I have posted on here many times and answered questions every now and then. Dad passed away Oct 7th 2013 from Liver Cancer . He was in a hospice facility for 11 days until he died. The day before he was admitted he was in the hospital and was talking,eating and very clear headed but his ammonia levels were high and he had been very combative, not eating and wouldn't take his meds for 4 days at his nursing home. ( He was in for a Psych Evaluation.) The hospice worker talked to me about admitting him instead of returning to the nursing home. I agreed to this and arrangements were made. He was transferred later that day and was alert and in good spirits. The next morning he was unresponsive and stayed that way until he passed. They gave him morphine and ativan around the clock. He never got any water but they did cleanse his mouth and moisten it with swabs. It seemed like he could hear me the first few days because I would shake his shoulder and say "dad". His eyes seemed to be moving under his eyelids and his mouth would move slightly. I did ask about them lowering his dosages so he could wake up a little. The nurse said he was getting a very small dosage already. I just wonder if the drugs made him unresponsive and if less was used he could have ate and drank and lived longer. I know it was time for him to go but I'm kinda puzzled about his going from complete alertness and straight into unresponsiveness so quick. The nurses did a Great job. I myself don't know how they do it. They treated dad like he was their baby. So gentle and compassionate. I was just wondering if anyone else had the feeling that death felt a little rushed once their loved one was placed in Hospice.
Death from liver disease does come quickly when the time comes and many people feel more could have been done for their loved ones. It is also common for patients to refuse medications at the end of life. Giving it by injection probably would not have been significant because an equivalent dose usually less than the oral dose would have been ordered. Once morphine has been started it is usually not stopped because of withdrawal possibilities.
Edward I don't think Maggie was suggesting you should have sent Mom to the ER from my understanding she was saying you could have just sent her in and let the Drs do everything and anything to "save' her life. Is that what you have wanted to see. She had a DNR so obviously did not want to be recusitated by people junping on her chest, breaking ribs, intubating her and maintaining her on a vent for whatever time she had left. It would not affect whatever disease was killing her liver.
Many people share your views about the use of morphine at the end of life including many nurses. All I can tell you is that I would gratefully accept as much morphine or the equivalent was offered if I had end stage liver disease. A few people are genuinely allergic to morphine but your mom had been taking it for some time so that can not have caused her death. In these cases there are equally effecive alternatives to use. Please be comforted that your cared enough for your mother to want to do the best you could to save her but she had already decided to be a DNR so her wishes were followed. If you continue to feel so hopeless and helpless please seek some treatment. Does not mean you are mentally ill or will have to take pills for the rest of your life just that this is an acute situation for you and if it was a broken leg you would not think of refusing a splint to assist with healing. Blessings
For my daughter, there was very little pain. She had Leukemia. The bone marrow transplant took, but it did not defeat the Leukemia.
On a Thursday she was sitting up and eating, but weak. She died on Saturday night. I administered her meds myself, and I know it was not enough to kill, just enough for comfort and peace. Please don't blame Hospice. It was his time.
Hospice is not a pain management program, except for those who are dying. Sometimes the evaluation is wrong about how close to death the person is, but the person must meet criteria that suggest death is likely within 6 months for the person to be even accepted. You apparently didn't agree with this prognosis for your father, but that is what the medical professionals determined.
You are absolutely right that a person should not go into hospice expecting to recover. Certainly that happens. It happened to my mother. It actually happens a lot. But hospice is for those who are expected to die soon. If you haven't accepted this prognosis, it is really best, in my opinion, not to use hospice at all.
My husband died on hospice. I hope that when my mother's time comes she will again be on hospice to ease the way. (I hope to have hospice for my own exit.) I do not believe that being on hospice shortens one's life. In my family's experience, it lessens the suffering.
"maseiloj,Hospice care is end-of-life care. A team of health care professionals and volunteers provides it. They give medical, psychological, and spiritual support. The goal of the care is to help people who are dying have peace, comfort, and dignity. The caregivers try to control pain and other symptoms so a person can remain as alert and comfortable as possible. Hospice programs also provide services to support a patient's family.
Usually, a hospice patient is expected to live 6 months or less."
Here is another explanations of eligibility:
"n order to be eligible to elect hospice care under Medicare, an individual must be entitled to Part A of Medicare and certified as being terminally ill by a physician and having a prognosis of 6 months or less if the disease runs its normal course."
Who paid for your father's hospice care? If it was Medicare, your father had to have been certified as terminally ill with a life expectancy of six months or less. I am sorry if this was not clear to you at the time. The fact that your father did die so soon after going on hospice tends to confirm that he was, indeed, terminally ill.
If some other source paid for hospice care, then perhaps the rules are different. Can you tell us whether Medicare covered that care? If not, who did? We learn from each other and I've never heard of hospice covered by some other funding source. So I'm interested in learning.