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My Grandmother lived in assisted living for 5 years. In January she started to decline in health. They rushed her to the hospital, intabated her, for low O2 sats, and monitored her. She recovered to everyone’s surprise but was definitely changed, not her normal cranky self. She no longer cared. She didn’t talk about her pain, she didn’t complain about anything, basically very slow and lethargic. It got to a point where she just stopped everything. Here’s my concern. I know the staff have a difficult job. They are under staffed to take care of so many elderly and end of life patients. My grandma was a difficult person. Nobody did anything right. She got nurses fired, in trouble, written up. With that said, when she came back from her near death experience she seemed very medicated. Did the nurses finally have enough? We’re they disappointed that she made it back? We’re they going to helper along this time and keep her more quiet with meds and the family won’t know better? So my mom and her siblings got all the funeral arrangements together thinking this is it. She was so medicated that she wasn’t eating or drinking. Well my aunt stayed with her all Day this one day and the staff didn’t give her any meds that day, by the end of that day she had awoke, was thirsty and hungry and came out of her fog. My question is..
Did the staff over medicate her to keep her quiet or possibly give a little extra to help her over the edge? But was disappointed when family came in and thwarted there plan?
She literally came back to life after she ate and drank. When your that medicated you can eat or drink so what happened?
Fast forward to yesterday, she is back to her old self, cranky, eating, drinking, wanting to go out of her room, get her hair done, visit with people, talk on the phone, get up and go to the restroom, talking about the good old days, you get the picture right, well apparently she got int it with a nurse and was screaming and carrying on about noontime and they gave her two meds. Antivan and Morphine. Now at this time she had a pretty deep cough and was on O2 to help her breathe.
Within an hour of administrating this combo of meds, her O2 sats dropped to the 50’s so they placed her on a higher dose of O2 and called us.
We got there around 3:30 maybe and they had called a hospice nurse to check her and they basically said she was actively dying. She did die at 4:23. We saw it happen.
We were told that the nurse who gave the meds was not there and she did not leave any nursing notes as to what happened. I was surprised as was the hospice nurse about that. My question is, is it just possible that the nurse had had enough of her screaming at her and possibly gave her maybe too much, concidering her bad cough and already compromised breathing?
She was alert, had eaten breakfast, gotten up to use the restroom, maybe got mad at something, demanded her pain meds and the nurse maybe gave her too much?
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Rest your mind, Darlene.

There are other posters here with the nursing and medical qualifications to give you the exact figures; but even as a lay person I know that to drop somebody's respiration by THAT much you would have to give them gigantic amounts of morphine. Massive. And it's a controlled substance, you couldn't just say oops I miscounted.

I'm so sorry for your loss, and for your grandmother's passing, but the sad reality is that by the sound of it her heart gave out. Her pulse slowed and became erratic, her circulation petered out (hence the low O2 sats), and she passed quickly and peacefully away.

And can I say how personally fond I am of bellicose, assertive, cranky elderly ladies who poke people with a stick if they don't jump high enough? Your grandmother was a character in her ALF for five years. I expect they miss her *terribly.*
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Darlene2266, you are asking if the nurse broke the law and essentially killed your grandmother. Anything is possible, I suppose, but doesn't it seem more likely that your GM's remarkable "recovery" was the oddity in this scenario, not her death. She had one last rally and then the decline that started in January continued to its logical end?
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I do believe her end was near. I’m under no delusion that it wasn’t. And I’m glad she went peacefully. My only concern is that she was a very difficult patient and tested the staff daily. It concerns me that she went from one extreme to the next after the cocktail. And the fact that the nurse left no notes and had left for the day by the time we got there.
Nurses are Angels. I praise them for their very tough job. But sometimes I think some maybe in the geriatric section might loose their composure and help things along to possibly relieve their stressful situation hence a bigger cocktail than necessary.
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I'm honestly sure you thought she was much worse than they thought she was. If you can't handle unreasonable and demanding and nuts and shouty and b*tchy and bitey and pinchy old ladies, you DON'T work in an ALF!

The notes ought to have been properly completed. Yes, they should. I wish I had a dollar for every time I've ever said that...

There will almost certainly be other records (stock, supplies, a room inventory, something) you can use to verify what she was given, if it's still troubling you. But I'll bet you anything the nurse was just in too much of a hurry.

Nurses and care aides do, sadly, lose it from time to time. They may shout, they may be rude, they may leave the room abruptly, they may even slap or roughly handle patients; and although it is never okay once you've been through the trenches you're not so quick to judge.

But I can't imagine a nurse will think "right, you..." and actually overdose a patient just to avoid tending her. The kind of very disturbed people who might do that poison their patients with insulin and get caught pretty promptly.
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My FIL, in his last days, "rallied" 3 times....it got to be so hard--we'd zip to the hospital and he'd be barely breathing, basically in a coma. Then, an hour later, he's awake and demanding strawberry pie!

