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Hospice-Morphine-Elderly=Demise
  1. #1
    sandra4453 is offline New Member
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    Default Hospice-Morphine-Elderly=Demise

    I am absolutely certain that my father died because of the medication he was administered by hospice (Vitas). I have been researching continuously since then about the meds, particularly the various forms of morphine he was given and with his medical history, it's clearly outlined that these opioids caused the respitory failure he went into as soon as hospice administered them to him. He was eligible for hospice with the condition, "failure to thrive" and "debility" after breaking his hip in November and had not been successful in rehabilitating as fast as the skilled nursing facility had projected for him. He had suffered a massive stroke 21 years ago, and was left-side paralyzed. His left side always pained him but was managed with over the counter meds as well as prescribed meds. He was just as alert (when he came home) as he had always been until hospice "snowed" him, their term for over-medicating. They were well aware that his respiration would be compromised, had past renal and heart problems which I've since learned was jeopardized as soon as they administered the different morphines and methadone to him. His latest health condition was recorded/documented at the hospital that performed hip surgery from one month prior where they (hospice) collected his medical history from and knew the compromise these meds would place on his condition.

    When he first got home the 2nd week in December, he was prescribed adivan and roxonol (1 mg) which immediately snowed him. We stopped administering and he came to almost 2 days later. Then hospice changed his script and started medicating him with methodone and vicodine. This was not controlling his pain so once again, they wrote a new script for ms contin (15 mg) and adavin. The ms contin was to be given every 12 hours. He was given 2 doses and by the next day, was completely snowed......48 hours later, he began to awake and once again, hospice gave him the ms contin. He never woke from this, began obvious signs of respitory failure and was gone 10 days later.

    Thougts, opinions, insight from anyones knowledge and experience will be greatly welcomed. I didn't hire hospice to push along my fathers demise. I thought I had hired them to offer pain management. I feel responsible for allowing them to continue giving him these drugs.

  2. #2
    makisupa is offline Junior Member
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    I really Don't know what to say? WOW!!!!!!! What a colossal f#$k-up!!! I really hope you can "Snow" them". they deserve to be exposed

  3. #3
    sydbean is offline Member
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    Sandra~ I am so sorry for your loss. I can't imagine the pain and sadness that you are dealing with. I can understand your going over and over in your mind everything that happened and wondering if it could have been different. fearing that maybe you let someone hurt the one you loved...worried you let that happen...

    I know that you are so hurt. Try to remember that figuring out if maybe the nurses gave him a bad combo of drugs isn't going to lessen your pain or obviously it won't bring him back.

    The best thing for you to do at this point would probably be to allow yourself to grieve your fathers death and celebrate his life with happy family memories and by continuing to love those who are still present in your life. Think about what he would have wanted for you after his passing. I don't think he would want to see you tormented by doubt!

    That all being said if you feel you must get to the bottom of this the first place you should check is the doctor overseeing your fathers care. The nurses were giving your father the medication but they have to be following a doctors orders. They do not actually prescribe the meds. This might ease your mind some to know that. Another thing I wanted you to think about was the fact that Hospice was involved is kind of a red flag. What I mean is that they are very strict about each patient they take on and I know that they are used solely in the interest of helping the patient be as comfortable as they can be and to allow the best support for them as well as their families until they pass on. This is the entire reason that hospice was created. The reason I mention this is it seemed like, from your post, that you might not have really accepted that. That perhaps you were looking for recovery and then rehab etc. From what I understand that is not the purpose of hospice.

    Again, I am very sorry for your loss and I think it is well within your rights to get in touch with the doctor that oversaw your fathers case and sit down with the dr. and go through the details of your fathers care and medication step by step. This may give you some peace of mind!

    Good luck!! I hope that you are able to find peace with your loss and are able to celebrate the life of someone that was obviously very important to you.

    Hugs,
    Syd

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    sandra4453 is offline New Member
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    Dear Syd:

    Whoever you are...thank you so very much for your insight. You write that you can't imagine the pain but these words were spoken from someone who's tapped into exactly what's going on with me. Seeing the underlying emotions that have caused me to channel my thoughts in getting to the bottom of what's happened, is delaying and denying the grieving I'm trying to deal with. Yes, I do fear and terribly regret that I may have let my father down; I didn't protect him.

    I was perplexed when told he was eligible for hospice when he was in rehabilitation. The doctor explained that because he required total assistance, was cause in itself and he had met the eligibility criteria by being so "debilitated." He was not given a terminal diagnosis but explained that anyone considered as debilitated as my father, was considered, terminal. I had private aids for my father (because of the stroke he had) and thought to myself that hospice would be able to assist me with additional care for him. This is why I brought them on board.

