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in answer to your question
Firstly, if you truly care for your Aunt as much as you describe, you will respect the decisions she made....verbally with you, and legally...to make sure her directives are followed.
Why is it important for you to have her receive Morphine?
She has made it clear repeatedly:
" that she is not in pain and doesn't want medications".
She is a Wise woman.
At her age she came into the world without various medications being given to her Mother (& her, via circulation)
And death was accepted, also on its own terms. No medications.
It has only been in the last 30years that morphine has been given to elderly patients close to passing over. Some with pain, & some without
Your Aunt has enough pride to choose to pass across the same way...
Drug free.
Morphine has many side effects...not the least of which is dysphoria (feeling badly)as well as constipation, nausea dry mouth & cramping. (80% of patients in a comprehensive medical suffered the constipation & 95%dry mouth)..
Think how depressed one feels when constipated, and suffering a dry mouth that cannot be relieved
And the total daily morphine dose had no impact on side effect patterns.
Translation: people Always suffer these side effects regardless of how small the dosage of morphine.

All Natural suggestions (many central benefits, & no side effects)
a. Dr Bachs Rescue Remedy.
Take a few drops every hour on the pulse points where one applies perfume. Do the same for yourself also . And add 10 to 15 drops to each glass of fluid
This product has been around over 85 years now & is available in big pharmacies, markets & amazon, eBay etc

b. Potassium Broth.
In all illnesses there is a lack of potassium in the body. Potassium is "the great alkalizer of acids" in the body.
It is the acids that cause irritation, which leads to inflammation and therefore pain
A potassium rich broth will soothe the nerves, calm the digestive system. boost the immune system and lift the spirits
3 med/lge red organic potatoes, 1 organic carrot, 1 stick celery, 1/2 bunch parsley
Cut the peel from washed potatoes with a knife about 1 to 11/2" thick
Cut carrots, celery, parsley.
Put all in a medium sized pot. PUT THE WHITE OF THE POTATOES IN THE TRASH! IT IS THE MOST ACIDIC PART OF THE POTATO
Cover the veg with DISTILLED WATER..only.....
Bring to the boil. Turn down and simmer 20mins w lid on.
Let sit 20mins
Strain off & keep the vegetable water. Throw away the peels & veg
Serve warm . Perhaps she will be able to sip it through a straw
If not you can freeze it & give it to her as a popsicle (rather than the commercial sugary type of popsicle)
This most simple of broths WILL improve her overall well being
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You are doing an incredible job. My suggestion is that you talk with a palliative care specialist or hospice nurse at your local hospital to support you. I am sorry that your Aunt could not understand that you need support too. She sounds like she is close to dying and dehydration is one of the most comfortable ways to die as long as there is frequent mouth care to relieve the dryness. She may not need any morphine unless her she looks like she is struggling to breathe. Then I might put a few drops under her tongue. She does not know how difficult it can be to die for her as well the caregivers. She may thank you if she is alert enough. You try and respect her wishes as much as possible but not to the point of suffering for both of you. I admire your courage and commitment. Please get support for yourself during this difficult time and afterward as you grieve and relive this experience.
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I forgot to add that I am an RN and clinical ethicist who has been at the bedside working with many dying patients, clinicians, and families.
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cherokeegrrl54 Jul 2019
Thank you for your wise words...
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This is what I would want. You are an angel to see her through.

Follow all her directions. If she changes her mind, follow her new directions.

