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Morphine

My sister recently placed my mom in hospice house. I do not agree on what the are doing. My mom has cancer and she wants to fight to the very end.  My brother and I were going in and feeding her. I couldn'lt figure out why they would not give her anything to eat or drink. Now I know. Hospice intententionall dehydrates you and gives you more and more morphine to move along your death.  This is suicide.  The mom now is comatose from the morphine. If I can get her out of there, is it too late to reverse the effects of the morphine. My sister is power of attorney. Everytime she cried, they gave her morphine. She would tell them that she wasnt in pain. She was dep. about being there. They made her take it.  This has been so devastating to watch. My mom is a fighter but they are forcing her to give up.  Such a shame!

ary


This discussion is related to Opioid induced Central Sleep Apnea.
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2107676_tn?1388977459
We had my sister at home and they put in a catheter type thing into her vein so we could inject the morphine into it.  There are also morphine pills that you could give your mom to keep her comfortable but also not enough to keep her sleeping and in a stupor like they make patients in the hospitals.  I know you certainly don't want her to suffer at all and I agree that they can sometimes give way too much to patients in the hospital.  If you have a doctor on your side who is willing to work with you so you can take your mom home and look after her it is definitely doable.  We also had a nurse that would come to the house and check on her.  It was a lot of work but so worth it to have her at home until it was time for her to go into the hospital.  You really need to find out how far the cancer has progressed and hopefully she can come around and spend more time with her family.
God bless and let us know how she is doing.
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Avatar_f_tn
I used to be a hospice nurse so I can tell you from experience that hospice does not intentionally starve or dehydrate you to end your life sooner. When you get to the end stages of life your body doesn't need food and giving it food will actually speed up death. Do some research on it and you'll see what I'm talking about. And morphine is a wonderful drug for people at the end of life. I understand your concern as I had many families with the same questions that you do and have the same believe. But I can promise you that but not the way that it is when you were dying your body does not need or want food and it will kill you. I had patients that the family would demand that we feed them but they could not eat any food physically because of their symptoms so they would make us put in a feeding tube for the patient even though we told them that it was not good for the patient and it would probably kill them earlier they never wanted to believe us they always thought we were trying to starve their family member. Because we had to listen to them and do what they wanted especially when someone had power of attorney we would go ahead and put in the feeding tube. And within 24 to 40 hours the patient would die. And if we had not put the feeding tube and they may have lived weeks or a few months longer. That is just one of the things that happens at end-of-life your body does not need food. I hope this at least help to comfort you a little bit but as I said I worked as a hospice nurse for a couple years and you're not the only one that had this concern a lot of people thought the same thing. The goal of hospice is not to kill somebody earlier it is to help them die comfortably and with dignity. Just do some research that's all that I ask a lot of people have the opinion about hospice that you have but it is just not correct. I am very sorry that you are going through this and I'm very sorry to hear about your mother.
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2083449_tn?1381358308
Hi Leanne! Thank you for this information and for clarifying! This is something I did not know! When my brother in law passed away, we did have concerns about him being fed! He was at home in Hospice and honestly, the nurses were absolutely wonderful and helped us tremendously! In my opinion, it takes a truly special and unique person to be able to work in hospice! Thank you!