    After he became snowed, 8 days after being on hospice, I insisted the doctor come to evaluate him. He had not yet met my father and I needed to know what was going on. He walked in the house and said, "You already know what's going on. Your father's dying." This man had never met my father, had no chart on him beforehand, didn't know anything about him except that the daughter (me) put in a call to him. Again, I was perplexed at how he determined all he had before even entering his room. The doctor who performed surgery didn't give him a prognosis, the doctor at the nursing facility, didn't either. I was told by both though that elders, in particular those with pre-existing conditions have over a 50% fatality rate when they break a hip at this late stage. But from what??????


    quote:Originally posted by sydbean

    The best thing for you to do at this point would probably be to allow yourself to grieve your fathers death and celebrate his life with happy family memories and by continuing to love those who are still present in your life. Think about what he would have wanted for you after his passing. I don't think he would want to see you tormented by doubt!
    Syd, I'm starting to be able to come to terms with all of this and I think that your advice here is exactly what I should be doing. Grieve then celebrate his life. He's going to be receiving full military honors at Arlington National Cemetery (inurnment burial) the end of April. He had 2 purple hearts, bronze and silver stars, good conduct medal. He was in 3 major battles (WWII) including the first wave at Normandy. I think having this as his final resting place will do my heart good. He would feel honored, this I know.

    Thank you Syd...whoever you are. You're a loving person and I'm grateful you bestowed some of your love, my way.

    Love,
    Sandy

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    sydbean is offline Member
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    Sandy,

    I am so glad to hear that you have been able to step back a bit and find some peace with your loss. WOW!! It sounds like your Dad was an amazing man and full military honors at Arlington. How proud you must be!!!

    As for that doctor that came into your home and spoke to you in that manner,unfortunately he is a shining example of exactly what is wrong with the medical community these days. It's one thing when you go into their offices and they treat us that way but to come into YOUR home and behave that way takes some nerve.

    I was thrilled to see you posted after I had and was so happy that you just seemed so much better. Your father sounds like he was an amazing man and I am sure he was proud of you every single day and now again he can look down and see you proudly celbrating the life of a true hero. He will see the honor that you are celebrating with his pasing and he will know that your love for him is never ending, as it should be.

    Good for you!! I know that you still hurt and that your loss is huge but you will go on and you will be okay...and for that I am very grateful!!

    Warmly,
    Syd

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    sydbean is offline Member
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    Wow Vcamo...That is such a sad story. I am not surprised that you received a settlement. It was certainly within reason to expect one. Like you said, of course it won't bring your mother back. I think that you did everything you could have for her and remember those decisions were not yours to make alone. You were strongly influenced by the doctors and nurses as they are supposed to be the ones you can trust under those circumstances. You did the best you could and that is all any of us can do in life. You are not God. If it was her time it was her time. You putting her in hospice or not putting in hospice would not have changed Gods mind whether it was her time to go or not. Try to think of it that way. You are obviously a good person with a loving heart and did everything you felt you could for your Mom. She would hate to know that you still thought about her passing with blame in your heart for yourself. Just know that the biggest favor you could ever do to honor your mother is to accept her passing, release yourself from the guilt and celebrate her life with an open and loving heart.

    ~Syd

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    sandra4453 is offline New Member
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    quote:Originally posted by Vcamo

    While she was in there she was assessed by a Hospice nurse and since she had so many other physical problems they agreed to put her on Hospice.
    This right here, is where and when things went wrong. I too believed whatever the medical community suggested as "right" and didn't question beyond how it all worked and the difference between a hospital giving medical treatment and hospice treating the patient. My father also had so many other medical conditions that had recently been compromised and I was told by the hospice representative that he would receive additional care to what I was already providing for my father, privately. He was being discharged from the nursing facility and I was overwhelmed, knowing that instead of the 2 - 2 hour shifts I had daily for him, he would now need more care. I thought they were going to provide more care, not hasten his demise. When they added additional medication to what he was already receiving (and was working well for him all these years), I stupidly and regrettfully did not question anything. They told me these medications would control his pain and I thought, "great!" He wasn't given a terminal diagnosis except, as the doctor explained it, he was more debilitated now and transferring him from the bed to the wheelchair would be improbable because he wasn't now able to assist in transferring. (The doctor was the one who suggested hospice for him.) They kept him comfortable by "snowing" him, their term for over medicating. He had renal problems, slight heart failure and had been operated on for a hip fracture when a new aide dropped him in November. It took the hospital 6 days to prepare him (working up his platelets, clearing up a UTI, etc.) before he was safe for the surgery. And hospice comes into the picture and they ignore his medical charts and feed him drugs that immediately put him in respiratory distress which caused him to die.

    I am living and suffering with an incredible amount of guilt and regret. I didn't protect my father and because I thought hospice would be a quick cure to my situation and help me in attending to my fathers care, my father died at their hands and I allowed them to cause this. He wanted to live. He lived with an extremely debilitating disease by his stroke 21 years ago and since then, had been severely disabled by the stroke but he managed to find pleasure in life and persevere. And that quickly, hospice comes into his life and robs him of what time he would have had, if they had not entered the picture.

    Vcamo, you did the right thing by calling Paramedics. Paramedics did the wrong thing by their carelessness, not you! You would not have received a settlement if they were not responsible for what happened to your mother. All those "IF'S" that we look back on are definitely bad medicine, for certain.

    Losing my father this way, is gonna eat me up. That's what it feels like now, 2 weeks after him being gone.