How amazing it is that you give her both choice, then respect that choice.
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She has dictated her wishes and you must respect them as difficult as that is.
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Thank you for sharing your heartfelt story with us. I think you did the right thing, but I understand why you might feel some guilt over it. Guilt on its own doesn't mean you did anything wrong. It is just a feeling. Seek out supportive people and give yourself as much time to grieve as you need.
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Sounds like she is near the end / with or without drugs it is never easy but you’re doing a most remarkable job - Bless you
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I would suggest that you seek out what's called a 'transitional counselor' to help you through this process. You can go through Elder Options Agency or if on military the VA.
I never heard of no morphine drip so that's why I suggested that type of counselor, my counselor has been through a lot if what we're going through and if she doesn't gave an answer she'll try to point you in the correct pathway. She will also help you with the transition/grieving process.
I hope this helps, other than the non morphine drip we are going through similar things. If you are a church goer or believe in a higher power seek them out for support believe me it helps.
Krep us posted.
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What a horrible situation you certainly have had more then your share of grueling caregiving. My mother passed away last week after a five-year battle with cancer she hated taking the chemo but It did help for a while. She wanted in home hospice which we were able to accomplish very well however she became bitter when I needed to give her medications she was a woman who didn’t even like to take aspirin. The one thing she wanted me to promise was to keep her pain-free. because we did not stay on top of the medication schedule she did experience an unfortunate amount of pain especially in her legs. What really helped the most I think was the Ativan the anti-anxiety medication it helped her to relax and be in a better peace with the whole situation. Then I was able to get the morphine at a regular level and she was comfortable and finalize the way after nearly a week of a coma like state. It was sweet relief when she took her last breath but I miss her so much then again I was really missing her for the past several months as she was not herself.
Stay strong! There is an end in sight and you will have your freedom back soon knowing you did your very best. Blessings to you both !
katlew23
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Thank you so much for being an angel to your loved one until the day she crossed over. I sincerely hope someone will follow my wishes as you followed hers. The way I see it if one is not willing to follow the final wishes of a loved one do not accept the role of POA, caregiver, decision maker, etc. It is not ethically right to give them the exact opposite of what they have entrusted one to do. I am my husbands caregiver,,12 years of living with Parkinson's and although my heart may be breaking as he passes, if the time comes and he needs me to honor his final requests you can best believe I am going to no matter what my personal feelings/struggles with it may be. It is my last gift of love to him. May you find great comfort and peace in knowing you honored your aunt's request.
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sunshinelife Aug 2019
This neice was wanting to have her on morphine...against her clear & specific written wishes.
Lucky for Aunty that she had the foresight to draw up a legal DNA & other documentation...clearly the niece was hesitant to go against it...for fear of legal ramifications.
Just as I thought, niece is the executor of the will...you can do the math
I always expect and hope for the best from people...and know that there are altruistic people...though few & far between
Do learn from this and make sure you record ALL your requirements, wishes legally. And ensure that whoever is going to be involved in the care of your husband...and yourself....when it comes time to cross over...will do exactly what YOU request....Not park you in a hospice on narcotics when they grow tired of you
Even if he can't express it well, I am certain your husband knows everything you do for him, and is deeply grateful
Although we want the people/soul we love to stay close with us forever...there comes a time when their body is a prison for them...and they are holding on and suffering terribley....just for us
I know its okay to let them go...tell them we will be okay...for death is but a thin veil. And sooner or later, we will be together again
"love is never separated from itself for long"
Lord Byron
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It has been about a week since my aunt passed away and I was just now able to read all of the comments. First, I want to thank everyone for the praise, kind words, and helpful advice. I'd also like to address a couple of things that I think I didn't express well before.

Regarding Hospice care: My aunt first became ill in 2014. In May of 2016 she was sent home from the hospital on Hospice care. We were provided supplies, oxygen, etc. to make her comfortable as she was only expected to live a few months. However, we live near a major city and our Hospice is severely under staffed. Our head nurse was aggressive, belligerent, and pressured my Aunt - who was alert, not having trouble breathing, and not in pain - to take large doses of morphine and Atavan. She refused. The nurse became verbally abusive toward both of us and threatened to take away the oxygen concentrator. Fortunately, I had quietly arranged private payment the day before and we kept it. It was just a bad experience throughout. That, combined with my aunt's fear of strangers due to a violent home invasion thirty years prior, caused her to be horribly fearful of strangers in the house and I didn't want her traumatized. My comments were in no way a blanket criticism of Hospice, however. I think they have their time and place.

A second issue throughout our journey was my complete lack of any medical training whatsoever. Although I had cared for my Dad throughout a series of strokes that began when I was 21 and ended with his death ten years later, and cared for my Mom during her cancer until she passed when I was 38, I had severely overestimated my ability to learn new things. I made mistakes. That's why I give myself an A for tenacity and a B for everything else. I learned as I went, watching You Tube videos, receiving instruction from a nurse friend, and reading online. I jokingly called myself Dr. Google. I don't regret doing this for her. But I wouldn't do it again without some proper training.

