Why does Hospice sound like assisted suicide?

Asked by shortmomma1  |  Jan 21, 2012

my mom and I met with the hospice case manager yesterday, and Hospice sounds like assisted suicide to me. Mom has congestive heart failure (she just told me that yesterday) end stage of COPD, asthma, cronic asperated pnemonia, panic attacks,,,,etc,,,so we meet with the Hospice case manager, at the encouragement of Moms hopsital case manager. And they want her to be a DNR, and if she has trouble breathing then they will ehlp her work thru it... and if she gets to the point she cannot breathe, dont call 911, but for ME to administer the meds that will make her " go to sleep"..... are they serious !!!! so let me understand this.... mom cant breathe, so I am supposed to be ok with giving her a medication that will relax her so she can stop breathing...? ! ? I dont think Im ok with this at all.
Everyone said " oh hospice is just wonderful" ,bla bla, bla,,,,,What I see is assisted suicide, and everyone else standin on the other side of the fence saying " oh look, she has hospice, her daughter will be so supported we dont need to do anything now"...............................

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jeannegibbs

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Jan 22, 2012

If you are not OK with hospice, you certainly do not have to accept it. It is totally optional. Please do not feel intimidated to use it.

People who do accept it generally accept that their loved one is at the end of life's journey. They believe that the outcome will be death, relatively soon. With medical advice, they believe that there is no cure for their loved one's condition, and no way to regain a quality of life. They do not want to prolong their loved one's suffering. They want the inevitable end we all share, death, to come naturally but also while providing comfort and reducing pain. They want help for themselves in understanding the process of dying, to help them accept the end.

What was your mom's reaction to the meeting with Hospice? Many people try to honor their loved one's wishes, whether it matches their own preference or not. Is your mother able to comprehend what was discussed? Did she express her preferences?

Like many people, I do not think of a DNR order as a wish to die. I do not think of death without medical intervention as suicide. You have every right to your own views and to make your own decisions, along with your mother. I hope you will not judge others harshly if they have other views.

I wish you peace with whatever decision you make. May you have strength as you face what lies ahead.

 
 

anne123

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Jan 22, 2012

From my understanding of it, the Do Not Resuscitate order is in place so that the patient (who is expected to pass away soon) does not need to have a breathing tube installed, which would only prolong this final period and can be very difficult for the patient. My mother asked for the DNR order, and she received her wish at the end of her life. She did not end up in the hospital on a breathing tube, being kept alive by this device. She was allowed to peacefully pass while in the ambulance.

Shortmomma, I don't blame you for not wanting to administer the morphine, or whatever the drug is they are talking about. Can one of the hospice nurses be responsible for administering the medication? I am sorry you are going through this....God bless...

 
 

NancyH

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Jan 23, 2012

Shortmomma1, I would check with private Hospice companies before I'd go through your county/state Hospice. We had real good luck with the one we chose for my mom. They will still bill Medicare etc just like the others. They aren't supposed to be hurrying your mother along to die you know, just supposed to be making her comfortable as she travels that road. We had a wonderful nurse that was more than willing to accommodate us when we wanted mom to stop taking certain pills that were causing hallucinations. You are NOT a slave to them, they work for you. If you're not happy with something they're doing, then make your voice heard.

 
 