    Thank you so much for your post. It shed a lot of light my way.
    [/b][/b]

  8. #8
    jessiegirl is offline New Member
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    Default I just came across your post about your Dad (m)

    I don't know when he passed away and I'm sorry for your loss.

    My Dad passed away on 9/11/07. He was 92. I miss him so much. The reason I'm posting is we had Hospice involved in his last few days. I'm not even sure why now. He was doing OK. He had mild Parkinsons disease for years. Over the summer we realized he needed someone with him almost full time. He had lived alone prior to this. (my mom passed away 4 years ago). My dad had fallen and he was acting odd (some dementia) so we took him to the ER. It turns out he had a bladder infection. They put him on antibiotics but he wasn't happy being in the hospital. He was thin to begin with and lost more weight in the hospital as he was hardly eating and we couldn't be there all the time to make sure he was. He assured us he would begin to eat more and drink more when he got home. He was ambulatory before he went in the hospital but then needed a walker to get around, and once he was home, needed assistance getting to the bathroom. In a few days, needed to sit on the walker and be wheeled in. He became almost skelton like. I can understand why Hospice thougt he was dying but this was a man who was living basically on his own 3 weeks prior! He was agitated at times so they gave him a anti anxiety type drug (very small dose) and 1/2 does of morphine when he seemed to be in pain. My Dad didn't have cancer. He was uncomfortable I think because he was so thin and laying on the hospital bed made him sore. He never had trouble breathing yet he breathing became labored the last few days of his life. My one brother thinks the morphine hastened his death. Like I said he didn't receive that much. My other brother thinks we did the humane thing and let him have peace from his anxiety. I'm in the middle. I didn't want to hasten his death. I feel bad that the last few days with him he was sleeping. I feel bad we didn't push more for rehab. But at 92, he was shutting down(as they said). Was he shutting down? Did he stop eating/drinking b/c he was shutting down or was he shutting down becuase he stopped eating/drinking. He wasn't receiving morphine in the hospital and was hardly eating. He had declined in his eating and drinking over the summer and had lost weight. I doubt he weighed 100 pounds at the end. I feel guilty. I feel remorse. I feel so many things. I miss my Dad.

    Hospice wasn't pushy. I just think they thought my Dad was dying and didn't help reverse that fact.

    I don't even know what I'm saying is making sense. LIke I said, I don't know when your Dad passed away. The sting is very new right now for me.

    Would 2 or 3 small doses of morphine put my Dad into respiratory failure? He received the liquid stuff.

    Thanks,
    Sandy

  9. #9
    mbales5459 is offline Junior Member
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    Default I am sorry for your loss

    I lost my father to cancer under similar circumstances using hospice. I know that everyone wants to blame someone else but I can tell you this, It was your father's time to help people in his next life. Do you realize the percentage of elderly people that die even heathly people that die after breaking a hip or having hip replacement surgery from lung related disease like pnumoneia, its incredibly high. Your father also had other underlying diseases and problems. I am in no way trying to say that hospice wasn't responsible for his death, I can tell you that the medicines they administered to him were in very low doses and were adminstered in the correct time frames and as far as your father being snowed I would guess that the ativan or lorazepam as its more commonly called did that more than the methadone. While methadone can make you relax and sleepy it usually does not cause a "snowed" type response, in fact that medicne is probably one of the safest medicines that he could have recieved. The MS contin was a very low dose and yes it could have made him appear tired and drowsy but unless they gave him more than the doctor ordered I doubt very seriously that your father passed away from any of these medicines. It took me years to get over my fathers death but one day it just hit me like a ton of bricks and I said to myself, If i could have my father out of pain, and be in the best place ever and be the happiest man ever where would I want him to be, that was easy, heaven. Again I am so sorry for your loss, I would like to know exaclty what doses were give to him of each and every medicine but again I highly doubt he passed away from overdosing. can you please let me know all of his meds and what strengths he was given while under hospice care.
    I will say a prayer for you and tell my dad to stop by and say hi to yours!
    Sincerely,
    Mark

  10. #10
    bobbob23 is offline New Member
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    Default Ignorance is sad. hospice + pain management = Dignity.

    As a medical professional I generally find it amusing when people go around spewing ignorant propaganda about medicine that is totally false. People who claim they have the flu when they have the common cold. People who insist they need antibiotics (which only treat BACTIRIA) when what they have is viral. These things are not hurting anyone, there just your way of showing us how ignorant you really are and how unwilling you are to listen to reason.

    THIS IS DIFRENT. you people are scaring people into allowing people who are slowly dieing to suffer unnecessary pain. Thats right DIEING. you can't be on hospice unless it is medically determined that you have LESS THAN 6 MONTHS to live. I understand the suffering of losing someone elderly or terminally ill that is very close to you. My grandmother was slowly dieing of bladder cancer and this ignorant propaganda that you are spreading caused my grandmother undue pain. the care giver didn't want to give my grand mother pain medicine because she thought it would kill her. I was in shock as to where she got this crazy idea. She told me someone else had told her hospice kills old people. I figured it was a isolated or cultural issue and that someone had been confused. Little did I know that there was a whole movement of non medical ill informed propagandists out there.

