been in that situation and - while utterly painful to watch - I did not kill her. She died a natural death.
Thanks for your reply R109. I respect your honesty, but am extremely grateful I''m not one of your pets or family members.\
My best friend and I have a vow that we''ll treat each other as humanely as possible should the need arise. That may mean making an extremely painful decision, but that''s the price of living beings showing responsibility and loyalty to each other. He means that much to me, as do my mother and brother.\
Every pet I''ve had put to sleep was like a knife in my heart, even though I know I did the right thing to alleviate their suffering.
[quote]It''s not juvenile to honor and respect life, [R106]. Sad that that needs to be explained to you.%0D\
You sound like a princess.
Just read this thread tonight. Sorry for your loss OP. Take care of yourself.
I''m very sorry for your loss, OP.\
This has been an interesting, enlightening and thoughtful thread, btw. Thanks for starting it.
Last year an older (60s) co-worker of mine put her husband in hospice care. He''d been sick for at least a year (not sure what exactly) and had been taken care of by his family up until that point. Anyway, there was lack of communication between the doctor and the family and the man died within 24 hours of being admitted to the hospice. He''d been taken off oxygen, etc. and his family watched him die, not realizing it was happening. Terrible.
Remember: eu = good; thanatos = the Greek god of a peaceful death. So euthanasia is a good, peaceful death.
my mother went home to die and had hospice come to the house they basically starved her to death and she was alert they didnt give her an iv fluid this was horrible to watch her starve to death i think this is so inhumane there should be a law against it i would not recommend this for anyone and i hope the ones that done this go through this themselves.
So, 116, did the cat have your tongue at the time?
[quote]It''s not juvenile to honor and respect life, [R106]. Sad that that needs to be explained to you.\
You are not honoring and respecting someone''s life by allowing him or her to die a slow, horrible, agonizing death. \
Sitting there doing nothing while a pet that could be humanely euthanized instead dies a miserable, painful death is pretty much the opposite of respecting life.
R116-- in what way did hospice starve your mother to death? Was she hungry, and asked for food, but was denied? Did they prevent you from giving your mother food?\
What was the IV for-- dehydration? If so, then you were taking measures to prolong her life. Sounds like your mother knew what she was doing and was ready to die.
Two years ago my mother was diagnosed with stage IV metastatic lung cancer, and the doctors said she had four months or so to live. We moved her into my house and had hospice care come in. Within 48 hours of admitting her to "hospice care" (hospice is more a concept than a place), packages of morphine began to arrive by FedEx from a pharmacy in Pennsylvania. Within three days I had enough sublingual morphine to kill a hippopotamus. We gave her morphine as prescribed, which seemed to be a tiny dose on an as-needed basis, but the nurses who came every other day to check in on her/us said that we should always feel free to double or even triple the dose if needed (i.e., if she was coughing uncontrollably, which never happened). The unspoken message was that we should feel free to give her enough morphine to end her life whenever we all were ready for that--and that there would be no questions asked. During the four months that my mother continued to live (quite pain-free, I believe, thanks largely to the morphine which we did dose quite liberally), we (honest to God) received at LEAST one bottle of morphine every three or four days via FedEx. An hour or so after my mother died, the hospice RN came by to take away all the drugs (and there were plenty), but I had tucked one of the bottles of morphine in the fridge for safe keeping. It's still there, two years later, right next to the tartar sauce in the door of the fridge. I'm wondering what to do with it.
my mother didnt make the decision not to have a drip for fluids hospice did and i was 850 miles away so dont speak unless you know what your talking about i hope you get the chance to go through this
My father''s second wife is kind of a pain in the ass, but I always thought she was fairly harmless.\
When her father was dying of cancer, however, she tried to forbid the other family members from giving him strong pain medication because he wouldn''t be lucid to "spend time" with her.\
I thought that was pretty fucking sinister.
When hospice put my father on it we had about two days. Make sure he or she has a catheter and make them as comfortable as possible, talk to them when they are awake, address any concerns they may express, reassure them everything is fine and everyone will be taken care of. Make sure they have every reason to let go and be at peace. You may have to read between the lines if they ask for anything - don''t take all requests literally. And if they talk about seeing dead relatives - go with it - it''s part of the process. My heart goes out to you right now.\
The best thing about hospice care is that you control the dosage and you can make sure they are comfortable until the end, esp for late stage cancer and lung cancer to boot.\
All my best to you - I''ve been there - big hugs.
I'm curious when my Mother was on morphine could she hear those around her? I know the morphine was nothing other than comfort measures and suppress breathing function and is essentially inducing her into a pain-free coma. I would even preferable this over excruciating, lingering pain. I would like to think she could hear us talking to her and that she was amazing and should have know that through out her entire life. what were her last thoughts,dreams just anything?
Don't be fooled. Most ppl don't last in hospice. We were never told that they would be putting my mother into a medicine(morphine) induced coma. That started at eight pm by six am she was no longer my mom. She lasted four days with the last two in terrible pain, fever, and suffering. Hospice did exactly what my mother was afraid of they were no help for us. She had more pain after hospice than before she ended up there. It was all lies from the very beginning meeting w hospice consultant who said, she can eat and drink what ever she wanted until the end and enjoy what time she had left. BS shame on them
I had exactly the opposite experience as r125.
I was primary hospice caregiver to my mother, who wished to remain at home, and did, throughout the extent of her hospice care. After an at-home explanatory session with a hospice nurse, I had total control over the morphine she was given. I could accept or deny hospice nurse visits, and when my family wished to be alone with my mother, I DID deny them, and my wishes were always respected.
My mother had a pain-free death at home, surrounded by her family, and I will always be grateful to our hospice association for making that possible. I wouldn't hesitate to repeat the experience for any family member who desired and needed it.
The last sense to go before death is hearing.
Sorry for your loss, OP.
I sat by my Mother's bed for two weeks, just going home to sleep. One day, I was so exhausted and my Aunt said, go home and eat something. Take a nap and come back. So I went home. Well, I just got home (about 30 minutes later) and I got the call. I do believe she waited till I was gone.
I think she knew I was there even though she was very medicated.
I'm sorry for you. My mother had a morphine patch on for 2 weeks. But what I remember hospice saying, that has always stayed with me, is a person can last a long time without eating - but cannot last long at all without drinking any liquids. Once my mother stopped drinking water, she was gone in 3 days.
Can I have what they don't use after they kick?
There is great variation in the quality of hospice care, as is true of other services. There are many nightmare stories. But, overall, hospice is a godsend for patients and families.
My Mom stopped breathing twice (at home and at the hospital) and both times it was when I left the room for a minute. But the second time she was brain dead in the hospital, had been breathing once every five seconds, her heart chugging along because they can't stop a pacemaker, and I was there by her side but I had not been talking to her. I had been there every minute since they stopped the life support and the breathing (which she'd had for more than ten years). But after several hours I really had to go and they said it might take two days. So I went to the bathroom, was gone less than 2 minutes, and when I returned she had stopped breathing. I don't see how she could have known I was there and then not there.
One fifth of Americans will need food aid this year.
I agree with R1.
I worry about this all the time. Doctors are getting very paranoid about prescribing anything that could end up on the recreational market. As soon as I was diagnosed with Stage IV Melanoma, my long-time clinic dumped me (said it was because they were quitting Medicare - no way to find out.) Doc was up front that he was very jittery about continuing to prescribe a tranquilizer I have been taking. I'm almost out of pills now, splitting them, and it is pretty much a race to the finish. Crap.
I would write a book (or a short story perhaps,) about the journey to a miserable end in today's insane medical climate, but I would have to care a lot more than I do anymore. Cheers anyway!
Wow, what stories. My heart goes out to all those who have lost loved ones.
r135 I will be thinking kind thoughts for you. That may be the most I can do.
Kind toughts are very special. Thanks R137.
My Mother's friend was a nurse and told her it's more common than not a patient will go when the room is empty. People can spend hours at the bedside and the moment they leave to take a break, it will happen. Of course people feel guilty and terrible they weren't there but she has to assure them it happens so often that she believes the patients want it that way.
The "Liverpool Care Pathway" is the new-speak term given to a protocol to kill patients gently.
It has been adopted by hospitals throughout the UK, and I suspect a great many worldwide. Basically it's simply justifying the withholding food and drink to accelerate death -- the modern equivalent of the Romans leaving the sick on the mount.
