Thank you taking the time to share the story. You make a good point about your view. It is important to keep in mind that there are many stories out there that talk about how indispensable hospice services were for them in their time of need.
I agree with you. When I would admit a patient I would make sure the patient and family understand...Many time a patient in active stage of dying would require more meds. Found Morphine than would be given to a person that was dying. I would explain to them... yes..the morphine MAY shorten life just little. That's not the goal of Hospicr. I would ask them when the time came..... did they want the to pass moaning and be in evident pain and live 7 more days as opposed to maybe 5 daya and pass comfortable. ALL, yes I say all of patients as well as the families, would choose the latter. Many times their fear was they would be in agonizing pain. I assured them the choice was theirs and I would support them in whatever decision they might make. Also they could change their minds as the time to their passing. Their last memories of loved one was GOOD ONES, if that is possible. The patient would thank me, know they wouldn't die in pain. I also would try and answer any questions that friends would tell them. Some had been told.. when hopspice comes in ... will not be long before they kill them. All my families thanked me for helping them during this time and assuring their loved one not in pain. Can't imagine the feekings they would have if patient died and they witnessed them in horrible pain. My son passed in 1/98 . Did not have hospice, but after woring as a hospice nurse.. sure wish I had. We were there 13mos. afterwards to offer support after anniversary of 1 year of their death. Madlyn
hospice is for the dying and since they have lots of experience at it; I think it should be left to family and dr.s at hospice and if speeding up death seems terrible then what does keeping a dying person alive to suffer mean.
no one works there because they like to kill old or sick and for any amateurs to the process to come along and cry foul; well they should just keep the old folks in their own home and see how well that works.
Hospice is a great thing and does not need to be scrutinized by those not involved.
My mother died on January 29th , 2015. Her vital signs were strong, she had been complaining of pain in the bladder area. The doctors at the nursing home where she had lived for 1 year and 8 months claimed that they could not find a cause for the pain. In the 6 months before her death she had become disruptive, often crying out and screaming. The nursing home could not control her and threatened us 3 times in the month before she died that we would have to find another place for her. Because of the notes in her file, no one would take her. A supervising nurse suggested that Hospice come in to assist with the pain she was experiencing. We agreed since she was in experiencing intermittent pain. We were told by the Hospice nurse that she was being administered the lowest dosage of Morphine .05 milligrams. After several days she became un responsive, when we asked the same nursing home supervisor about the low dosage, we were advised , yes it is .05 milligrams of Morphine but every 4 hours. We were never advised about the dosage being more than one a day and asked that it be administered as need for pain. The morphine was adjusted AS Needed , determined by Hospice. She died in less than 2 weeks.
I'm sorry for your loss. I have worked in Hospice for several years now and I stay in the field because I truly believe in the work we are doing and the relief we provide patients and families. We do not believe in accelerating death, we only want the patient to transition peacefully with as little pain/discomfort as possible. As far as the Morphine goes, a dose of 5 mg (.05 mg is not a usual starting dose and wouldn't provide any therapeutic benefit as this is too low) every 4 hours would not cause death in an otherwise healthy, or even less than healthy individual. It was likely that your mother's hospice scheduled the medication to better control the pain as studies show that pain medication is much more effective in controlling chronic pain when given ATC (around the clock), and she probably was continuing to experience pain episodes with her medication given on an as needed basis. I do believe they should've informed the family or POA (if that is you) prior to making changes as I do with all my patients. As far as Morphine goes, I have a patient with chronic pain who received Morphine 10 mg appx every 2 hours along with long acting MS Contin (morphine) 30 mg twice daily and Fentanyl patch 50 mcg every 72 hours, he has been receiving this for months. People become tolerant quickly to Morphine and a low dose of 5 mg every 4 hours wouldn't have caused death to your mother
Thanks for your input. I don't believe Sad is currently active. Many ppl come and go quickly from this forum, indeed from many of MedHelp's forums.