    You people don't want to let go of the ones you love, I get that. Get over it. death is natural and will happen sooner or later. A person on hospice was put on hospice because they where dieing. If you have never seen someone die you may misunderstand cause and effect.

    The person is on hospice because they will almost defiantly die in less then 6 months and there is NOTHING medicine can do to stop that from happening.

    The person is given pain medicine (morphine) to keep them from suffering and make it easier for them to breath and move. With out it THEY WILL PROBOBLY DIE FASTER.

    Losing the ability to communicate, move and eventually breath are all parts of dieing, the hospice people give the family a book on the stages of death to prepare you, you probably didn't read it.

    denial is part of the coping process. you are stuck in it and that is an unhealthy psychological state. you can not accept that your loved one was going to die no mater what. You can not accept that they are gone.

    Another part of the coping process is ANGER. You need someone to blame. As is the American way as of late i'm sure your thinking you can not only be angry but can also sue someone. get over it. ACCEPT IT, that is the end of the grieving process. You can still be sad you can still miss them as i am saddened and miss my dear grandmother.

    I am grateful that hospice exists to let elderly people die in dignity. listen, they let people die, not cause people to die. the really sad thing is the people who try to keep the terminally ill alive and in pain for long periods of time with no hope. I've seen family's insist on traumatic surgeries that will add maybe days or weeks of painful life to someone that has no hope of even being able to open there eyes and say goodbye. People insisting on tube feeding, colostomy bags and surgical catheters when the persons quality of life will be limited to laying there in pain. they insist on resuscitation of the dead just to watch them die over and over again. this mentality is the real tragedy in geriatric medicine. medicine can do many things but the fountain of youth and immortality are not in its grasp. death happens, accept it.

    I personally am strongly opposed to euthanasia and don't work in hospice. I am a nurse who works with geriatric patients alongside hospice nurses

  11. #11
    MaisieC is offline Senior Member
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    Quote Originally Posted by bobbob23 View Post
    As a medical professional I generally find it amusing when people go around spewing ignorant propaganda about medicine that is totally false. People who claim they have the flu when they have the common cold. People who insist they need antibiotics (which only treat BACTIRIA) when what they have is viral. These things are not hurting anyone, there just your way of showing us how ignorant you really are and how unwilling you are to listen to reason.

    THIS IS DIFRENT. you people are scaring people into allowing people who are slowly dieing to suffer unnecessary pain. Thats right DIEING. you can't be on hospice unless it is medically determined that you have LESS THAN 6 MONTHS to live. I understand the suffering of losing someone elderly or terminally ill that is very close to you. My grandmother was slowly dieing of bladder cancer and this ignorant propaganda that you are spreading caused my grandmother undue pain. the care giver didn't want to give my grand mother pain medicine because she thought it would kill her. I was in shock as to where she got this crazy idea. She told me someone else had told her hospice kills old people. I figured it was a isolated or cultural issue and that someone had been confused. Little did I know that there was a whole movement of non medical ill informed propagandists out there.

    You people don't want to let go of the ones you love, I get that. Get over it. death is natural and will happen sooner or later. A person on hospice was put on hospice because they where dieing. If you have never seen someone die you may misunderstand cause and effect.

    The person is on hospice because they will almost defiantly die in less then 6 months and there is NOTHING medicine can do to stop that from happening.

    The person is given pain medicine (morphine) to keep them from suffering and make it easier for them to breath and move. With out it THEY WILL PROBOBLY DIE FASTER.

    Losing the ability to communicate, move and eventually breath are all parts of dieing, the hospice people give the family a book on the stages of death to prepare you, you probably didn't read it.

    denial is part of the coping process. you are stuck in it and that is an unhealthy psychological state. you can not accept that your loved one was going to die no mater what. You can not accept that they are gone.

    Another part of the coping process is ANGER. You need someone to blame. As is the American way as of late i'm sure your thinking you can not only be angry but can also sue someone. get over it. ACCEPT IT, that is the end of the grieving process. You can still be sad you can still miss them as i am saddened and miss my dear grandmother.

    I am grateful that hospice exists to let elderly people die in dignity. listen, they let people die, not cause people to die. the really sad thing is the people who try to keep the terminally ill alive and in pain for long periods of time with no hope. I've seen family's insist on traumatic surgeries that will add maybe days or weeks of painful life to someone that has no hope of even being able to open there eyes and say goodbye. People insisting on tube feeding, colostomy bags and surgical catheters when the persons quality of life will be limited to laying there in pain. they insist on resuscitation of the dead just to watch them die over and over again. this mentality is the real tragedy in geriatric medicine. medicine can do many things but the fountain of youth and immortality are not in its grasp. death happens, accept it.

    I personally am strongly opposed to euthanasia and don't work in hospice. I am a nurse who works with geriatric patients alongside hospice nurses
    I see your point, but the truth is that it's not as black-and-white as you suggest. You're very quick to come to the conclusion that "you people don't want to let go of the ones you love" and to helpfully suggest "get over it" (do you really work in health care? I guess that's not actually too surprising).