Recently there was a horror story in the Daily Mail about a daughter's experience looking after her elderly mother in hospital: basically the hospital couldn't WAIT to ease her onto the protocol and if it hadn't been for the daughter's relentless protests and intervention the mother would have been.
I had a similar experience. A friend had a stroke and as soon as the brain scan had been done that was it: tubes out, no food or water: so long and goodbye! Yes the longterm prognosis was grim, but miracles do happen, however healing takes time...time that expensive hospital beds don't allow. So much easier to make 'The Decision' and make oneself feel better about it by making the patient 'comfortable' and 'clean and washed' -- while denying them not just additional oxygen which can be essential during the healing process, but food and water so they cark it faster.
I'd like to hear from nurses on this. And anyone else who thinks many patients are being shoved towards death with undue haste. My advice is: if you're an Eldergay and going into hospital: watch your wrinkled back bitches!
[quote]Under NHS guidance introduced across England to help doctors and medical staff deal with dying patients, they can then have fluid and drugs withdrawn and many are put on continuous sedation until they pass away. But this approach can also mask the signs that their condition is improving, the experts warn.
My Dad was on morphine patches for the last 3 days of his life. But he wasn't stupefied as the dose was so low. It kept him comfortable til he passed quite peacefully.
The care centre withdrew food and fluids about 4 days prior to death. He was incapable of swallowing then anyway, but it was still awful to watch him deteriorate. And yes we are in the UK.
Apparently dehydration is one of the biggest risks. The elderly especially get dehydrated easily, and then they can become confused, and then hospital staff can believe them deteriorating, and so they sedate them to knock them out, and so the pathway to death begins!
OP here. my grandfather passed on April 20, 2011 at home, so he was on morphine about 6 days before he passed. He was my last grandparent. His second wife moved away to Boston after he died. I miss her a lot. I thought about her a lot today. The house where he died is still up sale. nice neighborhood, crappy house, tough sell.
I was surprised to see this thread bumped up..
My husband seemed to be in real stress when we removed all extraneous machines. Then the doc authorized 4mg of Morphine and he sort of fell asleep peacefully and died within 24 hours. He had tears in his eyes when he died and I hope it was BECUASE he was grateful to be done with this earthly pain, was glad his family was there and BECUASE I begged his forgiveness the day before. I believ he truly loved me and was grateful I followed his wishes at the end of his life.
My mom went into hospice care right about when the thread got bumped up, she died peacefully three days later. I saved it to read when I thought I could handle it. I sometimes forget what good people are on here. Reading most of the posts made me feel better about my decision to go the hospice/morphine route with her care. I was lucky and she had good nurses but they were even greater to me. I had a hard time knowing she was going to die, even tho she was 83. I was lucky that Mom and I had been very close for a really long time and we had said all the things one wishes they could say before a person dies, so I had no regrets, but it was hard to loose her in a purely selfish way.
Condolences on losing your mother, R147. I'm glad that hospice was a help to you. For us, it's a real honor to be able to serve.
You mentioned that your mom was only in hospice care for 3 days. I hope that people understand that hospice is not being utilized well when it's done as a last minute thing, nor is it meant to be a morphine-dispensing service. (I'm not saying that you feel that way, R147)
Hospice is for people who have a doctor's diagnosis stating that they have 6 months or less. If you live longer than that- and you'd be surprised how many do!- you can get re-certified and remain in the hospice program. Sometimes we "graduate" people when they flourish under hospice care. So don't think you're giving up somehow when you call for assistance.
Hospices offer help with care-giving so that family members can enjoy some quality time with their loved one. Taking care of a dying person is exhausting and all-encompassing. Hospice docs and nurses are experts on how to manage pain, terminal agitation, etc. There's a lot that can be done to help patients and families long before the time comes to dispense Roxanol, Fentanyl, and Ativan. That's what we're here to do, as opposed to merely sedating during the final weeks of life.
R148, It was a heart attack that her doctors said there was no way she'd survive. The doctors said they could keep her alive with feeding tubes and ventilator, but in the end they'd just have to be removed and that was harder. I had to go that route with a frienda couple of years ago and it was hell, and I feel shitty about it still. My brother wanted to go that route, but I couldn't see putting her thru that. She was 84, and knew that she was pretty ill in the weeks before that. I think she'd been ready to go for awhile. Thankfully i had the medical power of attorney. She went right from the ER to the Hospice care area in the hospital. Knowing that she wasn't going to survive was rough, but knowing that she was in no pain made it easier. The hospice care workers were amazing. You don't get the praise you deserve.
My heart goes out to OP and everyone else suffering in this thread.
I learned last week my dear friend's good buddy is dying from liver cancer, then just this morning I learned my late partner's dad has stage four liver cancer, he's been given three to four months. It is a sad day for me.
I'm sorry R150. That's a whole lot of bad news to get in such a short period. Make sure you take care of yourself during this rough time, make sure you eat and get to the gym, or at least get a good long walk in every day, it will help to fend off the blues.
Thank you, r151. The hard part for me is the old memories of my partner dying. I recently re-watched "Long Time Companion," wow, that movie hit very close to home for me. I'm making it a point to take care of myself.
After several months in the hospital, they finally said it was time for hospice. I insisted on doing hospice at home. After spending three months running back and forth between the hospital, work, taking care of home, my pets, and everything else that needed to be done on a daily basis, I was exhausted. It was good to be home for both he and I.
Seeing my partner through death was an honor, I will always treasure that time, as difficult as it was. Peace.
I think hospice is the most terrible thing, my step father just passed away from hospice...I feel like hospice is just a nice word for murder!
R153, can you tell me what happened with your stepfather?
Calvary Hospital, the premiere hospice facility in New York City, now offers Hospice at Home along with their main facility in the Bronx and a unit at Brooklyn's Lutheran Medical Center.
[R147] Bless your heart, losing a mother is terrible. Mine died a year ago and it's still painful.
[R143] When my aunt (96, still meeting guys and a riot) was in hospice dying, there was a brochure there that talked about the last tears. Apparently it's not uncommon and is called lacrima mortis. Some view it as a final cleansing. Whatever the reason, I'm sure it's a good one.
[R150] You're in my prayers.
[R152] It is a privilege to be with someone when they die. I treasure my experiences as well - two friends from AIDS back in the '80s, and my mother.
Re stopping food and water, I've only seen that happen when the person can no longer swallow. At that point aspiration is a serious risk. That doesn't stop some family members from making the patient drink, often against their will, causing choking. A death following aspiration is definitely much harder-- both on the patient and on the loved ones. The patient has a very hard time breathing, and the chest fills up with fluid causing loud death rattles. Morphine actually helps with breathing, so is often prescribed when aspiration occurs.
Sadly, some families are in denial about their loved one's condition. Even though the patient is in hospice care, thus most likely terminally ill, some families think that the patient is supposed to get better rather than decline. Part of the dying process involves reaching a point where the patient no longer eats or drinks. That's just how it happens, and is not an attempt to starve patients. When a patient hasn't eaten in three days, I know that they've turned a corner and probably won't be coming back.
I'm amazed that this thread is still bumped once in awhile.
My grandfather is buried in Houston. I'm going to Galveston this weekend, and I'm putting a new floral arrangement on his headstone.
[R45] When my friend's dad was dying, it was a very long process and she and her mother were with him all the time. He was in a coma. One of the nurses finally told her and her mother that he wasn't going to die as long as they were there - she'd seen it too many times. Sure enough, they left and he died almost immediately.
[R135] Can't you find another Medicare doctor? You shouldn't have to suffer.
Thank you for your commentsd, my husband is dying now from cancer and heart trouble and his breathing is getting worse, Hospice is coming in theis week. From what I have read here today. It will be a God send. Thank you again/
[R163] All best to you, I'm sure it will be a Godsend.
My 83 year old father is currently dying in hospital...tonight he had the 'death rattle' but is still awake and open eyed a lot of the time....but completely unresponsive. He doesn't make eye contact and seems to be staring at the ceiling and high up on the walls at something we can't see. The Nurse is going to ask the Doctor for a morphine driver tomorrow. My poor Dad has gone so far downhill over the last 2 weeks...one side of his face is completely drooping now and he hasn't eaten for a few days but is on IV fluids for hydration. It's so hard to watch him - such a proud, stubborn and independent man - reduced to this. My heart is breaking so much. I just want this ordeal to end for him.