MJ, I'm so very sorry you are having to go through this! I've been there! My thoughts and prayers are with you and your family!
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Avatar_f_tn
Hi there. I am a certified CHAPN RN. Im not sure all that is going on with your mom other than you mentioned that she has cancer. One of the "requirements" for a patient to be placed on hospice is that the doctor has given them a prognosis of 6 months or less to live. Patients are referred to hospice when all measures to cure them has been exhausted and there is nothing left to do. It then becomes about pain and symptom management. At this point there are so many changes that are occuring within the body to prepare for the final stages of life. Patients will become depressed and sleep a lot more, they will stop eating and can even become withdrawn and isolated within themselves. The not eating is really really hard on family members, think about it we were raised that if you ate something you will feel better. That is not necessarily true with a terminal patient. In fact eating can make them very uncomfortable, have gas pains. increase chances of constipation also cause nausea and vomiting and sometimes aspiration can occur. I usually tell my patients to eat if they want to and if not that is OK too. I also stress that with the family members as well-let the patient decide. Several stages occur in end of life you get to a point were the patient is still arousable and able to interact and then they become more unresponsive. They may become restless and try and pick at their clothes and things in the air. They may show some facial grimacing that they are not comfortable and may wiggle around in the bed. Medications may be intitiated at this time to keep the patient calm and comfortable. There is a long standing stigma that morphine is used to kill people and only used for pain. Morphine in terminally ill patients is used more than just for pain. Another us it may be used for is for breathing difficulties. If a patient is working hard to breathe and breathing 20-30 times a minute morphine is given to slow the respirations which in turn relaxes the smooth muscles in the lung and allows better oxygen exchange. It also can be used to decrease restlessness and of course pain management. Alot of times morphine and lorazepam are given together-these medications potentiate each other and the end result is a calm peaceful death. These medications will not kill you. You would have to be giving a whole bottle of morphine or a whole bottle of lorazepam all at once to do harm. Hospice starts at a very low dose and then gradually may increase over time as the patient can become used to the dose and need a stronger one. This is all very normal-to titrate as neeeded to meet patient comfort. Please request a meeting with the hospice staff and you and your family so that you all can be on the same page. Def research dehydration and end of life. Hospice is not about starving someone. I am so sorry that you are going thru all this. Please keep us posted.((hugs))~Bkitty
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3112530_tn?1342559764
I had the experience of putting a veteran to 'sleep' when there was nothing more that could be done for him. He had a history of health problems that eventually severely disabled him and I could no longer take care of him at home. I brought him into the hospital where his doctor was honest with him and explained 'all avenues to improve his health had been tried but that nothing more could be done". The doctor offered a morphine dose that would put the veteran to sleep as a peaceful death. The veteran agreed. I worked at this hospital and was up on the floor constantly to monitor what they did and how they did it. Eventually, his morphine dose was increased until he was sleeping and he eventually responded to the dosage provided. I left the floor to take care of some business and when I had returned, my friend was gone and I advised the nurse. She replied 'I just gave his some ice cream' and was very upset by what had happened. Basically she told me that she gave my friend some ice cream to keep his lips moist and although he was not conscious, he passed away shortly thereafter. This was many years ago.
I also had Hospice at the house for another veteran who was diagnosed with cancer related to Agent Orange. When his cancer returned, it spread to his spinal cord. There was nothing more that could be done. He was given Fentanyl patches for his pain although he did not like the results of this drug. He took his oral morphine which increased as his pain did. He died bravely and peacefully as he told his mother that he was going to go to sleep.
The hospice was a new contract and they were not familiar with the 'rules' of Agent Orange. An autopsy was required by law and this was very difficult for his mother as well as myself. I had some bad experience with this hospice. It took over two hours to get a doctor to confirm this death. Again, the hospice was a new contract and were not familiar with what was required. The nursing staff was great. They explained so much of what was happening due to the drugs that were needed.
In my experience, the nursing staff of any hospital know more than the doctor. They have seen it all and deal with the patient directly and know the patient well. They invest the time to care. Their compassion, knowledge and daily experience of dealing with patients is something that cannot be replaced by anyone. I wish I could say the same for the doctors.
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480448_tn?1403547723
Bkitty and Leanne explained hospice beautifully, and I agree that you should set up a family conference with the hospice staff.  They will listen to your concerns and do what they can to meet your needs, along with your Mom's.

I think, somewhere along the line, you perhaps got confused about the purpose of hospice, as you're talking about wanting your Mom to "fight" til the end.  Like bkitty stated, a person cannot even be admitted to a hospice program unless they are diagnosed by a doctor as being terminally ill, with death being imminent within weeks to (usually 6 months).

If you understand that, then you need to start learning how to gain acceptance that this is the end of your Mother's life, and help her pass with dignity and in comfort, rather than encouraging her to "fight".  Her "fight" is over...it's time to move to the next phase.  I know that's hard,..she's your Mom and you dobn't want to let her go, and you dob't want to feel like you just stood by and did nothing.  Those are common emotions, hon.  The hospice nurses will explain all of that to you.  They are just amazing amazing people.  They have MANY patients, not just one.  They have to comfort and educate the family and friends on top of the patient.  I've had to help many of my patients pass peacefully, and I just can't express in words how invaluable, precious even, that hospice was to me.  Don't be afraid to ask questions, they will guide you through this, I promise.

Hospice does not kill people.  Morphine, when given in a hospice setting does NOT kill people either.  It eases the process.  Also, do some research on what the above girls said about the nutrition and hydration.  If you have ANY questions, write them down, and bring them up at your meeting with the hospice staff.

Prayers for your Mom, that she passes peacefully and pain free, and prayers that you can come to peace with what is happeneing.  God bless you.
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2333944_tn?1342915967
Very well said, Nursegirl.
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