    My mother is in hospice care now; she's in the end stages of Alzheimer's. Personally I am strongly in favor of euthanasia, not in my mother's case but in general. I don't see any reason to prolong a person's suffering. I agree with you that frantic attempts to save a person's life when there is little or no hope are really hideous, and that they're driven by denial.

    I think hospice is a wonderful thing, and I agree that lots of people have trouble with letting their loved ones go. But it's simply disingenuous to pretend that there are not cases where hospice overmedicates or medicates inappropriately, and the result is a hastened end. The fact is that happens sometimes, and I think it's pretty beastly to attack grieving family members who fear that's what happened in their case.

    My mother's caregiver said to me a few months ago that she's worked with hospice organizations that prescribe ativan to patients who are not agitated, in order to hasten the end. She told me that if I wanted to do that with my mom, she'd be willing to administer the medication. It was a discussion over the kitchen table.

    Don't pretend this stuff doesn't happen.

    In a sense it "doesn't matter" because anyone on hospice has a terminal diagnosis anyway. But a hospice assignment doesn't mean a patient is GOING to be dead in six months. My mom's been on hospice for a year. She is dying, but slowly. And hospice is not supposed to be the same as euthanasia. In reality, though, it sometimes is. In my opinion, as I've said above, that's not always bad thing. But when there's lack of clarity on what's being done, I'm not sure that jumping all over the patient's family is very kind or helpful.

  12. #12
    Robert_325 is offline Retired
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    Maisie ... you replied to that much more eloquently than I had intended on doing so thanks. Not only was this person being unkind to a family but it was also pointless as the original poster had only a couple posts 2 1/2 years ago. I doubt they will receive this person's message. Plus this person really has the ass at the United States for some reason and is assuming the original postser is wanting to sue someone! Give me a break! Typical "professional" that has to make a point to validate everything they say with credentials. Just another rant. God bless.
    I am not a dr. My statements are based on years of experience and related education. Consult with the professional of your choice regarding matters of concern.

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    bobbob23 is offline New Member
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    typical, first somone acuses a company of murder by name (lible), uses "their term" which makes no sense, first off if the company said we are going to "snow" him, that means give him so much drugs he's out of it and hopfully dies, most people would object. Second off gives evedence in their own story that it wasnt the morphine that killed him "ten days later" respertory failure from a morphine OD would take minutes not ten days, by ten days it wouldn't be in his system. yet they are confident that was the cause.

    and now you want to bash me and take what I said out of context, typical. grow up. you people are hurting termanaly ill people in more pain than you can possibly imagine. people right now have family members suffering, they went online to find out what these meds are and now are afraid that someone is trying to kill there family members. people in hospice are often so close to the end they cant explain to there family what is going on in there body. all they can do is cry, cringe, and groan. you have their family paralized with fear. ativan is often used to calm and relax patients, not from outbursts and panic atacks but from trembles and anxiety that put added stress on their already stressed body.

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    AzWickedCool is offline Junior Member
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    Don't feed the troll

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    Robert_325 is offline Retired
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    bobbobbobbobob ..... blah blah blah blah blah blah blah blah blah
    I am not a dr. My statements are based on years of experience and related education. Consult with the professional of your choice regarding matters of concern.

  16. #16
    cherry14 is offline Member
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    As another nurse, who does not work exclusively in hospice but has done hospice-nursing for patients in the last stages of life, I will respond simply to clear up some obvious misconceptions about the role of hospice, and what they do....and I believe I can do it without insulting anybody. I haven't looked at the age of the original post, and I really don't care how old it is, at this point.....this thread is at the top, and people are going to read it, making the issues discussed still relevant.

    Hospice does not "snow" patients, or do things with the intent to hasten death. EVER. For the person who said "don't think this doesn't happen"....it doesn't. Period. Plenty of people believe, especially in the South, for whatever reason, that hospice is what kills people, and that couldn't be more wrong. There is a lot of lack of knowledge about the dying process that brings on beliefs like that, though. Yes, the medications that ease both pain and respiratory difficulty CAN hasten death, but that is not why they are given, and that is a calculated risk....the MOST IMPORTANT GOAL is to relieve the patient's pain, and relieve the feeling of "air hunger." Even when the person is no longer responsive, there are non-verbal clues that those symptoms are present. Often, medication is given to prevent those symptoms, because wouldn't you rather err on the side of caution and KNOW your loved one is not in pain? I have, plenty of times, been the one to give that last dose of morphine....was it the last dose of morphine, or simply the act of dying, that resulted in the death? One can never say for sure, but I don't want to have ANYONE die in pain, and that's the point of hospice care.

    Also, in order to be accepted in to a hospice program, there has to be the determination of a less than six months to live prognosis. Obviously this is only a "best guess," some people live beyond that. But, they have what is determined to be a terminal condition of fairly short duration. It does not have to be cancer. Obviously when this is the case, they can go downhill VERY quickly, sometimes in a matter of days. That makes it very easy to blame the meds, but it's not the meds. It's the fact that the patient is dying. Someone mentioned their family member not eating or drinking, and whether that caused them to be unresponsive, or vice versa...when the body is actively dying, it not longer needs food or fluids (eating or drinking, OR IV fluids or tube feedings). That part of the brain shuts off. In fact, GIVING the body fluids makes it think it's drowning, it's physically uncomfortable and is detrimental at that point.

