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The job of hospice is to help people die. To even qualify for hospice, a patient has to be in their final illness. Hospice has counselors that help family members deal with the dying process, which can be very painful and upsetting, but it's going to happen. Family and friends need to accept that. Putting a person on hospice generally means withdrawing the medications and therapy that is keeping them alive. There is no point in extending the dying process. Let them go.
Yes but they do not have to purposely give them MORPHINE to end it faster!!
I have known several ppl who I think were brought to an end ON PURPOSE using Morphine in Hospice! (They might have come back if not for that)
They're dying (That's LITERALLY why they're in hospice) and they're in pain. Yet you suggest the carers deny them meds and keep them in pain so they can stay alive a little longer? That's horrific and cruel. Thank Jebus I'm not related to you.
We did in house hospice on our patients from time to time at my last job. One in particular still haunts the hell out of me. This poor man had AIDS and was put on hospice. He was sedated and all IV's were pulled out. He lingered and finally starved to death after over 3 weeks later. He was so emaciated and dehydrated that he looked like a mummy. He would open his eyes and look at you during procedures, but it's hard to tell how aware he was. He was "locked in" and there was no way of knowing if he was in pain and how much he suffered.
Yes I've seen mercy killings where so much sedation was given that a patient stopped breathing. I think it was the kindest most humane thing to do. I remember one conversation with a young MD that was distraught because he felt like he did something wrong. The patient wanted it and he helped him pass in a peaceful way. I told him that I hope I find someone as humane when my time comes and I need the suffering to end.
I've also watched this poor woman with end stage cancer on a ventilator who's husband refused to allow any sedation lest it kill her. It was horrifying watching her in so much pain and fluids coming out of both ends. I guess he was hoping for that miracle through prayer that never came. She needlessly died a horrible death.
One of my dear friends was on hospice and wanted to die at home. She was also very afraid that her pain wouldn't be managed adequately. I promised her that I would be at her side every minute. I had oxygen ready to go and the hospice nurse showed me how to over ride the parameters on her morphine pump. I promised her that I would not let her suffer. She agreed and went home. Her death was a good one and her pain was managed well enough. She went peacefully two days after she went home. She was one of the lucky ones and hospice was an amazing experience,
One size does not fit all and I've literally watched hundreds of people die. For those whose deaths are horrible and beyond inhumane I wish for another Dr. Kevorkian. I can not understand the mentality that it's okay to allow someone to suffer and suffer and suffer when one quick shot is all it takes. The outcome will be the same either way. I want the option of being able to choose a fast and painless death. I've said it before and I'll say it again. We are far more humane to suffering animals then we are to suffering humans. WHY?
Hospice workers are a special breed of compassion. Imagine knowing that every single one of your patients are going to die. We as human beings connect and get attached to people, yes even ones that you know are going to die. I still carry a few of my patients deep in my heart that have left the planet. Some of which I have had to terminate life support on. Thankfully most of the nurses I worked with were on top of the sedation, although I've seen a few bad terminal weans. They're not pleasant to watch. It's better to have too much sedation then not enough in my opinion.
Not everyone's cup of tea, but I found it very meaningful. Namely the film version of "The English Patient." The last scene in the film. I would have done the same in his shoes.
Okay so everyone has a pretty positive story here - well heres mine and it is not positive. My FIL(I am now divorced so FIL at the time) was diagnosed with colon cancer which they removed but it spread to his liver a few months later. He was going for chemotherapy treatments but they said his prognosis was not good maybe 6 months to a year. My husband and I lived next to my in laws in smaller home - my husband was their only child and they were very close to us. So my FIL becomes distraught because as a side effect from his treatment he gets the hiccups and can not stop for 4 + days. He decides he wants to just die and my husband has to literally pry the gun from his hands- I call his oncologist to see what we can do with him - he says take him to emergency I will meet there. They admit him and were able to get rid of hiccups immediately - 3 days later they move him to hospice. I did not see him for the first day or so at hospice - mostly because we had a toddler at time and were kind of trying to keep him from this experience. I finally go to hospice and find my FIL in a wheel chair unable to lift his head or speak. I freak out - immediately ask what they are giving him - they tell me and he was getting a large dose of oxycotin (spelling?) for pain several times a day. I asked why he was not in pain he had the hiccups? They can not answer so I was persistent and he was slowly taken off the pain meds and within days was walking and talking and came home within 2 weeks. While he was at hospice I watched them closely and did not like what I saw - which was more than happy people taking care of those who were dying some old and some young BUT they were doing it with such glee and pleasure. Next we were councelled before he came home by the "hospice" staff and he was assigned a nurse and some "bathgirls" to help with grooming. The problem was that he became very anxious and decided he was not ready to die and that he wanted to be here as long as he could be. So they prescribed some different meds for the anxiety and again tried to give him pain meds which he was having pain from the catheter they left on too long in hospice by mistake and so he had a bladder infection that was not going away. When he took the pain meds he got really out of it for days off one dose and it would terrify him- so I went and got him some over the counter meds that helped him with the discomfort. I also had joined an online support group and through them found Century City Hospital in California and they wanted to a CAT scan to see if they could treat him - hospice fought tooth and nail against this and we had to remove him from hospice to get it done. But he had the CAT scan done and the specialists at the hospital which was a team of 20+ kidney and liver specialist said he was not even terminal. He had only a small tumor on liver and that they would be able to remove it - we just had to get him there. The cancer society was told of his situation and offered to pay for airfare and a hotel room until he was in hospital and treated. Long story short my husband and his mom backed out - leaving him waiting to go with all arrangements made. They both refused to go and he was too sick by that time to go alone. He died 6 months later back on hospice at home- to this day I still dont understand what killed him because I was assured by many in the medical profession that he was not terminally ill with what they saw - even my mother in law said she wasnt sure what killed him and was convinced it was more mental than physical.But my point is that this hospice was terrible and they were just like murderers.
