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Old 08-06-2018, 03:10 PM
 
Location: Maryland
421 posts, read 884,649 times
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Quote:
Originally Posted by njkate View Post
hmmm, i had in home hospice for about one week for my husband before he passed. This was after 48 hours in a hospice center, they had him so doped up and tied in a chair at nurses station, told them to back off the drugs and transport him home. The nurses at my home were all very good, but i still think hospice hastens the death, jmo. I asked them a few times as long as he was comfy to back off the drugs, he didn't have to be loopy.
hospice does not hasten death !!!!!!!!!!!!!!!!!!!!! That is a really bizarre statement. My wife is a hospice nurse and I hear story after story how the "loved:" ones of the patient prohibit morphine when the hospice DR. orders it to ease pain and suffering of the patient, when the patient has less than a month to live because they don't want to have their dying relation addicted. So their "loved" one can be more lucid while suffering. Do you know the average stay in hospice is only three days. People are dying and everyone except the hospice RNs are freaking out, so be grateful there is hospice and don't knock a noble profession based on your biased opinion.
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Old 08-06-2018, 07:38 PM
 
Location: Somewhere in northern Alabama
16,839 posts, read 51,286,023 times
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Quote:
Originally Posted by seethelight View Post
hospice does not hasten death !!!!!!!!!!!!!!!!!!!!! That is a really bizarre statement. My wife is a hospice nurse and I hear story after story how the "loved:" ones of the patient prohibit morphine when the hospice DR. orders it to ease pain and suffering of the patient, when the patient has less than a month to live because they don't want to have their dying relation addicted. So their "loved" one can be more lucid while suffering. Do you know the average stay in hospice is only three days. People are dying and everyone except the hospice RNs are freaking out, so be grateful there is hospice and don't knock a noble profession based on your biased opinion.
Compared to hospital protocol, hospice can hasten death. Specifically, IV fluids are often discontinued when the 20 days of medicare funding end and a pt. is transferred to hospice care. That lack of support fluids alone can speed shutdown of organs. That is part of the reason that the average hospice is only three days.
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Old 08-07-2018, 12:09 AM
 
Location: Approximately 50 miles from Missoula MT/38 yrs full time after 4 yrs part time
2,257 posts, read 3,168,792 times
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Default A couple of additional comments, since my post of this past April .

Quote:
Originally Posted by Montana Griz View Post
I am in my 87th year of living through three experiences with a local Hospice facility :...My Mother....My Wife,...and My Sister.
All three were wonderful experiences for me and to observe the exceptional level of "care" that my family members received.....
HOW EVER,
BEAR IN mind, all three were the same facility, attached to a wonderful hospital located in a rural town of approx 5000 population, which is the County seat of a county of about 50,000 population, and that county has IIRC 5 or 6 private hospice facilities for competition.

IMHO, if my situation had occurred in a large city, my overall opinion my have been entirely different.
Also, the length of stay and the "condition" of the patient are also very important factors.
My Mother was 89 and in the very advanced stages of 8 years of Alzheimer's.......length of stay was 22 days.
My wife was 72, radiation and chemo had been stopped after I had been taking care of her at home for 14 months and she passed after 14 days in hospice.......I had lost 30 pounds in those 14 months, and putting her in hospice was mandatory for my health.
My sister was 86 was in advanced stages of 6 yrs of Alzheimer's, being cared for by her husband and daily outside help, and lasted 33 days in hospice.
So, in summation, my experiences with this particular hospice facility were 100% positive.
I am well aware that other people (relatiives of patients ) have "other-stories" to tell.........and I have great compassion for them.
.
I have now read all posts in this Thread............and am surprised and saddened that a significant number of the experiences are of a Negative nature.
That situation causes me to wonder, were my three Positive experiences primarily due to the fact that the Hospice facility I delt with is quite small (8 rooms), ....located in a small town of approximately 5000, and in a rural type of environment in general............Or, .....was my set of three positive experiences, ....the exception-to-the-norm?
I know that every Hospice patient has their own specific medical circumstances, and thus, each and everyone requires a different protocol based on their specific situation, level of pain and discomfort, and the family members desires for their loved one's comfort.
Perhaps I should just be grateful for my past experiences and hope my own time (when it comes) in this facility will also be positive.
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Old 08-07-2018, 03:20 AM
 