    Again, I realize that the OP is quite old, and while they are not going to see this, perhaps someone else in the same boat will, and I only hope that this can somehow help them understand. I assure you that I, at least, am not a *troll.* Just a (dreaded) healthcare professional well-versed in hospice, who does her best to help every patient die comfortably and with dignity.
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    Robert_325 is offline Retired
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    cherry ..... I have no problem at all with what you've said. I would NOT want my mom to go through unnecessary pain if she were in hospice dying. I would want her as comfortable as possible and that would include the medications required for that to happen.

    My problem was some person coming on here ranting about people in the United States wanting to sue everyone, yelling at family members who were obviously emotionally upset, coming across like everyone on the planet is an idiot except them and other hospice nurses. That was a crock.

    Everyone is entitled to post on this forum. It's not that person's place to determine who has an agenda about suing some dr or anything else. They came on here with their first post ripping someone who posted years ago and bad-mouthing families in general for their ignorance where hospice care is involved. There are lots of people who are NOT healthcare professionals who are still intelligent enough to make informed decisions about medical care for their families that are both living and dying. God bless.
    I am not a dr. My statements are based on years of experience and related education. Consult with the professional of your choice regarding matters of concern.

  18. #18
    cherry14 is offline Member
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    I do agree with you Robert, that person obviously said some things that obviously were out of line. Somewhere in there, though, WERE some truths (regarding requirements to be admitted to hospice, etc), which is why I wanted to post it a little differently. There also were some pretty glaring misunderstandings in the OP (even though it's old) that other readers could still benefit about learning a little about. That's all.

    I certainly don't think someone has to work in healthcare to have the ability to see a situation or make decisions, but I know with hospice in particular there ARE a lot of myths and misunderstandings. A good friend of mine went to another state to take care of her dying aunt, and the family that lived there referred to hospice as the "black angel of death" or something like that (can't remember exactly). They really did believe that hospice comes in and kills people, and that belief is unfortunately pretty widespread. She had to do a LOT of explaining and teaching about what hospice actually is and does. I only figured I'd post on the topic since it had been resurrected by someone that decided to come out with guns blazing; and be a voice of reason rather than condescension.

  19. #19
    Freedom4me is offline Advanced Member
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    Cherry,
    Thank you for your post. It was very well written and informative and I believe will give great comfort to many people who have had hospice care for family members, myself being one. You are obviously a very well educated and caring individual without an agenda. Very refreshing. Thank you again for taking the time. It made my day.

  20. #20
    AzWickedCool is offline Junior Member
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    Quote Originally Posted by cherry14 View Post
    I do agree with you Robert, that person obviously said some things that obviously were out of line. Somewhere in there, though, WERE some truths (regarding requirements to be admitted to hospice, etc), which is why I wanted to post it a little differently. There also were some pretty glaring misunderstandings in the OP (even though it's old) that other readers could still benefit about learning a little about. That's all.

    I certainly don't think someone has to work in healthcare to have the ability to see a situation or make decisions, but I know with hospice in particular there ARE a lot of myths and misunderstandings. A good friend of mine went to another state to take care of her dying aunt, and the family that lived there referred to hospice as the "black angel of death" or something like that (can't remember exactly). They really did believe that hospice comes in and kills people, and that belief is unfortunately pretty widespread. She had to do a LOT of explaining and teaching about what hospice actually is and does. I only figured I'd post on the topic since it had been resurrected by someone that decided to come out with guns blazing; and be a voice of reason rather than condescension.
    Hi Cherry,

    The person was called out as a troll. They posted on a thread that was dead for almost 2 years just looking to start a fight. The fact the person used some truths in their statement was for validation of what they said. Basically just a bully and to stir the pot. There are 100s of better places to make that argument and to be able to get a point accross to a larger audience. There was no point to that post. After spewing out a bunchof rubbish, they then turn around and cry poor me... Although the post was about hospice, it had nothing to do with hospice. Sometimes google is a door for trolls.

    Note: I am a supporter of Hospice of the Valley here.

    Just my take
    Pure Rubbish

  21. #21
    cherry14 is offline Member
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    Quote Originally Posted by AzWickedCool View Post
    Hi Cherry,

    The person was called out as a troll. They posted on a thread that was dead for almost 2 years just looking to start a fight. The fact the person used some truths in their statement was for validation of what they said. Basically just a bully and to stir the pot. There are 100s of better places to make that argument and to be able to get a point accross to a larger audience. There was no point to that post. After spewing out a bunchof rubbish, they then turn around and cry poor me... Although the post was about hospice, it had nothing to do with hospice. Sometimes google is a door for trolls.

    Note: I am a supporter of Hospice of the Valley here.

    Just my take
    Pure Rubbish
    No I do understand AZ. But, when someone, troll or not, uses the "I'm a healthcare professional" angle TO spew a bunch of rubbish, that's what I take offense to, so I can't help but correct the wrongs in that, KWIM? Gives any of us a bad name when people do that. I maybe should have left it alone, sorry.