The day after she died I hit the ground running, preparing to execute her will. I'm still going. It keeps me from crying too much because I miss her terribly but am so grateful she's at peace. Thank you again for all the responses, they were comforting to read this morning. Wishing you all love, faith, strength, and support on your own journeys. ❤
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Myownlife Jul 2019
Joy, I wish for you happiness and care for yourself. Keeping busy has always been my best way for coping with different difficulties in my life. I'm so sorry for the bad experiences with Hospice. I have only used them personally once in my life when my husband was terminal years ago. Unfortunately, we didn't get them in until the very end, because nurse or not, I just didn't know. The day they came in was the day he died, and all I remember of her was her being hyper, and hyper vigilant, and removing all the morphine suppositories ( I guess other meds... but I only remember that) and her being "paranoid/angry/yelling"... this was over 20 years ago. I now assume she must have thought my children and I would use them. I was so traumatized by losing my husband let alone her behavior... I never thought to call Hospice and report the bad experience. Looking back I even wonder if she may have taken them for herself.

But now, stay busy, focused and then allow yourself some time to grieve and then busy yourself again as it takes a long time to completely recover.
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It's good to honor your aunt by caring for her, but I would draw a line at the abusive behavior & start giving her low dose valium regardless. (Just 'taking the edge off' is not disrespecting her, but it's respecting yourself. (Adjust accordingly as situation requires). Best wishes.
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Just read that your aunt passed, sorry for her suffering, & yours. Keeping busy has helped me also, but it gets lonely when the work is done. I hope we can each find something meaningful to occupy our talents, when the time is right. God bless.
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I found out the hard way, hospice would not give mom the liquid morphine so it was up to me to end mom. Nurse told me if she feels bad, just crush a morphine pill like so and rub it in her checks. Every Hour. So I was up all night every hour crushing dry pills into her cheeks as she is spewing stuff out of nose and mouth. I called hopsice again, and my angel answered me. He came over around 7, a bit late, but very happy to see someone who knows what they are doing. He told be to grab the ativan in the ER BOX in frigerator... really? didn't know it was there.Anyway, he cleaned her up, turned her to her side to be most comfortable and the ativan calmed her brain so she could relax and drift to heaven. Hope you get a nice angel who knows what to do and how to do it. The first Gal didn't want to be there, so she turned away and said she's fine... A book Im reading now: The Wisdom OF FORGIVENESS. Its a good book and a good read. I highly suggest renting it att he library.

Question did hospice offer you morphine and ativan? Liquid or pill? Maybe you mom doesn't want to be pricked.maybe you can give morphie and ativan in a pudding spoon or something.Talk to your hopice people. Mom suffered, and she suffered worse because that nurse didn't want to stick around. Im really an big authority on this... I didn't even know that lady. I asked where my team was. When the time gets closer you will want YOUR HOSPICE TEAM at your beck and call because they know YOU AND YOUR MOM. You don't have to be drugged out of your gourd at hospital.. HOspice will set up in your home so Mom can be at mom peacefully - hopefully..
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Ok, make it fun when you see her. Play her favorite music, bring her favorite food, talk with her, ask her childhood, what did she like the best? What about boyfriends, or the sneakiest thing you ever did? or the funnies prank you did to your friend. Where did she work, did she want to work, and how did she meet her hubby? How did he propose, were you surprised? happy> How did her mom and dad feel about it? Was it a big wedding? Make it fun, bring little jello pops or pudding, if she changes her mind you can crush 1/2 pill and let it glide down with tbe puddiing if she agrees. MORPHIINE for PAIN, ATIVAN for BRAIN pain, it separates the brain from the body sortof... kinds of what I saw with mom.
REad to her. Readers Digest or magazine with small articles, not too long. Church? have the minister,rabi, or whomever come in and talk a bit.They are hired with hospice to do that too.They will talk with her and you, and try to ease the tension in the room.
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Now I feel very bad. I haven't been on here for a while and didn't read the other notes. I am sorry for your loss . She is in a better place.
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I’m glad your aunt is at peace and that you are no longer going through that hard time. I do hope you’ve slowed to a trot now and have let the natural grieving process start working. It’s rough, but there are wonderful memories, once you reach the point of remembering those without tears,
Take care of yourself, and be kind to yourself during the process, you are important too.
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