11,686 posts, read 13,074,643 times
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Quote:
Originally Posted by harry chickpea View Post
Compared to hospital protocol, hospice can hasten death. Specifically, IV fluids are often discontinued when the 20 days of medicare funding end and a pt. is transferred to hospice care. That lack of support fluids alone can speed shutdown of organs. That is part of the reason that the average hospice is only three days.
First of all, have a Living Will in place long before you are on Death's doorstep. Where I live they are recorded in a national record by number, so even if I were to be in a traffic accident alone and be completely unconscious as long as the number is on me, any hospital in the country can access my document and know what I want in the way of medical treatment in life-threatening circumstances. What my family or friends might want for me in critical circumstances doesn't matter a fart in a jug as far as I am concerned. I am the only one who lives in my body, and I am the only one who lives my life, and not least of all I am the one with reason for living or not.

I would suggest that anyone who is in involved in medical care decisions, or even moral support, for critically ill and terminally ill family members or friends would benefit very much from reading (Dr) Atul Gawande's book Being Mortal.

And I would emphatically recommend it for aged people, such as myself, so that you have a better understanding of medical and hospice decisions. The author does not just lay out his experiences as the physician to non-family members, but the book has an ongoing back story of his aging father - who was also a doctor - and the decisions the family, and the father, had to make when the father's health declined to the terminal stage. It is an honest picture of someone learning to do what they have been thinking, and saying to others.

Perhaps I should point out that the book is not a you-should-do-this type, but rather a what-and-why-do one.

Last edited by kevxu; 08-07-2018 at 03:32 AM..
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Old 08-07-2018, 11:52 AM
 
Location: SW US
1,992 posts, read 1,851,090 times
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Quote:
Originally Posted by kevxu View Post
First of all, have a Living Will in place long before you are on Death's doorstep. Where I live they are recorded in a national record by number, so even if I were to be in a traffic accident alone and be completely unconscious as long as the number is on me, any hospital in the country can access my document and know what I want in the way of medical treatment in life-threatening circumstances. What my family or friends might want for me in critical circumstances doesn't matter a fart in a jug as far as I am concerned. I am the only one who lives in my body, and I am the only one who lives my life, and not least of all I am the one with reason for living or not.

I would suggest that anyone who is in involved in medical care decisions, or even moral support, for critically ill and terminally ill family members or friends would benefit very much from reading (Dr) Atul Gawande's book Being Mortal.

Are you certain that the doctor/hospital would respect your decisions without having someone there to "enforce" them? I am concerned about that.


I read Being Mortal when it first came out, but am going to have another look at it now.
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Old 08-07-2018, 01:31 PM
 
11,686 posts, read 13,074,643 times
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[quote=Windwalker2;52729679]Are you certain that the doctor/hospital would respect your decisions without having someone there to "enforce" them? I am concerned about that.

I don't believe that we can really rely on the certainty of anything or anyone.

Be that as it may, in this particular place the document is a legal document - it is not just an I-would-like wish list. It also contains contact details for the person who has the right to make medical decisions if you are not competent, so in any case the hospital is duty bound to contact them as a kind of legal next of kin.

Quote:
I read Being Mortal when it first came out, but am going to have another look at it now.
A major plus about the book for me, aside from the experience and intelligence of the author, was the fact that he did not write a polemic, but rather a really honest and thoughtful examination of end of life care alternatives in various settings.

Many years ago now I was a volunteer who was paired with people with a diagnosis of a probable terminal disease, and we remained paired in most cases until their deaths. We were trained, albeit a bit briefly, and I am probably not the only one who could have used this kind of overview. Fortunately, as I did this for seven years, the very first person was an incredibly unusual young man - greatly concerned about the impact of his impending death on those in his life as much as about facing death himself, honest and very thoughtful, but with a spine of steel. When he died I still had much to learn and many less ideal situations to deal with, but John was a rock to start from.

Still...a book like this would have helped to get my bearings more rapidly I think.
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Old 08-07-2018, 06:25 PM
 
Location: Maryland
421 posts, read 884,649 times
Reputation: 761
Quote:
Originally Posted by LesLucid View Post
I have had one (remote) experience with hospice care. I was working and out of state when my mom requested it for herself. She was 92, congestive heart failure, arthritis, neuropathy, lots of things typical of that age. They were giving her morphine for a while, orally I guess, but when I went down to see her, she was on a morphine patch that had her pretty much unconscious. I asked about feeding and they said they couldn’t do that since she was unconscious. She had told them she was ready to go according to my sister and niece who lived down there near her.