    Freedom, thank you.

  22. #22
    sparkman05 is offline New Member
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    Default Possible Hospice Euthensia

    I had a relative pass away last night, who had been ill for some time. After being discharged from the hospital on Friday, with Oxygen in tow, Hospice was called. Hospice came yesterday afternoon to do their initial evaluation. They decided during the evaluation that the relative was still in pain, so ordered pain meds. The pain medications given were 1 ml morphine & 1/2 ml antivan at 4:10 pm, 4:30 pm, and 4:50 p.m. At 6:15 pm, my relative was deceased. This was totally unexpected by out family, though will did expect that this would occur within the next week, according to the guidlines of the booklet that Hospice had given us that afternoon.

    Somehow in the back of our minds, this seems like euthenasia.

  23. #23
    Anonymous Guest

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    firstly let me express my condolences on your loss. how sad.

    from my experience with seeing my uncle die, in the end, the pain outweighs the worry of giving them too much drugs, often it is classed as pnuemonia when a cancer patient dies for instance, but really it was the cancer. its all the other complications that get mixed up.
    maybe this is a blessing, as your loved one did not have to suffer many more days in pain,
    i also know a close friend, who was dying in the hospital, and in pain, they virtually said to his wife, he is in pain, but theres a good chance if we give him any more pain releif, he may not wake up.
    he didnt. but he was no longer suffering either.
    its so hard to know, i feel for you. i was nearly prepared to give my uncle too much one time, just so he didnt have to be suffering any more. its seems so unfair, and at times like that i wonder where god is.

    it sounds like your loved one had very little time to go, and making sure they were pain free is one of the main objectives of the hospice as well.
    please take comfort in that fact, no pain, think about it.

    i wish you all the best during this time
    cheeky

  24. #24
    doc.rose is offline Advanced Member
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    Let me first say how sorry I am for your loss. Second, you don't want them to live for weeks once they are suffering like this. Is your family member would have lived for 2 weeks, they would have been in the most horific pain. Pain you cant even imagine. Be thankful that they were spared any further pain and suffering. My mother in law passed away the day after hospice came also. It wasn't euthanasia, just their body shutting down.

  25. #25
    newyorkgal is offline Platinum Member
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    Both of my parents passed away while under the care of the kind people at hospice. I am grateful to them forever. The rule as I remember it in fla. is you had to have a diagnosis of 6 months or less, you had to know you were dying and you had to be done with any medication that might prolong life. The main concern of hospice is comfort. While it might look like the medication is hastening one's death (and it very well might be the case to a degree), the patients are dying anyway, no mistake about that. Hospice could not afford to treat people who were just being rehabbed. Hospice has a specific purpose and it is to make a terribly painful situation much more manageable. I know if it were a loved one of mine or me, I would want whatever meds possible to control pain at that time. In this country, we don't accept death and want to keep people alive longer than what's natural. It's out of control, the steps they'll go to to delay the enevitable. Death is as natural as life. Pain management and comfort should be the number one priority at the end.

  26. #26
    PeterRabbit2 is offline Senior Member
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    Yeah, my dad died a very peaceful death because of hospice care. Without the morphine, he may have lived another couple of days. (It put him into heavy sedation and probably exacerbated his inability to cough and clear his lungs.) He was dying painfully until he looked me in the eye and asked for his priest to give Last Rites; after that, we called hospice. His pain was no more.
    Last edited by PeterRabbit2; 03-10-2010 at 09:16 PM.

  27. #27
    fauxpaintlady is offline New Member
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    Default My Dad in Hospice

    My Dad had home health nurses coming to his home 3 times a week to bath, check blood pressure and do PK test as it was very taxing for him to go to the many dr. appts each week. He always was a very hard worker and used Celebrex and other similar pain medication. In time I believe that these meds caused three strokes in approx 8 years. As a result of one of the strokes he was started on blood thinners. While in the hospital he started to bleed uncontrollably and was rushed into surgery where he was given 16 pts pf blood. An undiagnosed ulcer on an artery in his stomach started to hemmorage from the blood thinners. He lost about a third of his stomach in that surgery. He recovered physically from each stroke. The effect was loss of memory. As an avid Mr. Fixit this was frustrating to him. He is one who is always in good humor and laughs readily and doesn't complain. He has been getting along pretty well. He is 81 yrs old. This past November he fell and injured the bursa sac in his knee and was bedridden for approx. 2 months. The pain was very intense. When the pain subsided, he able to be mobile again. He has a pacemaker, and his kidneys are in a weakend state. A shunt was installed approx 4yrs. ago in his arm in preparation for dialysis which was never needed. Home health came in so that he didn't have to make so many trips to doctors to simply get test results. Approx. a month or so ago the home health nurse made a recommendation that my Dad go into hospice care as he needed more than she was able to offer. The Dr. agreed and my Dad is now in hospice care. He did not have a terminal diagnosis. Hospice brought in all of their parafinalia and would check on him approx. 3 times a week or as needed. It is very visiable to me that since hospice is involved, he is going down extremely quickly. He is now bedridden, but has good days and bad days. My concern and the main reason for my writing is morphine and atavan useage. I only know morphine as a painkiller. Hospice says it is used to open blood vessels so that he can get more oxygen throughout his body as his heart is weak and cannot pump adequately. Then if he struggles and get agitated to breathe give him the ativan. With the use of these drugs, I see him going down extremely fast. I live out of town and when I go to his home to help take care of him I try to limit the drug use. My Dad is not in pain and the breathing treatments help with his breathing. When he is given the morphine, he falls asleep during chewing his food and I have to keep tapping his arm to wake him up. While I was there he was able to get out of bed and walk around some. He got confident and overdid it a little and was confined to the bed again given morphine again and I see him sleeping the remainder of his life away.
    I'm sorry that this is so long, but I thought that with some of his history, that someone familiar with drugs could possibly tell me of some other drug that could open blood vessels while not contributing to a comatose state. I have as little to do with any drugs as possible so I am not very familiar with them at all. I would be all for morphine if my Dad was in pain, but he isn't. My sister agrees with me that with limited morphine, he is alert and able to talk and visit. I just want to make sure that we are doing the right thing by him. He was always so concerned and helped us throughout our lives that I want to do right by him during the last of his life. If anyone can give me some insight into this I would be eternally grateful. Thanks in advance.