The final day was just like the others--we raced to the hospital, kind of expecting the same outcome---and his dr asked if we would allow him to give him some morphine as he was choking to death and in terrible pain. OF course the kids said yes to that--within 20 minutes he passed.

Did that dr kill him? Absolutely not. Just gave him a peaceful passing.
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Hi Darlene, sorry to hear about your grandmother’s passing.
I am trying to wrap my head around what alleged behavior you’ve assigned that nurse.
Nursing & Drug Administration is very important to every nurse out there. To entertain the thought that a nurse was circumventing physician orders and decided to (arbitrarily) administer more of the Hospice cocktail to your GM sounds like you are implying the nurse was simply giving bolus doses of the meds.
That nurse wouldn’t know your GM was feisty or so 3 months ago & can only see an elderly woman that has reached her end of life. A good nurse must/will assess the patient’s pain, etc, evaluate what’s already been given & any acquired relief from the meds first before administering any more. The decision to administrate the Hospice cocktail medication formula is not determined until the nurse performs an accurate assessment & data review - like intake, BP, output & uses nursing judgement for managing a Hospice. 
Again my condolences to you & your family.
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What if the patient does not want it and it is being forced upon him by his caregiver?
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That would be assault, compassionornot.

Would you like to say a little more about the situation?
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Compassionornot:

Yes. If the patient is willing to put up with the pain, they should not be forced to take the opiates or any other pain meds.

Some people can tolerate a high level of pain and do not want to be medicated into oblivion.

Many patients are medically savvy and know what these drugs can do to breathing and to kidney and liver function.

On opiates patients often lose interest in eating and do not think to hydrate themselves properly.

No patient should ever be given pain meds, when they do not want them.

Please report this promptly to you state elder abuse organization.

These opiates are being overused.  They are also being used as a form of chemical restraint.

For those who are claiming that the meds are merciful.  Here is something to think about:

A neighbors son died of a Fetanyl over dose.  They found him on the floor with clumps of his own hair in his hand, pulled out by the roots.

The doctor explained to the boys mother that Fetanyl can shut down respiration and that is very frightening and can cause panic. He likely pulled out his hair in a panic.

Yet, when an elderly hospice patient is given a deadly hospital cocktail for pain and it hastens death, the family is told they died peacefully. Hmmmmmm!
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My sister had my father killed off in hospice while my mother thought he was getting better. My sister told no one what she was doing and no one got to say "goodbye." He was healthy..broke his hip. she lived out of state and didn't want to deal with him recovering since my mom wasn't very capable of caring for him. They had tons of money and insurance to get Mom help with him but good ol' sis' "took care of it." Never again.
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Prolife, what have the legislators you've contacted said about the situation? Are they recommending a medmal suit?

Since you keep posting, I'm sure that you're expressing your concern by taking real action, not just posting here, but contacting law enforcement, legislators, and other people who have the authority to introduce legislation or initiate investigations.

As I would think anyone could surmise, posting on a forum is not going to initiate any change. We don't have the authority, and most of us are too busy taking care of our parents or other loved ones in the family to take up someone else's cause.

So, please share with us the results of your legal contacts, or grass roots lobbying groups you've started. I'm also especially interested in which legislators specifically have expressed concern and will be introducing legislation to address the issues.

Oh, and how is your med mal suit for wrongful death proceeding? (I'm assuming you've filed one?)
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Prolife1, you mentioned that your sister had killed your Dad. Has she been arrested for this killing? Has the District Attorney set-forth a case, and has a Grand Jury been picked? Just curious how this case is coming along? How does your Mom feel about her daughter killing her own father [Mother's husband]?
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I'm a different person than Prolife. I'm Prolife1. It is hard to put the info together since my mother was flooded out of her home. So, I was just presenting the other side of this euthanasia issue. Some people take the last moments of life seriously as in they want to see their children and other loved ones and settle up. My mother still thinks he just died all of a sudden. My sister is sole controller of her finances now. Mom knows that she's angry and controlling, but in order to work on getting info I need to just let her think what she wants. And the state probably won't do anything because there are so many people who are pushing for expedited death of the elderly in elder care. I'm not kidding myself about this fact. This website has opened my eyes to how many people prefer to take their family members' lives. It's really sad and ill-informed. But, I sleep great at night knowing my dad knows I would have done something had I known. I would have loved to have been with him until the end. But, this callousness is what happens to those who don't respect life. She is also pro-abortion. Euthanasia and abortion go hand in hand. People who think they should kill innocent people are dangerous across the board. And btw, I can post anywhere I darn well wish. I don't much like your tone, GardenArtist. Want to walk that back a little since this is my first post?
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Prolife1, I'm so sorry for the loss of your dad.