Well just an hour or so after I posted 165...he died. I got the phone call from the Hospital saying to come, I got there only to find he'd gone 2 minutes before....just 2 lousy minutes I missed him by. He was still warm as I hugged and kissed him and told him how sorry I was....I'm gutted. Don't think I'll ever get over this...
my mom was diagnosed with small cell cancer which is a very aggresiv cancer it has done spread to her whole body even her brain they tried chemo and they said the cancer has just got a lot worse they are sending her home with hospice today can someone tell me how long she will have and if it helps the dr said maybe days maybe weeks they wasnt sure
R166, when a person is dead they have no memory, so there is no reason for you to feel guilty.
The person who was in your life has no memory of being alive so the person doesn't know there was no final goodbye.
You'll be dead too one day without a memory of life - so really it doesn't matter about final goodbyes.
R167-- I'm really sorry about your mom. Without seeing her in person, it's impossible to tell how long she has, but there are some indicators. Is she still eating or drinking anything? Is she speaking and does she seem to care about anything?
The hospice nurses and CNAs will be able to give you an idea of how long she has. People who work in palliative care are much more helpful and informed about that than doctors. Even so, until the final 24-48 hrs, one never knows for certain. I've been surprised often enough.
Usually, when a person enters into hospice or "palliative care" as some call it, they have to agree that no extreme measures will be taken to keep them alive and that they will not be transferred to an acute care hospital under any circumstances—they are to be kept comfortable and as pain free as possible using medication. Depending on the program, the person usually has less than 6 mos. to live.
The administration of morphine is to control pain and help the person to be comfortable—because there is no worry about addiction, the dosage can be more generous and more frequent. It does depress respirations as it builds up in the system, and the unsaid agreement amongst staff and families is that towards the end, as the dosage becomes more frequent, the result will be that respirations slow and then stop altogether. It is a very peaceful and humane ending for both the patient and their family. Thank goodness that we have moved beyond the barbaric policies of patients needing to be kept in an acute hospital setting in order to receive this kind of help.
Here's a link for a 2008 New Yorker article on hospice. I hope it's helpful to those reading this thread.
One thing that I've always found interesting is that patients in hospice care often live longer than their counterparts who undergo painful intervention like feeding tubes and respirators. Their quality of life in hospice care is certainly much much better as the care is centered solely around the patient's comfort, not around what makes the family feel good.
Big hug TJP
Lost my mom a few weeks ago (yes she was given morphine in the end) and I missed her by about 15 minutes but another family member was there.
The best advice I've been given is to allow myself to feel it.
More hugs to TJP and to r174. I am sorry for both of your losses.
My partner's Mom is about to go into hospice. Her cancer has spread to her liver. She is 5'9", big boned and weighs 106 pounds.
My best thoughts are with you, TJP. I've been where you are. Please embrace the good memories you have, and don't be ashamed to grieve.
R148 is correct, if hospice is being used only for the last few days, it probably is being used too late.
My mother had breast cancer, well treated and often in remission or under control with chemo, for more than 12 years. But, at the age of 86, when the remaining chemo options would have been grim, she decidied to just stop treatment and see how it went. She died about 18 months later, after 8 months in hospice at home.
She was fortunate to have the resources to continue to live in her assisted living apartment, with daily hospice visits to bathe her and do a few things around the apartment. My brother and I, both of whom live a thousand miles away, managed to be there about ten days a month, sometimes longer. And we did eventually get someone to come in to make sure supper (which at that point had to be pureed food -- like lobster bisque! -- got prepared and made available.
But she had a wonderful last 18 months, and though the last week was not fun, she was comfortable and surrounded by loving family and friends. And the hospice nurse, aides, etc., were outstanding.
I'm convinced she had a longer and better life going the hospice route than she would have continuing to fight aggressively via chemo.
Anyway, if your loved one is probably going to die within the next six weeks, please consider strongly going the hospice route. It is an amazing service and people who work in it are angels.
My father passed away from complications of advanced prostate cancer last August. Upon his diagnosis, he was given a low dose of morphine (in a drip.) The morphine controlled his pain very well. Otherwise, my father was awake, alert and good spirits. While his health declined very slowly, the morphine did not expedite his death. My father spent about 3 months in a nursing home where his health was stable, but the nursing home environment was more than he could handle. He was able to come with hospice care. The hospice group was wonderful and with the exception of one evening, a nurse or care taker was with us 24/7. The hospice team gave us a little pamphlet called, "Gone from My Sight," by Barbabra Karnes, that explained the dying process. My mom and I read it (in about 15 minutes) and the information immediately put us at ease. We asked the nurses how long he had to live nad they said they never know. But when the MD came by, she said when my father stops eating and/or drinking, he would die in about 4 or 5 days.
His final days were quite peaceful. He ate, we could visit and talk. He was in a great spirits and just seemed to be at peace. The hospice nurses were dilligent in enesuring that he was not in any pain.
About a week before he passed, the whole family was home for a Sunday visit which he really enjoyed. A few minutes after my 2 brothers ended their visit, my father started a rapid decline. (In my mind, that's the day my father passed away.)
The next 2 days my father started eating and communicating less and sleeping more. He died 3 days later while my mom and I were sleeping. He died peacefully at 5:30 in morning; the same time he would normally started his day before he becamme ill.
Hospice was a Godsend. The nurses were pleasant, upbeat and supportive. They took care of everything when it came to his care.
[quote]how long until they die, on average? I am going through this with a loved one right now.
Can't wait to get your hands on his stuff eh?
My partner's Mom is dying. They moved her back home from the hospital today. I really hope she makes it past Mother's Day.
Really sorry to hear this R180, and my thoughts are with you and your partner. Is she already in the actively dying stage?
I hope you have hospice resources at your disposal-- they will be able to make her fully comfortable. Home will be a more peaceful place for her. Hang in there.
[quote]Re stopping food and water, I've only seen that happen when the person can no longer swallow.
"Nill by mouth" is standard procedure in British hospitals under the "Liverpool Care Pathway", which is the 1984 newspeak term for starving patients deemed terminal to death. They're doped to put them sleep while it happens - within 10 days or less depending on their hydration levels - because there is no drip either. They don't get one drop of water or crumb during that dying period. If they're VERY lucky they may get their mouth swabbed once or twice. Of course this is all wrapped up with a pink bow in softly softly newspeak terms, but it's the equivalent of leaving them on the mountain. Other countries have taken the Liverpool Care Pathway (so named because it was developed at Liverpool Hospital) and renamed it to something equally innocuous sounding. Beware.
This is the funniest thread in a long while.
R182-- I haven't experienced anything like the Liverpool Care Pathway used here in the US. It sounds brutal, especially because they aren't even offering basic mouth care. Here, even patients who are completely incapable of swallowing liquids are given frequent mouth care.
More about it. Even if patients get better, they're so sedated it's impossible to know. So they continue to death. Other countries call them end of life care pathways and integrated care pathways. But they're basically the same. They provide a tick box so care can be to moved on to other patients. At bedrock it's all about scarcer hospital resources and economics.
To Reply 100:
And YOU have no right to tell others what "God's plans" are. How dare you?
My brother is dying of end stage liver failure and thank goodness for hospice and morphine to make the loved one comfortable.
I'd like you to spew your "God's plans" to my face. Pompous ass.
OP my personal experience with this is that it can take as long as 7 -10 days, but no longer. Usually, 3-5. A lot will depend on whether someone's organs begin to fail. You will observe the system starting to shut down.
This means no more ability to swallow, so no food or water, the kidneys stop functioning and there's very little output of fluid. The body temperature will begin to lower.
When my dad was in hospice, the nurse would come in to take his temp in his upper thigh, and check his pulse, which becomes rapid and irregular, as does the breathing. Dad's was shallow, like he was out of breath. and she was able to call it within the hour it happened.
Wow--hospices must be really haunted places!
We just went through this with my sister's wife. My sister signing that order was one of the bravest, most loving acts I've ever witnessed.
Lori, my sister in law, was in actual hospice for about 24 hours before she passed. She was on hospice care for the last 48 hours, though (we had to wait for a hospice room but the hospice people came over to the hospital and made arrangements for the hospital to let us use the room the way a hospice room is used.)
She was on morphine 1x an hour as needed, with a minimum of 1x every 4 hours. The same with ativan.