Now let me tell you about said mother in law - she died just two years ago in hospice which when she was diagnosed she begged us not to put her there after what she saw with FIL . But they sent her there for a 2 week stay and she liked this new hospice and so did we. They were completely different than the first - she had to go back after first stay after 6 months home bedridden. I will be honest though she was worried about being "doped up" as she called it and was telling them she did not want that. After a few days though they did give her more meds until she finally did not recognise my son. I was the last person to see her - just hours before she passed and let me say that it is never a good thing for me as I find it very emotionally hard for me and them but I did think her facility was different than the first all the way around- their whole demeanor was different. So I would say you just have to check out the place and if you get a super something isnt right feel - let it be known regardless of who has the power. At the end of the day that person might legally be the only one allowed to call the shots BUT they wont and dont like it if someone is watching them and they are not up to par on what they are doing and if nothing else they will be on their toes. You just have to get a feel - we all thought it would be terrible when MIL had to go after our 1st experience and we were wrong they were soooo different so try to keep open mind. And if you cant get in then you will have to just trust whoever is calling the shots or try to reason with them to change it so you can see him. Good luck !!
A person going into Hospice is, "actively dying". I have no problem with them hastening the death if it means the patient isn't suffering.
I watched my husband take 8 days to die. He was basically unaware of anything after the 3rd or 4th day. He had no I.V. and the only fluids he had was some water on a sponge that I moistened his mouth with. It sure beats trying to force his cancer ridden body to survive by artificial means. I hope I get the same care when it's my turn to die.
I watched my mom take 11 days to die. She didn't have cancer but had a major stroke that did her in. It was major enough that they said there would be no coming back from it. Mom had a DNR so there were no 'life saving' procedures done. That was the first time I was sorry she had that but for my own selfish reasons. She couldn't swallow so no food or water but, like you with your husband, that tiny sponge for water had to do. I was grateful that what she was going through wasn't painful like cancer would be. It was hard watching her waste away day by day and nothing I could do about it. I will say that she got excellent care and the Hospice nurses were great.
OP, I am sorry you may not have a chance to say goodbye to your father in person. My thoughts go out to you - even if you and he didn't get along, I think it is often very important to say goodbye. And I hope that you can find some way to make that happen before it is too late.
Canada has recently approved 'assisted suicide' (by application made when a person is of sound mind and able to submit the request themselves and to reiterate their request when the time they wish to die has come/been chosen). Not all are approved but I think the momentum is starting for those who are suffering greatly and want to be able to determine the hour and manner of their own passing.
However, that doesn't cover the situation that I lived through with my father which was he was alert and awake and then he was suddenly not well and was taken to the emergency room. They diagnosed him with sepsis - going into septic shock - threw him on antibiotics and waited about 10 minutes while his blood pressure went down and down. As soon as it hit what they said was the point of no return, they immediately turned off the antibiotic drip, pulled out the intravenous line, said he will die within hours and had him sent upstairs to a regular hospital room.
He was fully conscious for most of this but then went into a semi-conscious state. He could squeeze my hand but his eyes closed and he didn't talk any more. That lasted about 7 days.
No one apparently expected him to live more than those 'few hours' - but he lived 10 days.
He came into the hospital with a 60 plus year old excruciatingly painful condition which was almost constant (spasms in his solar plexus which had been severed during the war causing his right arm to shrivel up and effectively die). It was not 'treatable' with any opiate though the doctor had been (against my wishes - and I had a POA) feeding him various ones constantly for years in the retirement home he had been in and that was continued during his final few months at the nursing home.
