Anyone experienced giving morphine to someone with liver failure?

Hi,
My mother-in-law has declined rapidly with stage four cirrhosis and end-stage liver failure. She was gardening just six weeks ago. Now she is sleeping almost all the time. Doctors turned her over to Hospice and they are very nice. SHe had complained about severe pain, and now she is getting 5mg of morphine every four hours. I want to know how much damage it will do and if it will cause her do die more quickly. We have asked the nurses if she should take it, they say to make sure she isn't in pain. I don't know what's best for her?

[ladybug52]

It's vrery difficult to accept that a person is dying. Trying to prolong her life by denying pain medicine is not in your mother-in-laws best interest. Be thankful that she has hospice and they are keeping her free from pain. Her quality of life would be miserable if they weren't keeping her comfortable. I know she doesn't have much quality of life being asleep, but it's worse to watch someone suffer. Hospice ofers counseling for the family members also, maybe you could look into some grief counseling with them.
Sorry for this difficult time for you.

[Mary Z]

Yes, I do know that she is dying, and watching someone suffer is the WORST feeling. I am VERY grateful for Hospice and their care. I appreciate your help and post. I am trying to help her along with my husband. We really want what's best. Again, I appreciate your post and care. Anyone who can share an experience please post, the experience is so assuring to us when we make these difficult decisions.  

[ladybug52]

I work on the opposite side of Hospice, physical therapy rehab in long term care. I make every effort to help people get better, go home, or at least stay as independent as possible. However, once I know that they aren't a candidate, or they would best be served by comfort measures only, I am happy that there are good hospice services available. It's difficult for me to realize I can't make them better. Sometimes they are only fighting to go on to make their families happy.

The nurses know the correct level of pain medication to administer, you just have to trust that they know what they are doing and are experiencing in dealing with pain management.

I'll shut up for now and hopefully some one else will respond.

[Mary Z]

You are all wonderful to respond to me in such a kind way! I appreciate your time and respect your opinions! I will continue checking on the posts and look forward to learning more!
Maryz

[BRL]

My thoughts and prayers are with you.
We all I think know someone that has been in "hospice" and touched our lives.

Hospice is an extremely wonderful exceptional institution with people that are angels from above.

Again my prayers go out to you and your family members.

[desrt]

Opiates do relatively little harm to the liver. 30 mg over the course of the day sounds like a small amount. I worked with someone with end stage liver disease who took that much to get out of bed in the morning and go to work.
Please know that our thoughts and prayers are with you.

[hightrekker]

Hospice is the place to be at this time. Don't worry about the morphine-- it is very benign to the liver.
I delivered end stage drugs for hospice, and could tell the status of the patient by the doses and medication they were receiving (this was ironic considering I was a former heroin user delivering very large quantities of opiates on a daily basis).
Anyway, hospice contains some of the most compassionate people I have encountered. Eventually, I left the job (I'm a artist, and it was one of many survival strategies), as watching everyone die finally became overwhelming.

[MyDzire]

Yes morphine IS common during this time. They had my husband on a morphine drip pump and also had a button we could push every 15 minutes on top of that to give him added comfort. They also gave him liquid Ativan.
MyDzire

[Mary Z]

Wow...that is amazing. I admire the Hospice nurses and staff. Thank you for sharing your experience with me! It is good to know that she can have the medicine without causing further damage.  

[Lonestar823]

Yes.  Yes, I have experience Mary.  My childhood friend Noah died of liver failure related to Hep C in 2003.  He lived alone under quite desperate circumstances.  I hadn't seen him in over 20 years but we kept in touch through letters.  When he wrote me and confessed he only had a short time left, I left immediately and drove four hours to find him.  He planned to go to a remote beach nearby where he lived and take his own life with the oxycontin and other drugs he was supplied through his free clinc doctors.  He was a Viet Nam veteran awarded a Purple Star among other honors.  Apparently the government had lost his records and he was advised to go to Hospice.  He refused.  I left my home and family and made camp in his tiny trailer where I found him half dead already.  I contacted hospice and they came to me.  They came every day and trained me on giving the morphine injections every four hours 'round the clock.  I, like you wanted to spend more time with him awake but in a very short time I realized how much he needed the morphine.  I could have never bathed, fed him, talked and laughed and brought him out to look at the beautiful constellations in the autumn sky without it.  I'm not sure if it shortened his life but if I thought it stole one hour I would do it all over again.  It made our six short weeks more beautiful and easier to accept.  The last night as I lay beside him on his bed I was panicked but didn't show it.  I only had one injection left and wouldn't have more 'til nine in the morning.  7:16 that morning he turned to me, laid his long bony hand gently on my face and said, Beck, I think we're out of time and then he was gone.  I took a long, long time to remove his hand from my face and call Hospice.  Don't worry about the morphine Mary.  There's not been a day since I haven't thanked God he had it.  Four hours after the little black van came to take him away Noah's phone rang and I answered.  It was the VA saying they'd made a terrible error and that I should get Noah to the VA hospital immediately.  I hung up on them.

[Mary Z]

What a friend to have to come and care for someone like you did. I would like to read more about your time. You should consider writing a journal. I have learned that most people care a LOT about each other, and I am greatful that human nature is mostly kind. I would bet that publishing your story could help others who's records are "lost" due to paper shuffles. In the end though he was probably better off with a caring friend by his side~ God bless you!

[KRO]

I came across this post when I did a search for hospice patients who had recovered from this assumed death sentence.
About four years ago I was put into Hospice care as a result of my liver shutting down because of heavy drinking most of my adult life. I was in a semi-comatose state for about six months. From what I

[nicky58]

Just so that u know, Morphine is metabolised by the liver, and a patient with liver failure will develop toxic levels of Morphine, as it cannot be excreted by the failing liver, very quickly. Perhaps a new form of euthenasia?

[Marcia2202]

This thread is over a year old. I don't think you will get a reply.

[sal717]

To nicky 58,
You may never read this post. Your response however is right on the money. My brother was robbed of a good dying experience by a "compassionate" doctor who prescribed 60 mg of morphine a day when he complained of pain (stage 4 esophagal cancer). What the doc didn't tell him was that the large dose of morphine would speed up his dying process as well ease his pain as his liver was not fully functioning. His hospice nurse explained this. He had his dosage reduced to 2mg a day and added 600 mg of acetametaphin and this controlled his pain quite well. Unfortunately, the excessive dosing of morphine had gone on for weeks before he discovered the full purpose of the docs prescription. Instead of dying as good a death as possible, he spent his final weeks in a zombie-like state, lost all appetite and as a result was in such a weakened state that he had no opportunity to say his good-bye's or make peace with his dying. Easing pain is one thing, speeding up a patients dying process without their permission is quite another.