The hospice people were really great. They explained that the plan was to neither hasten nor postpone death. They attended to every need Lori or one of us had. They even gave us permission to bring her pets in, though she passed before that could be arranged. My sister was allowed to sleep there with her all night and was holding her hand when death came.
I don't know how hospice people are able to handle being around all that sadness and pain every day. They are just amazing and I could never, ever thank them enough.
R189, I'm sorry about your sister-in-law.
Thanks for your kind words about hospice workers. We actually consider it a real privilege to do this work. It's an honor to be able to help people-- patients and their loved ones-- at this difficult time in their lives.
Usually when a patient is on hospice it is because they are close to death, having less than 6 months. I actually think that is like a rule with hospice. Hospice is great and they make sure the patient is comfortable and does not suffer. Most of the time the patient gets enough pain medication that it eases them up enough to let go and like another post said, it slows down their breathing. In my opinion, when a family member with holds pain medication because they think it will speed up the dying process, it is just cruel.
More likely it is when the family leaves the patient alone, Hospice is free to increase the morphine and hasten the death.
R192-- you couldn't be more wrong. More like when the family member finally leaves the bedside for a minute to go to the bathroom, the patient dies. There so much evidence to show how common it is for patients to wait until they're alone to die.
This paranoia that Hospice workers are running around murdering patients the second their family members turn their backs is ludicrous. The purpose of Hospice is neither to extend nor shorten life. It's simply to offer comfort and care to those who are dying.
Thinking of you. May you find strength and comfort in friends and loved ones. These times are never easy.
RIP OP GF
more death stories plz
I found this thread by searching google.
I think my father is nearing the end of his life but I'm not sure and no one (at the hospital) will say much. He has 7 daughters and a wife but I think I am the only one grieving.
He has been in a vegetative state for 6 days; moved from palliative care to ICU.
The have decided to put him on a morphine drip. He has been battling cancer (NHL) for 7 years, went into remission to be diagnosed with AML. (Leukemia) He underwent 2 life time supplies of chemo. Since the last treatment 10/01/12, he fell ill and hasn't been able to recover. This happened 6 months ago and they discovered pneumonia but he doesn't have that now. His BP has been low for 6 days, low respirations, low heart rate, etc...and now, when the DR looks into his eyes (he doesn't open them on his own) they were pointed in different directions...possibly a subarachnoid hemorrhage?
It's breaking my heart to see my father like this. I know the drip is to make him comfortable, but how long can this go on?
I think there is something to the idea that people die alone. I was with my father in the last hours of his life. The nurse said his body was shutting down and they'd start morphine the next morning. He was obviously failing and fading but not in any discomfort. So I was sure he'd make the night and we'd be there the next day. I left at 9:30 and he was dead by 11:30. It wouldn't have made much difference though, he was so out of it between dying and dementia. I often wondered what he could hear, if it mattered. Anyway, there's nothing to be done but do your best.
My mom died of breast cancer, it was the same night for her.
This thread has come at a time when I really need it, and could do with pouring this out to people have been there, none of my friends understand. Dad has stage 4 colon cancer, a rectum tumour, which has advanced rapidly since diagnosis in April. Tuesday last, he was given 4/5 weeks to live. Since then he has deteriorated beyond belief, he has lost the will to fight, and the cancer has taken hold of the body and the mind :-((((
He is currently in hospital now, after being admitted last night because of constant vomiting and nausea. He had to wait 7 hours in A&E before he was given a bed at WRH, Waterford, Ireland. Shameful as he was so ill we didn't know if he survive the 6 minute ambulance journey, they left him in a room for 7 hours while there was a bed ready in the cancer ward for him.
My dad, in a matter of weeks, went from a handsome, mentally and physically strong, young at heart 59 year old man, to a frail, frightened bag of bones. It's been horrific to watch. His skin is grey and his bones are jutting out of his body and face, his eyes are standing out of his head and he looks like a 90 year old man!
The fluid from the tumour has accumulated to a point where it has suffocated his organs, he can't keep food down, no interest in food or fluids, although he chugged down a few glasses of water earlier. The nausea has been terrible, he described it as like a constant tummy bug,he could not keep a meal down, hence the weakness, and now the weakness has made his leg muscles give in, he cannot go to the toilet, he has to do it into a bottle in bed, with help. The fluid is causing all this damage, and they gave him a drainage bag last week to ease the nausea... Even though the fluid was spotted THREE months ago!!
Anyway, the only thing we could be thankful for as a family, was Dad has ZERO pain. He was agitated last night, but he hadn't taken his Xanax yesterday, but the nausea was stopped due to anti-nausea injections. But he has no pains, and has been pain free throughout this ordeal.
Now, what I find interesting is they hooked him up to the Morphine box today! Despite the fact he has no pain at all, they also have a drain through his nose into his stomach to drain the vomit in his stomach as the retching was mental torture. So today he felt OK and wanted some jelly and ice-cream. They said NO. I think all the posts I read here about the morphine being administered to ease the passing and not prolonging the persons suffering are very accurate. And although I do not want my dad to die (the thoughts of having to tell the children in the family days before Christmas kills us) I feel some gratitude to the oncologists for making the call to give him the morphine. As he has no pain at all and Xanax has been relaxing him pretty well I can only assume that the morphine has been given to help him go sooner and peacefully.
Experiencing this whole ordeal has put things in perspective that's for sure. It helps a little hearing peoples stories, knowing that Dad is not the only person that has had to face a drawn out death, and knowing that I am not the only person to has had to look on helpless. It helps, but doesn't make it any easier.
I do not want to be at his bedside while he passes, somehow I think he would want to die alone or just with my mother at his side... I know I would want to go alone, and I am the shadow of my father. And I do not want to sit around his bed waiting for the end or in that horrible little room they give families use of when someone is dying! My father would HATE that! I went to every chemo appointment with him, sat with him every day for hours chatting and laughing and teasing one another and constantly having our usual battle of wits. I want to remember him that way and I know in my heart that's what he would want. I have that element of guilt that its wrong to not be at his bedside at the end, like I am being a coward.
Who knows where he will go, tonight, tomorrow, next week. But I hope when he does he just closes his eyes to go asleep, and goes in the middle of a beautiful dream or happy memory
My beloved father died three days into hospice care. He was at home and it was when the nurse went out of the room for a minute and my mother went to sleep because she had been up for several days tending to Dad. It was like he waited for them both to die.
My uncle is currently in hospice care and on a morphine drip. He's in a facility. I will not be surprised that when he passes, it'll be when my aunt and cousins are out of the room.
R199, sorry to hear about your father. I'm glad that the meds are working to completely ease his pain. I'm curious though about their refusal to give him a bite to eat. Did they give you a reason for that decision?
Here in the US, we let the patients eat and drink whenever they want. Ice cream is a big favorite. If the patient is a serious aspiration risk, we do warn the families that there's a possibility of aspiration pneumonia. I've seen that fairly often, and would not prefer to die that way myself. Rule of thumb is that if it's really difficult to eat or drink, aspiration is likely.
The agitation you described yesterday may mean that your father is getting closer. Make your decision about being with him near the end, but don't do anything you may regret later. Just be sure to take care of some necessary business first. The dying are often comforted by having people sit with them quietly, or hold their hand softly. It's good to tell them that you love them and will miss them, but understand that they may need to leave you. You can say "If you feel like you need to go, it's okay." If you haven't done so, please let your father know what he meant to you and tell him that you and your mother are going to be okay. Even when they are in a "coma" they can often still hear.
R200, best wishes to you.
Sitting vigil with my Mom now. Diagnosed with stage 3 breast cancer 6 years ago. Radical mastectomy, chemo, and radiation in 2006. Symptom free for almost 5 years. Started accumulating malignant fluid in pleural cavity a year ago. Another round of chemo this year and was currently on Faslodex when fluid started collecting around her heart on December 4th. Procedure to drain fluid done last Wednesday morning with no complications. Then she stroked about 12 hours post surgery. Rare bilateral thalamic damage. She's been sleeping ever since. Only a few waking moments with little recognition and limited response. Took off fluids and brought her home with hospice support on Monday per living will and previous discussions. No waking moments since Tuesday. On morphine, haloperidol, atropine - all sub-lingual. Nurse thought death was close for past 2 nights. She's still holding on. My BD is tomorrow, then Xmas on Tuesday. Horrible juxtaposition of emotions. Nightmares about her being conscious but unable to respond.