  28. #28
    Robert_325 is offline Retired
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    fauxpaintlady ...... based on your post I am not comfortable with this scene at all. Why is hospice treating him? Hospice is, to the best of my understanding, used for patients who are terminally ill. They have a responsibility to make patients basically comfortable during the last part of their life whether it be six weeks or six months. I think a six month prognosis is about the standard limit for hospice care, but I stand corrected on that. I know though that hospice care isn't designed for treating patients to make them better, it's preperations for their death.

    There are several medications that can be used for dilating blood vessels besides morphine. That doesn't make sense to me. And morphine along with ativan could result in respiratory depression in an elderly person.

    What is his normal blood pressure? Unless he has very LOW blood pressure he could be taking a calcium channel blocker like I take for my illnesses. I have Raynaud's Phenomenon, along with three other autoimmune diseases, and it causes a lack of proper blood flow in my extremities. So I take the calcium channel blocker to dilate the blood vessels then simply take a full 325mg aspirin in lieu of a bonafide blood thinner to help my body with blood flow. There are tons of calcium channel blockers that can be dispensed in low doses in an extended release form causing even less stress to the patient. I wonder if he wouldn't be able to do something similar eliminating drug combos like morphine with ativan, especially for an elderly person with a weakened bodily state to begin with. He has a pacemaker for his heart and is taking med cocktails that could cause undo stress to his heart the way I'm reading this story. Perhaps I am missing something important? Tell me please if that is the case.

    The Celebrex is simply an NSAID medication like Ibuprofen or naproxen (advil or aleve). It can result in heart issues with longterm use. That is why Bextra and Viioxx were removed from the market. Why does he require morphine and ativan when celebrex or other much less potentially compromising meds are available and have been seemingly effective (based on your post) as far as his pain control is concerned. NSAID meds are metabolized in his kidneys so I understand a reluctancy to use them if he has kidney problems.

    I don't like the sound of this whole deal .... if it were my dad I would be demanding some detailed answers. I would carry him over my shoulder to the dr every day before I allowed hospice to prepare him unnecessarily for his death. Am I hearing the entire story? Yes he is 81 and not a kid. But my mom is 82 and acts like a 60 year old at the oldest. Just the fact that hospice is controlling his care is disturbing to me.

    We are on our way to church. Will be gone for a few hours. I will check your thread for more posts when we get home. I'll say a prayer for your dad tonight. Hope this is making you think some about what is going on. God bless.
    I am not a dr. My statements are based on years of experience and related education. Consult with the professional of your choice regarding matters of concern.

  29. #29
    MaisieC is offline Senior Member
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    This sounds very wrong to me, too. My mother died in hospice care last year, and they did a wonderful job. But she was terminally ill. My understanding is that hospice care can ONLY be approved for someone with six months or less life expectancy. It's NOT an alternative to any other kind of nursing care! They do what they do--they provide palliative care for people who are dying, so their deaths will be less uncomfortable.

    If you're sure that your dad doesn't have a terminal diagnosis, then it sounds to me like his doctor was way out of line in approving hospice. I know you live far away, but I think you need to get there and sort things out.

    Take care,
    Maisie

  30. #30
    fauxpaintlady is offline New Member
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    When his doctor ok'd hospice, we agreed, so that he could get the periodic pk checks for the coumadin, blood pressure medication, kidney checks, etc. Maybe we didn't have enough information when we made the decision. I have spent this day informing myself on meds that open blood vessels and I had found info on calcium channel blockers........I just spoke with my siste and he is on Norvasc already. When I was there 2 days ago his blood pressure was high, I believe the # I heard was 184 over 84. My sister was putting out a "dust up" so she couldn't talk for long. She told me that the hospice nurse that she spoke with today said that Dad was not coming out of this......We don't know who to believe, as in the short time that they have been in place we have found numerous errors. No one in our family has had to deal with hospice situation before and we just don't know what the right thing to do is.............

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