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Old 09-12-2010, 06:39 PM
 
Location: state of procrastination
3,487 posts, read 6,537,177 times
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The morphine should have been enough to keep her comfortable even though she was dehydrated and starved. Food and water can keep somebody alive indefinitely against their wishes in certain medical conditions. If that was her wish not to receive any nutrition, especially if she could not eat on her own, I think it should be respected. My grandmother was literally braindead (the whole brain except brainstem was probably replaced by tumor) and the artificial feeding kept her alive for at least 6 months. Obviously she was not able to eat and drink by herself, so it would have been the natural course for her to die of dehydration anyways. I wish they had turned the nutrition off and just given her pain medications.

Advanced directives are always a difficult decision. I hope you find your answer!
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Old 09-12-2010, 06:57 PM
 
Location: Dallas TX
15,443 posts, read 22,699,915 times
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It is an awful choice to make, and I am sure your Aunt had a part in the matter. My dad is in hospice right now and has a DNR. He and my mom talked about what extent that meant. Needless to say he chose not to go that way.

It seems like an awful way to pass away, but sometimes living is just as bad of an alternative. With the disease my dad has, his quality of life is horrid. There is no right answer.
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Old 09-12-2010, 07:16 PM
 
Location: In the real world!
2,178 posts, read 8,689,243 times
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new jersey mike- That was just about word for word the same situation with my own Mother. Colorectal cancer, she refused any kind of surgery or treatment (herself). She also was 81. She knew and so did we, that just sedation for the surgery would most likely kill her. Hospice was only called in 3 days before she died but she had stopped eating a week before, she was taken food but wouldn't eat it. Getting her to drink anything was almost as bad. She also had dementia but the one thing she repeated over and over was that she didn't want surgery and we respected her wishes.

We had 17 wonderful months with her after it was discovered she had cancer. She stated over and over, she had a great life and was ready to go.

Hospice only came in on Friday and she died peacefully at home in her own bed on Sunday after a day full of people coming by to see her. After all the company left, she went to sleep and never woke up.

MaryleeII- From how my own Mother stopped eating and drinking 7 days before she passed away, I expect it would have been the same with your loved one. I was out of town and they called me to tell me Mom had quit eating and drinking so I knew her time was near and went home. Just prior to her going to sleep, she asked me if I would help her go "home".
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Old 09-12-2010, 08:59 PM
 
9,967 posts, read 16,583,019 times
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Thank you for all the frank, helpful responses. To all those who have lost loved ones, my deepest sympathy.

Thanks for all the insight your shared experiences have provided. The loss of my aunt was difficult to handle, especially not knowing what the hospice process involved. My dh and I have medical directives, but they allowed food ad water. I guess we hadn't thought it through well, not having any personal experience with hospice care. We've now changed our minds, based on my aunt's experience, and the responses here.

Thanks again, everyone, for helping me sort through these difficult issues.
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Old 09-12-2010, 10:41 PM
 
Location: Mostly in my head
19,865 posts, read 57,975,738 times
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In my health care POA, I state that I do not want artificial food or hydration - a feeding tube or IV fluids. If I can't swallow, it's time to die naturally, with dignity, in God's time.
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Old 09-13-2010, 10:44 AM
 
2,222 posts, read 9,728,129 times
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Quote:
Originally Posted by new jersey mike View Post
My mother died today at 3:34
My sisters were basically in charge with what was called humane hospice care. My mother was told she had stage 4 colon cancer after a liver biopsy. She was 81 and did have slight emphysema. It was decided to bring my mother home and not do any follow up test for the colon cancer. Her doctor said to my sister that a colonoscopy would possibly kill her due to anesthesia. I was outraged that no other follow up tests were performed. That was 1.5 months ago and the last 2 weeks of what I feel was torture. My mother had slight dementia and had no concept of what hospice meant.
I wish she had died on the table.
My condolences on the loss of your mother, Mike. I'm a little confused about the diagnosis of Stage 4 colon cancer from a liver biopsy. Perhaps someone can enlighten me.

But because your mother passed away after only 1.5 months, I will have to assume that her cancer (no matter where it was located) had advanced to the terminal stage. I lost my mother to pancreatic cancer 20 years ago at the age of 69. She did not want chemo or any other means to keep her living. She felt it would only prolong the process and cause more pain to all. My experience was that we could only make my mother as comfortable as possible with pain medication. She refused any food or water in any form in her health directive. Even though she was dying from cancer, the nurses told me starvation and dehydration often facilitates the dying process. Your mother may not have understood everything, but she passed pretty quick, bless her heart. My mother hung on for 9 grueling months.

I can't say the memories of how my mother's dying process unfolded no longer exists, but it does ease after time and the wonderful memories begin to take over. I hope you find peace with your loss. Losing a parent or a child is most difficult. Your mother is at peace now. She would want the same for you.

Take care. Beth
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Old 09-13-2010, 10:53 AM
 
29,986 posts, read 38,307,892 times
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Quote:
Originally Posted by new jersey mike View Post
My mother died today at 3:34
My sisters were basically in charge with what was called humane hospice care. My mother was told she had stage 4 colon cancer after a liver biopsy. She was 81 and did have slight emphysema. It was decided to bring my mother home and not do any follow up test for the colon cancer. Her doctor said to my sister that a colonoscopy would possibly kill her due to anesthesia. I was outraged that no other follow up tests were performed. That was 1.5 months ago and the last 2 weeks of what I feel was torture. My mother had slight dementia and had no concept of what hospice meant.
I wish she had died on the table.
So very sorry for your loss.