My mother was 94 and had pneumonia. She was in the hospital for about a week. The last time I saw her, on a Sunday night, 10/22/96. I went to visit her because I had a feeling she needed me. I had been there the Friday before and my sisters were there on Saturday. We were taking turns. On Sunday, I called her room but there was no answer so I became concerned and went to the hospital.
When I got to the hospital she was asleep and hooked up to an iv. The nurse said that I shouldn't give her a drink of tea I had made for her because "it made me feel better than it did her". When I put the spoon in her mouth with a drop or two of tea her tongue was black and as hard as a bird's beak. I was shocked. She did not get any of the tea, it dripped right out. Soon after, having nurses training many years ago, I realized that her feet were cold and her breaths were further apart. I counted the seconds in between. The seconds got longer and longer. I used the call button but no one came. I didn't want to leave her so I held her in my arms until finally she passed away. I was frozen to the floor, unable to move for I'm not sure how long. Finally, I went out and got a nurse and told her what had happened. She checked her and said she would get the Dr., who came in about a 1/2 hr. later and pronounced her. Many other things happened in that room that night. The TV went off, the phone wouldn't work and, at the time of her passing, I felt cold water sprinkles all over my body. To this day, I still get the sprinkles of cold water sensation that tell me Mom is still around. I've had other esp since I was a child so it doesn't scare me. I know that mom is ok and still around and watching out for me.
I wk at a nursing home, and I'm totally AGANIST ROXANOL(MORPHINE). People don't or aren't educated enough about Roxanol it kills folks and the staff at the nursing hms don't tell family members that . They say it relaxes your family member there is no pain anymore. Well SCEW that!!!! It slows down your breathing and basically stops it all together!!!!!!! It's an easy way of getting rid of someone fairly quickly but legally. That's plain selfish to me.... how do you know if their in pain ? Because they move around in their sleep, or they make a face? Come on!!! Don't we all move around in our sleep? Don't we all meek faces in our sleep????? When The Lord calls then he will take us, we are not GOD so stop acting like it!!!!!! Put yourself in that situation would you want someone to end your life and say oh they were uncomforable so We made it more comfortable? How the hell do you know what that person is feeling?????? Othef than throne out, and a burden. The medical personnel and family members should really think and be truthful about what they communicate to nor another because going this route is AGANIST the Ten Commandments. Thou Shall Not KILL !!!!!!!!!!!
How do u know he had pain ????? Or was it just a speedy way to get rid of the burden he put upon your family!!!!! Selfish ass !!!!!!!
My husband has a terminal blood cancer and pneumonia. He is in palliative care in a medical center. About two days ago, his breathing became much worse so morphine shots were given on demand. Until yesterday, he was minimally responsive and could speak a bit. He had a crisis last night and his breathing worsened. He then was put on a morphine drip and no longer responds to voice or touch. I read here that hearing is the last to go. We continue to speak to him and i wonder if there is anyway to know if he hears about our love and reassurances. I asked a nurse today and wondered aloud if hypothetically sensors applied to a brain could determine if voice is still heard. After that, even if the voice is heard, does the brain also understand what is being said.
When one is dead, one doesn't remember a thing.
So any assurances in the last days, hours, or moments before death are really pretty meaningless because it is as if they never happened seconds later upon death.
Once they start the morphine drip, I have never experienced it lasting more than two weeks and that's along time. On average 5-6 days, max. I have had to deal with this for 6 people in my family. All of the elderly.
Im going through this now with my 35 year old brother who had a drug OD..He has been on MO. Drip for 14 days now..He is hangging on for dear life with every breath..I dont believe he wants to die..I dont believe we gave it enough time..The hospital forced me and my family to choose comfort care..This is the worst exp. of my life..
My sister is in hospice right now dying of cancer that has spread like wild fire inspite of all the cemo and radiation. It hurts so much watching her go through the pain... screaming as the tumor causes pressure blinding her first then giving her headaches. It is hard I still wish for that miracle yet the thought of seeing her in such pain. Even with the morpine and all the other drugs they are giving her. Her dying is not easy nor peaceful (at least not yet anyways) For all the talk of seeing people and going on a trip.... she remains at time convinced that this is all a mistake and that she just has to wait for a better ending of this nightmare... I am heartbroken
My father was at home with hospice,he had not been prescribed on Morphin.But this person gave it to him anyway.He passed away within two days,He was coherantbefore that,suffering from demenciay.Will this still be in his body?He passed away July 11,2012.
To #205 My brother just got out of prison after 30 years and just took over after we were so tiredand vunerable.Dad was very healthy his doctor told me,that he could not make any real decisions Because of his demincia.Two days before his death my brother was giving him Morphin.It was not prescribed.My father was 96 years old,he pased away in July.
My sister Karen passed away last night I wish I could say peaceful. She fought death for every breath it was heart wrenching when the doctor perscribed her more meds ( he thought that perhaps she was hanging on to the pain to stay here) she finally slipped away 2 hours later but you could tell there was no more pain. It was the saddest thing I have ever had to watch. As much as I love her I would not have her suffer like that longer. We treat animals with more kindness. This was cruel. The staff at the hospice was wonderful I have nothing bad to say of them except to say the doctor should have done this sooner to save her the pain for as long as she had to endure it over a week.
barb, I know we are strangers but my heart aches for you. And for your sister.
I can only wish you peace and strength. I am truly sorry for your loss.
R204 Do You Have Any Mercy In Your Soul. If A Person Knows They Are Going To Die & They Have Made Their Peace With Their God & They Can No Longer Breathe On Their Own And Are In Horrendous Pain , What You Want To Do Is Barbaric. Just Went Thru This With My Partners Mother Who Passed Away 2 Weeks Ago. They Were Forcing Air Into Her Lungs With A Mask. It Was Horrible, She Was Getting Anxious. Her Heart, Lungs & Kidneys All Were Giving Out All At Once. My Partner & His Brother Did The Compasionate Thing & Told The Nurses It Was Time For The Morphine Drip, They Were Selfless Enough Not To Have Her Suffer, Because They Didn't Want Her To Leave Them. They Let Her Go In Peace.
Hey, Churchy at r204: take a hike, asshole.
Wow, did this thread get linked to a Xtian Bad Spellers forum or something?
"When one is dead, one doesn't remember a thing.
So any assurances in the last days, hours, or moments before death are really pretty meaningless because it is as if they never happened seconds later upon death."
Since you haven't been dead, how would you know?
Being kind, caring and loving to a dying person eases their transition, it don't see what's "meaningless" about that.
They need s haircut
Barb, I'm so sorry to hear about you losing your sister. I lost my sister to cervical cancer at the age of 51 and the ups and downs during those 2 years were incredible. I didn't have the courage to see her the last week of her life because her condition had deteriorated so much. You are very courageous. I paused and prayed that God would give you comfort. God bless you.
I just lost my mother. She had dementia, broke her hip and then her dementia got worse and physcially she also got weaker. She was 95 years of age. I had to put her in nursing home 9 months ago, hospice came on the scene about 3 months ago. They bathed her, washed her hair and did her nails - they were extra company for her as staff is so busy. She got pneumonia twice not long before she passed and was on pureed food. She hardly knew anyone and could only remember something briefly - then everything was all new and strange to her immediately and she was fearful and confused.
She had pain in her shoulder (no rotor cuff at all), pain in her back and hip from arthritis - and sometimes pain all over just due to being old and tired. Hosice had switched her from her meds to morphine, small dose every four hours under tounge to ease her pain a few weeks ago.
They called me when she had not eaten all day on a Friday - (there was several times she skipped meals or barely touched food right before that though)but that next Saturday morning, they could not rouse her for breakfast or wake her at all and her breathing was shallow (the breaths were becoming further apart) I went down and they called hospice nurse at my request. After about three hours, they came in and wanted to give her morphine and ativan under the tounge to make her more comfortable which I agreed. Her eyes were only about half open and glazed and she made no movements at all and it was obvious she was totally unconcious/coma like.
I did sit and rub her little shoulders and stroked her hair and talked to her til finally one gasp, a teeny gurgle and her eyes closed and she was gone. It broke my heart,but I was telling her that her Mommy and Daddy were waiting for her to come home (as for a year she cried wanting them) - and to get ready to go for I was going to take her there. The first hour as I petted, talked and sang to her a tear fell from each eye. At the end, one tear fell from one eye and I wiped it away. I am concerned that I allowed her to pass with the medicine administered, but I did what I felt was best for her.