What life-limiting illness caused him to be admitted for Hospice care?

If there was no life-limiting illness that was documented, you should report this to the DA, to the Ombudsmen and to CMS.
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Yeah my brother-in-law need an insulin and I guess methadone from the clinic or whatever but as soon as hospice took over he went to the hospital with bad blood sugar and the lady even said it was up to 7:50 or more and they never gave him anyting then they probably gave him some morphine and moving to the hospice room and what she was dead within 6 hours just like the other person said. Pretty sure that was not a coincidence because he regularly went to the hospital like once a month but not after he signed up with hospice. He was older and had diabetes but I had just saw him dancing at his birthday party like 2 days before
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Pistol, I've reported the rather rude message you posted on my message board. I'm not sure how I've offended you.

"Probably" gave him morphine?

After you sign up with Hospice, you no longer go to the hospital. Signing up with Hospice is an acknowledgment that what you have can't be cured. Not that you want to die, just that you want comfort rather than curative treatment.

To make public the response I gave to your message board post, signs of imminent death are not religious in nature; rather, they are physical. Breathing is different, skin becomes mottled and cool. There are others that I don't remember from my mom's recent death. And yes, I was there. They gave her morphine to ease her breathing and pain, not to kill her.

I'm sorry for your loss. Your brother in law was a brave and realistic person if he signed himself up for hospice.
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"This website has opened my eyes to how many people prefer to take their family members lives"

Really Prolife1? Perhaps you need to reread the whole thread. I think most people on here had no choice but to utilize hospice care in order for their loved ones who had reached a point where comfort measures were the only way they could know for sure their loved ones, whose death was imminent would not die wracked with pain and mental anguish.

Go stand on a street corner with a sign or better still go to your local government offices and campaign for the changes you want to happen.
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Prolife1:

I am so sorry to hear about your difficulties and concerns.

You wrote: [" And the state probably won't do anything "]

It is difficult to get the police or DA involved in a sick elderly person's death.

If the body was cremated, that would also make a thorough investigation as to the actual cause of death, impossible.

So you are right, the state is unlikely to get involved, unless you have video or some other type of proof that your family member was not being treated properly.

For example the authorities were able to get involved in the recent death of H.R. McMaster Senior mainly because there was video tape of the nurse's blatant neglect.

Also it likely helped that this elderly man was the father of former White House national security adviser, H.R. McMaster, jr.

Without those two factors, the DA would most likely not want to get involved, due to lack of concrete evidence.  

You may have a civil suit, though, if you have any proof.

You can likely also file a complaint against the Hospice and ask for an investigation.

Again, I am sorry that you had to go through such a traumatic ordeal.

Sending big hugs, your way.
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Heather10: I may have to file a suit against my sister on some land that she is trying to control that belongs to me as well, so there's only so many lawsuits i can do at one time. :) My dad was the sweetest man. I really miss him and my mom got washed out of her home in Harvey, so I'm trying to leave her in her denial about what my sister did while she has had so much loss and going through a lot of health problems herself. I did get her to give me the name of his dr. this weekend when I was with her for Mother's Day. So, I am starting to put together some documentation.

Gershun: I did read the entire thread. Maybe you should as well. Also, it's funny you mention standing on a street corner with a sign. I actually do that, but for the sake of trying to end abortion. There are only so many things that a person can do in this life and still care for themselves and their families, but yeah...my kids are also pro-life activists. And yes, many people on here can tell themselves whatever they want about what they're doing or have done, but in their hearts they know the truth and they're going to need some help reconciling it before they die or they're going to wish there was an afterlife they could have the pain drugged away from as well....but, that's not an option from what I understand.

Once in awhile it's not a bad idea and stop to think what our actions actually lead to.
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The only thing I will ever need help reconciling is how my MILs caregiver chose to let her suffer. How I feel helpless when she loses her breath and struggles to catch it and he sits there and holds her hand instead of administering a little morphine. How he insists on feeding her when hospice has already told us she’s shutting down and food is causing discomfort. How he has made it clear her death will ultimately be on his terms and that he will do nothing other than sit and hold her hand. She’s not gone yet but I am already struggling knowing that she’s going to suffocate to death and struggle to breath until the very end all because one very selfish person thinks he can keep her alive! If it was up to me, I would give her a peaceful passing and there would be nothing to reconcile. It’s the right the thing to do. It’s the humane thing to do.
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Comfort is one thing but giving someone the drugs to get their lights to turn off isn't okay. People are apparently doing exactly this every day. Anyway, I will be doing my darnedest to make sure my sister doesn't kill my mom over something like a broken hip like she did to my dad right under my mom's nose. Never again.
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Prolife1, has your sister been arrested yet?