So, it was clear to me that the procedure was to get her unconscious and withhold nourishment until she died. Cause of death was listed as “failure to thrive” and “congestive heart failure”. Is this the typical procedure used when someone agrees to hospice care and says they’re ready to die?
When a hospice patient is in the final stages of dying their organs are shutting down and the body has no need for food. My dad, who died in hospice, didn't eat for 8 days. He was unconscious 22 hours a day. When he was conscious he didn't ask for food.

People should become more informed about hospice rather than making claims that hospice wanted her unconscious. People that work in hospice are real saints, and people go into that profession to help people rather than what you are accusing them of doing.
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Old 08-07-2018, 07:36 PM
 
5,154 posts, read 2,992,030 times
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I volunteered for three months in a memory loss unit and during that time I sat with a number of dying people who had no one come to visit them. Resources and care were scant and I mourned that so many could live and die like that all alone.

There aren't words for the experience. What I was able to do for others paled in comparison to the knowledge and blessings that I was given. It was a holy and humbling experience and helped to prepare me for sitting in hospice with my own parents.

My father's hospice experience was wretched for me. The hospital had just opened the unit and the staff was poorly trained, sullen and disengaged.

My mother's was just the opposite - nearly a celebration of her life. One of the hospice workers told me one evening, "I go in there and the room is full of angels."

My mother told me one morning they had awakened her on her birthday and danced her around the room singing, "Happy Birthday to you." True or imagination? Either way, what a pleasant thing!

Such small gifts as that can make such a big difference.
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Old 08-12-2018, 11:54 AM
 
Location: El paso,tx
1,486 posts, read 572,187 times
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My mom went into acute kidney failure after getting a uti, and being prescribed bactrim antibiotic in june. She went from being active, grocery shopping on her own, to not able to get out of bed or up from a chair, in 3 days. Went back to dr, and they did bloodwork and called me 2 says later, and said to get her admitted to hospital because she was in acute kidney failure. She was there a month, did 7 dialysis treatments, then wanted to go home and stop treatment. She was suffering from periods of hospital dementia so we convinced her to get the permacath put in, so if she decided she wanted to do outpatient dialysis after getting home, she could. She went into A fib when getting port put in. Then was unresponsive for 12hrs, so we arranged to take her home on July 19th and put her in hospice care there.

They were very good to deal with. I had already arranged a hospital bed, air mattress that prevents bed sores, hoyer lift, and wheelchair. They brought me meds, oxygen and bathing supplies.

The nurse came by weekly to ck on her. They offered a cna to help bathe her 3 times a week, but my sister in law and I decided to do it. I slept on an air mattress in her rm. I was able to spend time with her, talk to her and play her favorite music for her. Her birthday was 3 days after she got home, and so very sad for me.

My mom lasted just under 2 weeks at home. She wouldn't take any morphine until last 2 days, when it was given to help with air hunger. She passed peacefully at home last week.. Hospice nurse came out about a half hr after she passed and called funeral home, and destroyed meds. Took care of getting the dr to sign death certificate.

Everyone was good to deal with, but I used them minimally, since I had already had medical equip arranged, and took care of my mom myself. They called me a day later and told me about the grief support they offer for up to a year later.

I doubt I would do hospice in a hospice facility, as I wanted my loved one home. I do see how some people might need that option though, as it is very difficult to provide needed care, cleaning them, and turning them.

Morphine doesn't hasten the death, although it will relieve pain and can help with air hunger. The terminally I'll patient will often not eat at the end. They dont need food when they are at the end. Forcing food may prolong them a little, but may make them suffer longer. At the end, we sat with mom, and told her she could go, that we loved her, that my dad and 2 brothers were waiting for her, and that my (living) brother and I would be ok and take care of each other. I believe it's important to give the terminally ill permission to go.

Hospice can be a great help. But talk to them about what they do, what to expect, what help you need, what funeral home you want, how long you can spend with them once they pass, purpose of meds, etc.

Everyone should have a will, a living will, durable power of atty, medical power of atty, advance directives, so family will know your wishes. It will make it much easier for your family.
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Old 08-12-2018, 12:42 PM
 
3,962 posts, read 5,247,246 times
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Spottednikes, I am sorry for the loss of your mom. Despite all the trauma, it sounds as though you handled everything well, and that your mom's death came without pain and suffering. Thank you for sharing your story and your experience. Whenever we talk about these things, there is potential that someone else can be helped as they walk their own path.
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