It has been my experience that the quality of hospice care can very greatly from state to state and city to city. Much depends upon how far in advance a family is able to contact hospice and get the process going. Last minute hospice care is usually less than optimal for the patient and family member satisfaction alike.

You mother should not have had to suffer and should have been made as comfortable as possible. Cancer can be a very painful disease towards then end and I've watched too many immediate family members suffer through it, partially because they felt hospice was a sign of giving up.

In Florida I had a friend who was well served by hospice for a number of years even though he was still getting chemo treatements. Had it not been for hospice he would not have been able to stay in his home. They provided needed care and served as a bridge between patient and the physicians office right up to his final hospitalization and death.

Each state is different.
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Old 09-13-2010, 11:56 AM
 
15,246 posts, read 17,437,145 times
Reputation: 25475
Quote:
Originally Posted by new jersey mike View Post
My mother died today at 3:34
My sisters were basically in charge with what was called humane hospice care. My mother was told she had stage 4 colon cancer after a liver biopsy. She was 81 and did have slight emphysema. It was decided to bring my mother home and not do any follow up test for the colon cancer. Her doctor said to my sister that a colonoscopy would possibly kill her due to anesthesia. I was outraged that no other follow up tests were performed. That was 1.5 months ago and the last 2 weeks of what I feel was torture. My mother had slight dementia and had no concept of what hospice meant.
I wish she had died on the table.
I'm very sorry about your losing your mother. I lost my dad 9 years ago and I still miss him.

Unfortunately, at the end of life, things often don't go the way we hope or wish. While you're saying right now that her last two weeks were miserable and you wish she'd died on the table, you may feel differently as time passes. While it is everyone's wish to die quickly without suffering, she would have had to do all the prep work for the colonoscopy and that would have been very hard and she might not have died "on the table." She might have been in a coma or heaven knows what else. And in any event, even if she'd had further testing, with cancer that advanced she probably would not have survived any treatment.

The last two weeks may have given her a better chance to say good-bye than you realize right now. In any event, I hope you find some peace.
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Old 09-13-2010, 02:16 PM
 
Location: Georgia, USA
25,320 posts, read 30,140,673 times
Reputation: 31528
Quote:
Originally Posted by new jersey mike View Post
My mother died today at 3:34
My sisters were basically in charge with what was called humane hospice care. My mother was told she had stage 4 colon cancer after a liver biopsy. She was 81 and did have slight emphysema. It was decided to bring my mother home and not do any follow up test for the colon cancer. Her doctor said to my sister that a colonoscopy would possibly kill her due to anesthesia. I was outraged that no other follow up tests were performed. That was 1.5 months ago and the last 2 weeks of what I feel was torture. My mother had slight dementia and had no concept of what hospice meant.
I wish she had died on the table.
Dear Mike,

I am so sorry about your mother. No matter how old we are, we are still children when a parent passes, and the sense of loss is overwhelming.

If the liver biopsy showed metastasis of the cancer from the colon, there was nothing that could be done at that point which would be likely to provide significantly prolonged survival. In view of her mental status and emphysema, major surgery with its attendant risk was probably not in her best interest. Further testing would be expensive and only tell the doctors what they already knew. The fact that she survived only six weeks is telling.

I think your family did the right thing. Your mother died at home surrounded by caring family. That is the best way to go, in my opinion.

Take care,
Suzy Q
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Old 09-13-2010, 02:31 PM
 
Location: Georgia, USA
25,320 posts, read 30,140,673 times
Reputation: 31528
Quote:
Originally Posted by Beth56 View Post
My condolences on the loss of your mother, Mike. I'm a little confused about the diagnosis of Stage 4 colon cancer from a liver biopsy. Perhaps someone can enlighten me.

But because your mother passed away after only 1.5 months, I will have to assume that her cancer (no matter where it was located) had advanced to the terminal stage. I lost my mother to pancreatic cancer 20 years ago at the age of 69. She did not want chemo or any other means to keep her living. She felt it would only prolong the process and cause more pain to all. My experience was that we could only make my mother as comfortable as possible with pain medication. She refused any food or water in any form in her health directive. Even though she was dying from cancer, the nurses told me starvation and dehydration often facilitates the dying process. Your mother may not have understood everything, but she passed pretty quick, bless her heart. My mother hung on for 9 grueling months.

I can't say the memories of how my mother's dying process unfolded no longer exists, but it does ease after time and the wonderful memories begin to take over. I hope you find peace with your loss. Losing a parent or a child is most difficult. Your mother is at peace now. She would want the same for you.

Take care. Beth
Beth ~

Finding the cancer in the liver biopsy means that it is already widely metastatic, which is by definition Stage IV, and in the case of colon cancer, incurable.

Everyone ~

Do the colonoscopy. Most colon cancers start as polyps. Find and remove the polyps, and the cancer doesn't get to start.
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