By the way, does your Mom have a Medical Directive? If yes, and if there is wording regarding pain comfort, then you have to abide by the legal document that conveys your Mom's wishes.
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My mother is Catholic. She will probably need to visit a Catholic attorney. thanks for reminding me.

Yes, I know about "pain and comfort" issues. People are getting medicated to death. Drug addicts "medicate" to death as well. I would think that people would want to avoid that and have more time for their families, but the law has made it easy to kill people off before they can say their last "goodbyes" when one member of the family wants the person gone and doesn't want to wait for family to get there because, for instance, their mother-in-law was already in the process of dying in another state...which was my case. She died the day before my sister killed my dad off.

Regarding whether or not my sister has been arrested yet...you can go back and read.
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Prolife:

You wrote: [ "People are getting medicated to death. Drug addicts "medicate" to death as well. I would think that people would want to avoid that and have more time for their families, but the law has made it easy to kill people off before they can say their last "goodbyes"]

You have a valid point. Please do not let anyone convince you otherwise.

It is a fact that many elderly patients are over medicated as a way to keep them quiet and compliant.

These elderly can be over medicated by a nurse or hospice personnel or their own family simply for the convenience of the caregivers.

If you go to the courthouse in your county, you will find many lawsuits filed in which medical professionals emphatically state that an elderly person died before their time, simply because they were given pain meds that their systems could not handle.

Whether or not they needed the pain meds is questionable, if you read the court cases.

There are many cases where giving pain meds is indeed compassionate. There are also many cases, where the caregivers have simply become overwhelmed and wish to keep the patient compliant for convenience sake.   Very sad.

A comatose patient requires far less time and effort than does an awake and alert patient.

To my mind, caregivers, whether family or professionals have far too much freedom in meting out toxic pain medications.

Remember that sometimes an elderly patient on many medications can easily be overdosed by a very small dose of pain med or combinations of pain meds.

These caregivers later try to convince themselves that they did it in the best interest of the patient.

Perhaps sometimes this is true. But when it is true, then the caregiver is at peace with their decision.

If someone is protesting too much or attacking others for speaking their mind regarding overdosing with pain meds, then the protesters are not at peace with their own decision.

I have empathy for those protesters.   Still, I have to wonder why they are not at peace with their decisions, even as they claim their decisions were in the best interest of their elderly charge.

If I were at peace with a decision to give pain meds, I would be totally understanding with someone who may feel otherwise. 
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Sometimes what happens is Hospice is called in at the last moment to be assigned to a new patient, thus some in the family will feel that Hospice was the cause of the demise, instead of the patient terminal illness being the cause.

I agree 100% that the elderly in nursing homes and at home can be over-medicated due to too many prescription meds, but it a whole different subject debate when it comes to Hospice. We cannot compare the two. In Hospice, it is the opposite, most of the prescription meds are no longer given to the patient. In fact, there are patients that start to feel better and are taken off "graduated" from Hospice to live months or years longer.

One has to realize the amount of morphine that is given in Hospice is the same amount given to a patient who has had major surgery. I remember having a morphine pump after two major surgeries.

And I do understand that one can be allergic to certain pain medications. I cannot tolerate Codeine which is widely prescribed and my allergy is noted on medical files and a Medic-Alert bracelet. I learned I was allergic to it via a pain med which had Codeine. This allergy runs in my Dad's said of the family.
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Someone who's concerned about overmedication should also be concerned about the opioid epidemic, through which people who have nothing to do with needing hospice care are drugging themselves into oblivion, and often death.
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Yes, the opioid epidemic is a problem.

IMO, they should not be prescribed so freely.  People are stealing them from Grannies cabinet.  I had one case where the grandson was taking pain meds on Grandma's nightstand and substituting them with look alike pills.

I have had cases where paid caregivers do the same to take themselves or to sell for a profit, in the street market.

I think every normal person is concerned about the opioid epidemic.

However, As for it being normal to remove all meds a hospice patient is taking.

........That is not accurate.

Hospice care does not "stop giving patients all medications", but rather, eliminates many that are no longer appropriate.

For example they will remove those that really are not helping keep the patient comfortable.

Also, if a patient wants to continue taking medications not related to their terminal diagnosis, they can do so.

Do not forget, if you remove a diabetes medication, the patient will die more expediently.  Some people are still clear headed and want to hang on to life as long as possible.

For those asking questions here, please do your own research before blindly accepting advice, including my advice.

The facts are the facts. It is important to always get the facts from the appropriate authorities, before blindly accepting information offered.
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Heather, you made an important point regarding facts.

For myself I have my go-to websites such as the National Institute of Health, and also the Mayo Clinic. Even Web-MD is good for quick facts to use when one is going to the big research centers to gather more historical facts.
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I like the NIH too, FF.
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