I too have worked in Hospice. My dad recieved Hospice in my home the last 8-9 months of his life. The care, love and support was more than impressive. They will be forever in my heart.
My mom received Hospice Care in a hospital setting a year ago. There was no time to move her. I saw a huge difference in the nurses and care. One hospital nurse refused to followed the physician ordered medication protocol saying, "I'm not Kevorkian." My mom suffered more than need be initially. Thankfully all we children and her physician fought for her right to die in peace and dignity as she requested.
Ppl fear Hospice unnecessarily. I've not witnessed nor heard first hand of Hospice "killing" anyone, though sadly that is the public's general opinion. We need more education. Ppl have actually been on Hospice for several years, or come on and off Hospice. Unbelievably I've known of ppl that actually improved and no longer required Hospice, rare yes but it can happen.
Death is difficult. It's often easier to blame someone or something else for a loved one's death than to accept the facts. We all die and often too early for the loved ones we leave behind.
Thank you for the work you do. Good Hospice staff have a gift! I'm so glad they share it.
I don't know if you are still monitoring this site - but I feel compelled to respond to your comments.
You apparently have a rare bad experience with Hospice or are misinformed on the subject. I'm sorry for you.
Hospice does not "kill" ppl. The Hospice client makes the choices from day one of admission - or even before in writing. Hospitals, Clinics,Physicians, Attorneys and so forth ask today that you put your last wishes in legal form. This is encouraged at any age. The general public just doesn't seem to know the true function of Hospice.
The patient - or the person the patient chose as his/her POA of health care make all the decisions - not Hospice, not even the attending physician. At any time you may leave Hospice and seek care at a hospital... including right up to your final day(s).
You may chose the medications you want or don't want - initially and at any time. My father did not want Morphine and never received it. Morphine did not address his pain. I refused other offered medications for him in the final 2 days of his life - meds that I knew my father would not have agreed to. No one pressured him or me. It was his way - and his way alone. That's true for everyone in Hospice. I've seen other patients chose morphine to ease their pain. We're all different as to what best treats our pain.
To suggest that siblings or children place loved ones in Hospice to hasten their death because they have busy lives is absolutely ridiculous - and far from the truth and cruel.
Hospice is an extension of Home Health. There is criteria for both programs. Yes private insurances and Medicare dictate what they will pay for and what they won't - as it has been since Medicare and Insurances began. It's true when you are young and basically healthy and it's true when you are in your final months and days of life.
The fact is we all die. When my time comes - unless it's sudden - I have already chosen to have Hospice Care.
I watched my mother who had Alzheimer passed while in hospice. The medications that we allowed them to give my mother is what killed her after 2 weeks. My mother was up walking around and talking and eating chocolate her favorite. The hospice nurse was very aggressive and kept pushing the meds. One med would cause her to act out and another med was given to calm her down from the original med. I have to live with this every day because I was at fault and didn't protect her. My father is now terminal and in hospice and I fight them everyday because of all the meds they want to give him. He is now in the hospital and I doubt he will go back immediately on hospice. The hospice nurse actually got angry because we called 911 to get help for my dad. There is something called Pallative Care that might help before you try hospice, talk to your drs about it and maybe it will help you. Just remember its your responsibility to protect your loved ones. I do believe hospice takes their lives before its there time, we do not have that right to take any ones life.
I am so sorry I did not see your post earlier - more than that I'm sorry for your mom's passing. I lost my mom a year ago. It still hurts deeply. Please my dear don't hold this guilt. Her passing is not your fault.
Hospice medical professionals did what your mother's physician directed them to do. Hospice does not prescribe meds. It's illegal for anyone but a physician (or N.P. - P.A. under a Physician direction) to prescribe meds - so talk to the physician that ordered (orders) them for your loved one.
I can't speak specifically about your mom as I don't know what medications were ordered - or what if any medical condition she may have had besides Alzheimers. I have not know of anyone being placed in Hospice due to a diagnosis of Alzheimers alone. I'm not saying it doesn't happen - I just have not heard of it.