He was as I said semi-conscious for about the first 7 days but could not speak. When the spasms happened (every few minutes) his arm would go up in the air and he would moan. Once he seemed to be more in a complete coma after that first week, they stopped (or at least the signs that he was having them stopped). They continued during this entire period to feed him morphine (which certainly didn't help THAT pain at this point either - maybe it helped other new pains though but I cannot know that). I tell you though .. had I (or my father) been allowed to order a lethal dose of morphine within a few days of that 'death sentence' being issued I would have done that and I have no doubt he would have too if he could have.
He was dehydrated and starved to death though - and that was THE hardest thing ever to watch. It may be fine for the dying - but often they cannot tell us what it feels like, what they really want, unfortunately. But, for the living? It is horrible especially when it can extend that long and you never know when it will end - but you keep getting told it is imminent and you know it will.
On the other hand though, my mother died of cancer. She was in an official hospice facility for several weeks and hated it. She asked to go home and they said they could not allow that unless she was MUCH stronger - figuring she never would be. But the power of the human mind is amazing. She literally willed herself to begin eating and drinking (I think but don't know for sure - it was a long time ago now - that she had not had much to eat or drink for a few weeks but I don't think that was forced on her or requested by her - she simply didn't feel like eating, etc.) to get off her deathbed so she could go home within days - she stood up by herself to prove it (something she had not been able to do for over a month). So they relented and she was transported home. Within a few hours of that happening, she slipped down into a coma with a smile on her face and a day later after everyone had arrived, she died very peacefully without pain killers and it only took a few hours.
I strongly believe that the concept of 'assisted death' should be extended to allow for situations that are not expected but it is obvious that someone is going to die but they are not able to speak for themselves any more - which would then make it 'euthanasia' - and the medical professionals are treating that person as though they are dying with what may at least informally be called hospice care. They should allow the POA to make that decision under those circumstances.
In my mother's case, we would have let it play out. It was essentially a serene experience once she was able to come home - and she was in no pain and was conscious and able to speak till the last few hours of her life.
In my father's, I would have asked that they give him an extra large dose of morphine in a heartbeat after about the 3rd day when it was obvious that it was going to be a prolonged death, that he was MUCH stronger than they apparently thought he was (but of course was still not going to recover), and that he was in pain despite the morphine (and some other drug whose name I cannot recall just now) they were giving him. It was bad enough that he had suffered greatly for 60 plus years .. he should not have had to suffer for that last 10 days.
From my perspective, it was cruel for everyone involved and of course would have been deemed murder if someone had listened to me when my father was dying (I did 'suggest' at one point that perhaps the dosage could be increased a LOT) - but we should bless those who will, if requested under circumstances like this, put a loved one out of their pain quickly. Believe me I did not want my father to die at all but I didn't want him to live (or die) like that either and I know he would not have wanted ME to suffer watching it all.
A couple of weeks ago I had to put my beloved dog down. One shot to relax him .. a few minutes later another shot to stop the heart and within seconds he was asleep forever. That was traumatic enough for me but it was what I would call merciful.
Okay so everyone has a pretty positive story here - well heres mine and it is not positive. My FIL(I am now divorced so FIL at the time) was diagnosed with colon cancer which they removed but it spread to his liver a few months later. He was going for chemotherapy treatments but they said his prognosis was not good maybe 6 months to a year. My husband and I lived next to my in laws in smaller home - my husband was their only child and they were very close to us. So my FIL becomes distraught because as a side effect from his treatment he gets the hiccups and can not stop for 4 + days. He decides he wants to just die and my husband has to literally pry the gun from his hands- I call his oncologist to see what we can do with him - he says take him to emergency I will meet there. They admit him and were able to get rid of hiccups immediately - 3 days later they move him to hospice. I did not see him for the first day or so at hospice - mostly because we had a toddler at time and were kind of trying to keep him from this experience. I finally go to hospice and find my FIL in a wheel chair unable to lift his head or speak. I freak out - immediately ask what they are giving him - they tell me and he was getting a large dose of oxycotin (spelling?) for pain several times a day. I asked why he was not in pain he had the hiccups? They can not answer so I was persistent and he was slowly taken off the pain meds and within days was walking and talking and came home within 2 weeks. While he was at hospice I watched them closely and did not like what I saw - which was more than happy people taking care of those who were dying some old and some young BUT they were doing it with such glee and pleasure. Next we were councelled before he came home by the "hospice" staff and he was assigned a nurse and some "bathgirls" to help with grooming. The problem was that he became very anxious and decided he was not ready to die and that he wanted to be here as long as he could be. So they prescribed some different meds for the anxiety and again tried to give him pain meds which he was having pain from the catheter they left on too long in hospice by mistake and so he had a bladder infection that was not going away. When he took the pain meds he got really out of it for days off one dose and it would terrify him- so I went and got him some over the counter meds that helped him with the discomfort. I also had joined an online support group and through them found Century City Hospital in California and they wanted to a CAT scan to see if they could treat him - hospice fought tooth and nail against this and we had to remove him from hospice to get it done. But he had the CAT scan done and the specialists at the hospital which was a team of 20+ kidney and liver specialist said he was not even terminal. He had only a small tumor on liver and that they would be able to remove it - we just had to get him there. The cancer society was told of his situation and offered to pay for airfare and a hotel room until he was in hospital and treated. Long story short my husband and his mom backed out - leaving him waiting to go with all arrangements made. They both refused to go and he was too sick by that time to go alone. He died 6 months later back on hospice at home- to this day I still dont understand what killed him because I was assured by many in the medical profession that he was not terminally ill with what they saw - even my mother in law said she wasnt sure what killed him and was convinced it was more mental than physical.But my point is that this hospice was terrible and they were just like murderers.