My mom fought with cancer for a year. The doctors told her she had three tumors on her brain that had returned. In reality, she had around 20 metastatic tumors. I found this out when she had a stroke and her nurse in the hospital said that he was tired of those cancer doctors just playing us along. She was put on hospice and once she got home she was okay for a couple of days. Less than a week into she began to really slow down. Once they gave her the morphine that was it. It was like she was there but she wasn't.
"Killing is not for me"
So you prefer being in unbearable pain just for a few days longer of your life. I hope you are only making decisions for yourself and don't force you brutal believe system on others.
I hope you are brave enough to stand by your crazy believe system, when it's time for you to go. And I hope you are nowhere near me when I am about to go.
Would you also refuse medication that cures illness and disease.
You religious idiots make me sick!
All I can say is I hope none of you care for me, it sounds like you want the person to hurry up and die, this happened to my grandma, all because her daughter wanted money, Hospice new all along that she wanted and thought she would be taken to a hospital. they sure fooled her. iT SICKENS ME THAT SOMEONE WOULD EVEN ASK THE QUESTION HOW LONG DOES IT TAKE FOR SOMEONE TO DIE. Better hope who takes care of you on your time is not like this.
my uncle was put on hospice care as well as the morphine you need to watch the dr.s and the amount of morphine they are giving!! It will kill them. Yes my uncle had cancer and was dying from it but he was clearly being over dosed. There are some dr.s and nurses that want them to die A. because they dont care and B. they have better things to worrie about. they are dying any way why not give them more morphine, they wont feel it..... I watched the dr.s and nurses over dose my uncle on morphine... all I am saying is watch what they are doing and keep track of times and amounts the meds are being given.....
My sister was on morphine for a few weeks but also had a gastric tube removing fluid so she would not throwup. Not Hospice's idea but my dumb brother-in-law who only managed to make her suffer for extra weeks because he was not ready to let her go. Such a sad time. May your person leave this earth with dignity and peace.
my dad is 80 year old and is in hospice.so i know how it is to loose a loved one,however i feel that it shouldnt be a hospice.they are treating the elderly last animals that need to be put down.they give them only moraphine with no food and water.im looking for help on how to start an aliance against hospice.if you feel the same way i do please help me!my contact info is email@example.com
r204 and 228 are unhinged. Have been on both sides of this equation. Two years after I lost a friend who had full, at-home Morphine to treat the pain of late-stage lung cancer (he was not a smoker) I got colon cancer. The challenge was to keep him drugged, "ahead of the pain". He lasted for three months. At the end, he requested his "last call".
I had a large tumor that became infected and swollen. Sometimes the pain was so intense that I felt warmly at peace with the prospect of dying. I was in bed, at home, alone. My medical team would not prescribe opiates (i.e. morphine) because it causes severe constipation and that was part of my problem. Sorry to be so graphic here.
When I was in the hospital for antibiotic infusions, I got a drip of multiple analgesics, and hourly shots in my ass. I think morphine was among them. Would not have survived without it. Hadn't eaten solid food for months during chemo, anyway.
Wanted to jump out the window at times. My family didn't know if I was in hospice or being earnestly treated. The medical staff didn't really know, either. I was so dopped up and didn't care about the outcome. Got into fights with the attending physician about when I could get the next dose. It was clear that I needed a shot whenever I became conscious, but the attending doc was on a major power trip with me. That was hell and I will never forget it.
I recall hearing multiple conversations about me going on in my hospital rooms. But I could not respond due to pain, exhaustion, or drugs, or all.
Have been in "remission" for four months now. I have to get scans every other month. Recently went to the tropics to learn scuba diving. It was on my bucket list. Had to lie about my medical history.
Don't know if the drugs made me less "willing" to live and put up a fight, or if they saved me from wanting to kill myself. My brain has managed to erase most of the experience.
My letters helped to get the attending physician fired. It was his 23rd job.
What's haunting to me is that someone mentioned upthread that hearing is the last thing to go. As sick as I was, I can remember vividly the conversations around me that I could not respond to. You're in a semi-state of sleep, unsure of what is real, and you really, really don't care. I felt grateful for the life I had and was well aware of it. I was able to think to myself: "So this is it. Right here. I'm going to be OK". Had I died, it could have been peaceful, as long as I would be alone.
I now have a will with strict instructions that I not be resuscitated if the cancer returns and I'm at late-stage and apparently non-responsive. I do not wish to live with a colostomy bag and neurological damage. Was lucky to avoid that, but it was a close call.
The pain meds were a last resort. On one hand, I wanted to die without them, on the other, I don't know if they kept me from fighting for my life. My tumor was inoperable. Luckily, it shrank with chemo and radiation. Not fun. Can't imagine putting up with all that hell ever again.
I sympathize with everyone's loss of loved ones, but we all will have to go at some point. I would hate to have to face a dilemma of inadequate pain management versus fighting in pain to extend a poor-quality life in order to please my family.
R229, thank you for that post. It may be one of the best I have ever read here on Datalounge. I wish you well in your ongoing health struggles.
everyone is different. it depends on what they are taking the morphine for. i mean i was on morphine for a few months recently but now i am off it...it just depends on the person and the circumstances.
someone with 10 yrs with alzheimers with muscle contraction on left arm and right leg, and prior finding of pleural effusion treated with antibiotics and lasix,. Was told on a hospital visit they have malignant lung cancer? Is this possible?
Even to consider aggressive treatment?
My father passed away in October 2011 from stage IV kidney cancer. Never really sick a day in his life except an occasional cold, and it was a pain in his leg that led to the kidney cancer diagnosis (it had spread to his spine which caused the leg pain).
That said, he did well up until his final two weeks. In order to have hospice workers come in during his last month, he had to sign papers that said he was no longer going to seek other remedies, chemo, etc. Basically, agreeing it was time to stop fighting it.
The workers were fabulous and did the things my mom (a retired nurse) could no longer do, such as bathing him in place and changing his clothes. They gave us a supply of morphine with specific instructions on the dosage. I have to also mention it was a Catholic Church related hospice.
I find the posts stating that the hearing is the last sense to go interesting. On his last night we sat up as he listened to the final game of the 2011 World Series. After the game (he was aware who won-- not his team) he started getting agitated. After his first and second doses of morphine, which I administered, he slipped away. My brothers and I joke that he had to stay alive long enough to know who won the Series.
What I found interesting is the hospice worker came out that night at 3am to sign the paperwork and collect the drugs. I had to sign papers stating how many doses of morphine we used, and the remainder was carefully measured to audit against what I said was used. It was then poured into a zip lock and mixed with a liberal amount of dish washing liquid to destroy it.
Since then I've done more research on the use of morphine and have no guilt over using it. It eased his pain and made him comfortable. Thank you to all who have shared and further educated me.
There is so much misinformation out there that is being given to families during their most vulnerable time, and it is causing many families to make the wrong choices for their loved ones.
For instance ... families are being told by Hospice (sales person) to watch for facial expressions that indicate their loved one is in pain. However, many times their loved ones may grimace, not because they are in pain, but because they know they are being killed with morphine or other central nervous system depressants, and they are trying to tell you to stop killing them!
Lay persons are most often not professionally qualified to read facial expressions! They simply have no formal medical or psychosocial training that qualifies them to determine the level of pain a loved one is experiencing!
Here are a few things that you may not know about Hospice, but I bet you will be glad you learned!
1. Hospice is 'for-profit'. They are in business to make money, and often that is unfortunate for the patient.
2. Hospice is given a certain 'capped' amount by the federal government for costs, per patient. When that amount is exceeded, that is when hospice has to spend more on your loved one because they are living longer than the anticipated 6 months, then hospice must reimburse Medicare! (Hospice loses money! So it seems people must die 'on time' and before allotted funds are spent ... so hospice will profit!!!!)
"When the Medicare hospice benefit was implemented, the Congress included an aggregate cap on hospice payments, which limits the total aggregate payments any individual hospice provider can receive in a year. The Congress stipulated that a “cap amount” be computed each year. The cap amount was set at $6,500 per beneficiary when first enacted in 1983 and is adjusted annually ..."