Yes there is a difference between a Hospice and Palliative Care Programs. A few of the differences are where Care occurs. Hospice is an all inclusive generally at home program - Palliative Care is usually in a hospital, long term care facility or it may be in the home too, it is not all inclusive. The differences can be slight or not-so-slight, depending on the person's wishes and prognosis.
This site may benefit from a better explanation in another thread. Those who are interested should do their homework. There are advantages and disadvantages to both programs.
Teri I am so sorry about your mom. I really don't believe that Hospice "kills" anyone. Do mistakes happen when a patient reacts poorly to medications, certainly - but they happen in the hospital, in clinics and in a Palliative Care Program. You are not responsible for your mom's passing. Please don't carry this burden on your shoulders. You did exactly what most of us would have done, you trusted her doctor to call the shots. We do that because they are - or should be the experts.
My heart goes out to you. I carry guilt with my parent's passing, we all try to guilt ourselves - but it's not your fault anymore than it's my fault.
Bless you sweetie. Talk to your minister - or someone that will have some insight for you.
I'm sorry for your loss, and the loss of others who have posted. However, I am currently sitting in the hospice room with my grandmother who has been in nothing but pain for the past two weeks. She has not had nutrition or liquids for over a week and is still in pain. I actually keep thinking that our hospice nurses cannot give us enough morphine. She is still in obvious pain and the morphine doesn't seem to be doing a damn thing to make her comfortable. Our nurses keep saying things like "morphine overdose" "morphine poisoning" and all I can think it, does that really matter? We are in hospice because we know that death is near, we are sitting here waiting for it, and waiting for her pain to end, for some relief and comfort and it still never comes. At this point an overdose seems almost more humane than sitting here and watching her suffer day after day.
You cannot get mad at nurses for doing their job, and it was not the medication that killed them in the end. You were in hospice because you knew that death was near, and the morphine and other various drugs are the help the transition without pain. In the case of my grandmother she is still in tremendous amounts of pain and with the amount of morphine and no other nutrition or fluids going in it is truly a wonder how she can still hold on like she has.
Oh my dear - my heart goes out to you. I feel your pain as I have sat where you are sitting. It's more than difficult.
I thank you for taking the time - at this point in your life - to share your comments and thoughts with us. I agree 100%.
There are medications that can be given along side the morphine to reduce your grandmother's pain. I hope that will be considered. It's so sad that the nurses are concerned with morphine overdose at this point. No one should have to suffer needlessly.- especially in their final days on this earth.
God be with you - and your grandmother and family.
Gentle (((HUGS))) to you,
My friend had terminal Cancer. We knew the cancer would kill her.
A couple of months ago, she was convinced by the Dr's and nurses to allow hospice to take care of her because of the high doses of meds she was already receiving. (That were working.) They assured her this would her to access the meds faster.
Hospice came in and refused the meds that worked and prescribed meds that were cheaper but less effective.
The nurse then suggested she allow her to pick a scab that would cause her to bleed out. Was told it would take about 3 hours, but the nurse promised to help her through it. That Hospice organization was fired on the spot.
Thursday they convinced her to try another hospice company. It's Saturday and she's died this morning.
My friend NEVER signed a DNR because she wanted to be resuscitated. She just wanted pain management. She stopped chemo. But she was still fighting to live as long as she could.
She asked for a hemoglobin count before she left the hospital to make sure her blood count was high enough. She was refused. Hospice wouldn't allow it.
She should have just turned around then and said she wasn't leaving the hospital. But she wanted the weekend with her 11 year old daughter.
She planned to fire hospice on Monday and go back to the hospital. But she had a fever on Friday night. Hospice didn't even want her getting water. Didn't want anything that would bring her fever down. The ambulance was called. But they wouldn't take her cause she was on hospice. And by that time she was too incoherent to fire them. She died hours later
Hospice may be great if you are ready to die and just waiting to go. But if you are trying to live as long as you can but need high doses of pain meds, hospice is NOT the answer.