Now let me tell you about said mother in law - she died just two years ago in hospice which when she was diagnosed she begged us not to put her there after what she saw with FIL . But they sent her there for a 2 week stay and she liked this new hospice and so did we. They were completely different than the first - she had to go back after first stay after 6 months home bedridden. I will be honest though she was worried about being "doped up" as she called it and was telling them she did not want that. After a few days though they did give her more meds until she finally did not recognise my son. I was the last person to see her - just hours before she passed and let me say that it is never a good thing for me as I find it very emotionally hard for me and them but I did think her facility was different than the first all the way around- their whole demeanor was different. So I would say you just have to check out the place and if you get a super something isnt right feel - let it be known regardless of who has the power. At the end of the day that person might legally be the only one allowed to call the shots BUT they wont and dont like it if someone is watching them and they are not up to par on what they are doing and if nothing else they will be on their toes. You just have to get a feel - we all thought it would be terrible when MIL had to go after our 1st experience and we were wrong they were soooo different so try to keep open mind. And if you cant get in then you will have to just trust whoever is calling the shots or try to reason with them to change it so you can see him. Good luck !!
This sounds very strange. Hospice does not maintain residence facilities, so it sounds like you were dealing with a rest home of some kind. It was not skilled nursing care or the doctor and nurses would have been on top of it, with the doctor doing rounds. Hospice will visit rest homes to assist with dying.
The patient calls the shots if they plan for their own death. An advanced medical directive overrides anything the doctors want. If they didn't have one, shame on them. If they did have one, they were the ones who chose how to go, and nobody else had a say. Their doctor should have helped them prepare an an advance medical directive, unless they got crosswise with the Rs who decided to forbid that. Blame Congress, not Hospice.
You can also assign a medical power of attorney. That takes a lawyer, but it is not expensive. That assigns near-death decisions to one person.
For my grandpa- he had lung cancer. They kept him at home in bed. His last meal was liver & onions. They gave him blue liquid morphine and O2. They would turn him every so often and of course clean him, sit with him, etc. He died at home. I dont know if he suffered or not.
For my grandma ( his wife)- she had pancreatic cancer. She tried to go home but the cancer spread and she was out of it and couldnt take care of herself. She refused to eat. They put her IN hospice. They put an alarm on her bed so you couldnt sit on it and she couldnt get up. She was in and out of it. I HATED seeing her that way. I went to visit her and she had no idea who i was or what was going on. I REGRET i didnt lay on her bed with her and just hold her. I truly REGRET that i didnt. I wish i had asked, begged, pleaded with someone. I wish i had known. I told her id be back and i didnt. I couldnt. ( she was like my mom, it was hard). I dont remember them giving her any meds or O2, they probably did at the very end.
My grandmother had bone cancer. Supposedly that is very painful. It was hard to tell because being the Scot that she was, she prided herself in being very stoic. But I know that at the end, she was morphined up at hospice - and I was glad of it because she was FINALLY able to relax and sleep for a few days before she passed peacefully.
I am grateful for what hospice does.
My grandmother was there for 11 days but my dad was only at hospice for 24 hours. But it was like night and day for him as well, from the hospital to hospice. At the hospital he was being constantly poked and prodded and messed with - because of course they were trying to save his life. When it became obvious that wasn't going to happen, he was moved to hospice. When I walked in and saw him all cleaned up, with the ventilator removed, sleeping peacefully instead of in that odd, anxious semi coma he had been in at the hospital, it was a huge relief.
My dad did not open his eyes at hospice, but he did respond slightly to us there, up till the last hour or so. Honestly, we tried to let him rest once we all got a chance to tell him how much we loved him.
He looked so incredibly peaceful when he died. Such a stark contrast to the fear and pain when he was in the hospital.
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