Probably when this allotted amount is close to being exceeded, the patient will die, as hospice has no further funding for this persons care. Hospice will never admit that the hospice seems to be nothing short of a Kevorkian killing machine!
" If a hospice's total Medicare reimbursement for the cap year exceeded the hospice aggregate cap, then the hospice would have to repay the excess back to Medicare." (In short, if they pay more for each patients care than they receive, they must reimburse Medicare. Source: from same link above)
So, as you can see. A patient or customer in all cases, probably needs to be dead by a specified time, because it seems that extended life will not be profitable for hospice and will likely result in hospice being forced to repay Medicare!
"... remember that the for-profit corporation may take that money and pay its Chief Executive Officer many hundreds of thousands of dollars each year in salary and benefits!"
So it seems that for hospice, quickly killing patients with 'pain control' is a profitable business model. Is it also 'legal' because 'pain control' is allowed even though it might cause death?
Morphine is a central nervous system depressant, it will in ALL cases, suppress breathing.
Please 'research' BEFORE you sign up with any hospice. Sure they seem compassionate, but so does that car salesman that you just fed a sob story! They are in business to make money! That is their number one concern (not your loved one), otherwise they would be a NON PROFIT! Talk is cheap. No matter what they TELL YOU ...Life is precious and we all only have ONE. Please protect your loved ones from early death. God Bless each of you and I wish the best for all, especially those that are struggling with life and death decisions....
If there were a moderator, this thread would be GONE. It should be deleted, because it went from being supportive for gay people going through loss (lots of stories about losing partners to AIDS) to a sob thread for straight women who found it, they say, through google.
This goddamn thread is on a GAY site. It is a site for GLBT people, not straight fucking religious freaks who google 'euthanasia' and find it and come to preach an ugly, hate-filled religion that doesn't accept any of us.
(The only religion anyone here believes in is the kind that views gay people as equal... got it? If it's any other religion, fuck right off and die.)
As for 'Barb' and 'TJP' and 'Andrea', this is NOT a site for people with dying relatives. No one wants it to be. It's a gay gossip site that doesn't want or need any more straight people on it. Go take your sad selves to a site where you can talk with other grieving people.
I'm so jealous of anyone getting to take morphine.
my mother has ALS and her religious believes does not allow her to take her own life, is it okay to give her morphine?
Yes, R238, because it is still above all else a medication for the PAIN. If you think about it, most drugs come with some risk, you can accidentally die from penicillin, too. Bottom line, if you need it, you need it.
My mom wasn't on Morphine...she was on liquid percocet. The Hospice said they preferred LP over morphine because there were less risks. My mom didn't want to be on morphine. She had seen her sister dying, clasping at her morphine drip and told me afterwards that she didn't want to end up like her. So in the end, the fact that the hospice didn't administer morphine made my choice easy as her caregiver. In the end she was on the maximum dose of LP and I could see the relief in her face every time the nurse administered it.
Whoever is "against" painkillers like morphine: The whole point of hospice is to make people comfortable when they're dying and narcotic painkillers are a part of that painkiller. If you are against Morphine, you should not go anywhere near a Hospice.
OP, she died in less than a week from starting LP. Piror to moving to hospice, she was on vicodin in the hospital. What contributed the most to her end of life was stopping the things that had sustained her for so long...things like blood and platelet transfusions, neupogen shots (white blood cell booster).
my mom is on morphine over 21 days ovarian cancer, bone cancer and skin cancer, pain patches plus a morphine pump, lord love her, she still embrorides stuff and does crossword puzzles,,,,you have to love it, she squeezes every bit out of life,,,,
Thank you Hospice, , ,
I have not had time to read the posts but from the few I have read that's ridiculous! When did it become humane to cut a person off of food and water and the proceed to tell the family at their request will a liquid diet be administered but it will just prolong their suffering/pain. So the goverment won't pass assisted suicide for terminally ill people but will starve them and dehydrate them ,give them shots of morphine on the hour ,let their families watch them waste away in pain ! Wow what is wrong with people .
My Dad just passed away in hospice and it was a very comfortable experience for everyone. My sister tried taking care of him at home but it was too difficult. So he spent two weeks in hospice. The morphine is a blessing. Dad was scared. The hospice people explained the death process to him in a way he understood. It relaxed him, and he died peacefully last Friday.
The people who work in hospice are angels.
Are you on a tight schedule, OP? Need to be somewhere?
Does it stop your heart?
[quote] My sister tried taking care of him at home but it was too difficult. So he spent two weeks in hospice
Wow, you're lucky. My mother could only get a health aide at home in the daytime when my father (who stayed up all night calling for my mother) was dying. There was no hospice to go to. My aunt was a nurse who was friends with the night supervisor at the local hospital. She drove my father to the hospital ER and told the supervisor, "We're not taking him home," and left. My mother was working full time and hadn't sleep more than a few minutes for weeks. The hospital tried to get her to take my father home (he refused morphine and was breathing more than 40 times per minute and calling my mother's name the whole time. I swear the man did not sleep for two months). My aunt told her, "You tell them 'no, I can't. I will kill him and myself'."
When people begin the dying process, their digestive system starts shutting down. Food isn't processed and sits in the gut causing distention and pain. Hydration by artificial means adds circulating volume that further strains the heart and kidneys. Also during the dying process, metabolic processes slow down/stop and the body doesn't require nutrition. Reading some of the responses here makes me glad I left clinical nursing. I never hastened anyone's death for my own convenience or profit. As for narcotics, they may slightly hasten death by a few hours but the benefits greatly outweigh the risks.
R248, I applaud you and the work you do. I think nurses are very special. Every time I've been in a hospital, either for myself or to visit a family member, I've seen so much compassion from the nursing staff. Of course the doctors are great, but its the nurses who really care for these patients day in and day out. My father wanted my sister to explain the processes of death. (I had been over this with him many times.) He didn't like what she said and when they took him into hospice, someone there explained it to him in much the same way you just did. It gave him a lot of peace. He was so scared. I remember that day he didn't need Xanax to calm his nerves because the hospice nurse had done it for him.
@249: Thank you. The hardest part was dealing with dysfunctional family members who are angry at the dying process and who take it out on the nurse (see previous posts by dysfunctional Christian women). BTW, I no longer wear plastic shoes.
It's an instant death sentence. Dose after dose of morphine will kill anyone. Hospice spikes dosages to kill them quicker so they don't have do deal with them any longer. Hospice tells family numerous lies just to keep them at bay with situation. Hospice took my mothers life, her last breath. She fought it, couldn't talk, eat, object, dehydrated and starved, intentionally. Withholding food & water, sedated her with dosages or morphine, methadone and versed which stops the heart & lungs. Hospice commits medical fraud, their horrid trickery for a horrible death. Why can hospice do this and how can it be stopped? No one in authority can stop them, and people just won't get involved to stop this killing. Innocent people are loosing their lives for no reason, that's what hospice does! They are true killers!!!!!!
R251, if you were facing a painful death from cancer or end-stage disease, would you rather be sedated and pain-free and die a comfortable death, or would you rather suffer unrelenting agony until you finally died?
Most people want to die with dignity and comfort and medicine. Hospice allows them to do so.
There's some of what R251 said that I agree with.
When my mother was dying from lung cancer she went into hospice in January. We were told it would be a matter of days. but she hung on for 5 months. She did not want to die. She was a stubborn old woman and did not want to go.
The longer she as in hospice, the worse she was treated. She was ignored at best. There was definitely mistreatment. My younger sister, who is in law enforcement, put the fear of god into number of hospice nurses after she found my mother in very disturbing conditions when visiting and she reported them to state authorities after my mother died that found mistreatment at the facility.
My grandmother has alzhimers and COPD. I have been taking care of her for 5 yrs come Xmas. Anyways these past 4 months she has been going down hill. At 1 point she was bedridden then had a burst of energy for atleast 3 woks now she is sleeping alto eating and drinking less again and in little pain. Hospice sent care package a while ago but I didn't use it because she did a complete turn but now I'm not sure what to do. Its hard to watch her like this again and especially for my 3 little kids.but I'm afraid if I start her on these meds will I be the one who ends her life. Please give me a answer
i just happened to have this popup in front of me about people dying of cancer,and being on morphine,damn i couldnt believe some peoples responses!iam sorry,my big brother suffered horrible fighting cancer,he was only 49years old when he passed.this is a ,horrible,suffering,long death that nobody should have to endure for any length of time.the person with cancer isnt the only ones who suffer,this breaks down the most stongest of familys.still to this day i still feel the pain,2 years of watching a beautiful young man suffer and deteirate,and be in that much pain for so long.and then somebody has the nearve to ask about the morphine, hell yes give them poor souls morphine,i know what pain is ,and i know that person after awhile the pain meds dont work, so dam-it family members give them as much as they want,they are being ate from the inside out,iam sorry but i watched for 2years as my bestfriend,and big broyher suffer like i havent seen since,and it still haunts me.there dying,they have suffered enough!let them go out if possible with no pain!
[quote]So today he felt OK and wanted some jelly and ice-cream. They said NO.
This makes me so angry. He's dying. Give him what asks. But I presume they said no because liquids would prolong the process. I wasnt allowed to swab the dry mouth of a friend with Coke, which he absolutely loved, because I didn't have power of attorney, and they wanted him to die faster basically.
Oh the swabbing.
I remember doing that for my mother
I've known people who have died both ways: with the morphine drip at the end and without the morphine drip. Let me tell you, you never want to see someone you care about die in the agony that results from these diseases. As someone wrote above, it's better to have your life shorted by a few hours than to suffer absolute agony. I don't think some of the people here understand the extent of the pain that can be suffered.
Insofar as feeding a person who is at this point, more people need to read up on what happens to the body when it is in organ failure. There are very real reasons why saline drips and drip feedings become necessities.
My father is on hospice now, in the house. He had a stroke in October, spent 2 months in rehabilitation to regain use of his limbs, and then had two heart attacks within two weeks. After the second one, the doctors did an angiogram and determined there was nothing that could be done. In addition, his one kidney us failing. He's refused to go to any more doctors, doesn't want dialysis, etc. The doctor let us bring him home, but told me that he does not have much time left and to make him comfortable.
He's been on the hospice program for about a week, but didn't start taking any of the "heavy" meds until Saturday. Right now he's on 1mg ativan every 6 hours and .5ml Haldol every four hours. He gets morphine if he's in pain or having trouble breathing.
My mother and I are starting to worry a bit about hospice. His blood pressure yesterday was 100/60, which is a good blood pressure. They told us to lower his heart medicine and the lasix because his body could no longer tolerate that amount--does that make sense? They also want to stop the plavix. That seems a little too...too "rushing things along" to me. I'd rather just give him medicine to keep him comfortable and let nature take it's course. Doesn't seem right to take him off of the other meds. Any opinions?
At this point he sleeps mostly...when the medication starts to wear off, he's agitated, tries to get up (he still can't walk from the stroke), hallucinates and most of what he says doesn't make sense. His breathing is also very labored and, yes, at times there is a "rattle". I know that all of these things are "end of life" symptoms, but is there a possibility that this could be the medication? Hospice says it's unlikely, and my own research shows that Haldol actually STOPS hallucinations. Am I just in denial, or would you be suspect too?
First of all I have had 2 loved ones within 6 months pass away at home under hospic care. Now im looking into it and it isnt good idea to get on because I been hearing the morphine is actually killing the person . It lyk wen yhey give a prisioner the lethal injection.
Please research more before using it.
Unfortinately its too late for my loved ones that passed in the last 6 months
When I was thirteen now 52... I watched my father died from cancer.... he screamed and begged my mother to take me and leave the gun... which we didn't... the suffering was so bad.... my brother would sleep in the car so he didn't have to hear the Screaming....the begging..the grabbing for the bed post to take his last breath... today I'm a caregiver for my Ex-husband... we were together for 25 years divorced and 6 years later I helping my only daughter with her father...I found forgiveness and compassion for someone who hurt me. He has been in hospice for about 6 months now and has always been on morphine.... Hospice is end of life care... don't confuse care with cure.... I thank God every day that this man is not suffering the way my Father did... yes it's hard to watch some die this way...it makes me sad to read where people would chose to let their family member suffer needlessly.... breaks my heart....
It is the height of selfishness to deny a person morphine because YOU cannot bear to "let him/her go" any sooner. The death process isn't about the caretakers, the family, the friends. The death process is about the person dying. It is the responsibility of those around him/her to make the process as peaceful and comforting as possible. To allow a person to suffer in agony because they might die earlier than later with morphine is abominable. I have always believed that anyone who deliberately permits such agony must truly hate the person who is dying. Why else would you let them suffer so? You certainly would not want someone you love to bear such unspeakable pain.
My husband died an absolutely horrible death. I made sure he had everything he could possibly want.
Who on God's green earth would ever deny a person anything on their death bed? That's just sick.
Hopefully I'll have the same treatment when my time comes. While it was very difficult, it was a pleasure and honor to usher the love of my life to his death. His last request was scrambled eggs, he refused pain medications- tough ass bitch.
I love you, David.
I'm glad I live in Oregon where we have the Death with Dignity Law. Holy Christ these stories are awful.
My father has recently (this week) been given morphine for the pain in his neck/head. Radiation treatment for cancer (metastatic)on a lymph node in the neck region. He has complained about a headache once in a while. I've been giving him Hydro/ACETA with two ibuprofen. Seems to do fine. His caregiver and hospice have decided to give him morphine now. Question: His Rx of hydro was 100 count back in January. It is mid April now and only taken 15 hydro in 4 months. Has the hydro been given enough to know if it is not working? Does it merit going to morphine? I'm with him 2 1/2 days every weekend and do not believe he could fake being ok if now needs morphine. HELP! I don't want him in pain, but I do not think he has had the hydro enough to know if it is working or not.
My sister in laws mother was dying in the hospital.. She was 80 yrs old and in a coma.
She was on a morphine drip and they kept increasing the dose...saying she was in pain...they couldn't tell of course .
The sister in law is anRN as I am as well.
One of her brothers kept complaining about how long it was taking his mother to die...kid you not...when is it going to be over...why is it taking soooo long. It was only about 2 days.
Karma got him though...he died of ALS...wpuldn;t wish that on anyone.
He was never nice to anyone.
When my grandmother passed, they told us we could tell when it was soon because her feet would get cold. My cunty aunt kept reaching under the blanket and saying 'Not yet!' like she was checking baking bread in the oven or something.
R265, hydrocodone is not as strong as morphine, in my experience. Best wishes an lots of strength to you. I know this time is excruciating.
[quote] Have any of you been on morphine? If so, what is it like?
It made me nauseous, dizzy and I hallucinated. Dilauded gave me a horrible headache.
The best pain medication for me was Demerol but many hospitals won't even stock it anymore. Demerol rocks.
Medical professionals always want you to end someone's life quickly. They'll tell you this person can't recover when they can. I've been there. You should always be in complete control and don't get swayed by them because they know more and therefore guide you to their reasoning. If you love someone then you are willing to make the sacrafice to take care of them for at least a little while. If your thinking is "I'll have to care for this person and I don't want to do it" or "It will cost too much money to care for this person" then you never had a great relationship with that person, there was no unconditional love. Every one should implore their family members to take the best care of themselves including yourself because you do not want to be in a hospital or nursing home. They aren't blood, they don't care if you live or die. Many have terrible attitudes in wanting to make their work life easier by getting rid of people who are problems for them. Why sign up for that job if you can't handle it? Do something else.
R270 - you are really judgmental.
Not all medical professionals are as you describe. Most I have met are nothing like our describe.
Not all people want their loved ones to care for them.
my dad was 76 and found out his pain was aggressive cancer. He decided on hospice. they started morphine, lorazapam and a steroid and he died about 3 weeks later. I personally believe it was the morphine that killed him. they doubled his dosage and all the medications combined built up to toxic levels in his body. hospice is a way to humanly kill. I didn't realize this until it was over. He honestly could have taken just the steroid for pain and probably lasted a few months longer.
Looking back, I think he knew that calling in hospice meant being killed soon via medication. I took care of him for a month and was completely oblivious. I still feel like it was all a bad dream.
I'm an RN. The first time I gave morphine to a hospice patient, he died within 20 minutes. I've given it to many patients since then. Some passed quickly. Others held on for weeks.
[quote]He honestly could have taken just the steroid for pain and probably lasted a few months longer.
Would those "few months" have been quality ones?
I hope when your time comes, a family member or "dedicated" doctor keeps you trapped in your suffering body for just a few months longer.
Death is part of life. It's our fear of it that so often makes it more horrible than it ought to be.