vstefans

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Jan 23, 2012

Morphine may actually ease breathing as well as pain - it will relieve congestion casued by pulmonary edema (fluid/pressure build-up in the lungs) so it may be ethcially very much OK to give it to make the actual dying part less awful, even if it makes that part shorter too. But that said, if you are not comfortable with that part then it would be right to have a nurse there instead or just because this is all very hard on caregivers to face death so directly. My mom had a bad heart attack in inpatient hospice that took her away - they gave morphine, which she absolutely needed as she was having classic, crushing chest pain for the first time ever... no one thought that was going to be it, though, and they left just her and me in the room - then her breathing changed and I sudenly realized this was it. I pushed the call button again, but no way was I going to leave the room to drag someone back in more immediately than they otherwise would have/should have come. I was glad I was there to hold her hand, but I wish someone had stayed to hold mine. When we had first checked in they actually wanted to take her off all meds except phenergan and oxycodone around the clock, assuming what we wanted was sedation and the shortest time to getting it over with, but I was still hoping for a little quality time, and I did insist they keep other things going...we got a wheelchair ride to the garden and a couple of pizzas shared out of the deal. I had not been comfortable when my mom first asked for DNR but with her heart the way it was, severe, diffuse, and inoperable coronary arteries, it would have been cruel to keep trying to make that heart keep working and I had to accept that. We could have tried a procedure called EECP but I did not think she could tolerate it, and we could have kept anticoagulating which was not really working anyways (she came into hospice having had another stroke and/or coronary event where she had passed out at the skilled nursing facility, even on the highest dose of Ranexa and nitro she could tolerate) and I still wonder if we could have had a little more time that would have been worth anything if we had tried that. So, no, it is not easy to decide, but you do have every right to talk it through with the doctors and nurses and settle on what you think is right and best in the face of the inevitable. It should not be a cookie-cutter one-size fits-all type of thing.

 
 

shortmomma1

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Jan 23, 2012

thank you all for the clarity about hospice. That was what I was looking for, honest personal experiences. See what I was hearing is that it is soo great, but what they didnt tell me ( until i pushed) is that its extremely hard for the family, emotionally, and financially. when something is presented in a cult worship fashion, it makes me second guess it... sorry that how I am.....
Mom decided to go with the hospice. Her Case manager said Mom is more sick than she is tellin us girls, apparently she is protecting us. Mom has instilled the help of her sister, so we arent so overwhelmed. Seems like now we are just hanging out, waiting for her to get sick, and thats pretty morbid.....

 
 

kuli

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Feb 8, 2012

Shortmomma - My dad passed away in October of last year. I had pushed to have him admitted to hospice because he no longer wanted to go to the hospital but I didn't want him to suffer needlessly when the time came that his congestive heart failure worsened, as it does. The hospital would give him meds to get the extra fluid out of his lungs, readjust his meds at home and he'd be ok for a month or so then back through the same cycle. The experience we had with hospice was wonderful. The nurse, nurse's aide, social worker, pastor - all were nothing but supportive, assuring me that at any time I could send him to the hospital and if we decided to treat him for his heart failure, they would simply discharge him from hospice so that Medicare would cover the hospitalization. I never felt like they were giving up on dad or pushing assisted suicide. However, when the time came, and it came very suddenly in dad's case, it was comforting to know that they had the meds that could help him remain more comfortable and not struggle. As opposed to hospice expecting me to administer the meds that day, when the hospice nurse got to the house within a half hour of my call, because I too am a nurse, she said to me "Now YOU are the daughter and I am the nurse. Just be here for your dad and I'll take care of his comfort needs." I know she gave him much more Morphine than I would have been comfortable with and it didn't stop his breathing, it just helped him not struggle so hard. He was still talking to me and the family but wasn't panicky about his breathing even though it was clear he was not breathing normally. And as another has said, if you don't like one hospice, call another. I got lucky with the one dad's doctor recommended but had called several others to better understand the whole process. And instead of thinking you're hanging out just waiting for her to get sick, cherish this time. Spend as much time as you can with her, talk to her about how she feels about dying, tell her everything you want her to know and listen to all she says. Those will be the memories you will cherish forever. God bless ~ kuli

 
 

3pinkroses

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Feb 8, 2012

My mother was gravely ill this past summer with pneumonia. She is in a nursing home. She has a host of other problems as well. She was on oxygen and the nurse manager called me to suggest hospice care. It was the best decision I ever made. Another person here posted that morphine can open up the lungs; one of the nurses told me this as well and I had no idea it had this effect as well as pain relief. My mother was suffering and I would do anything to help her. She made a miraculous recovery and showed results soon after the morphine. Of course this was administered my nurses; so I don't blame you for not wanting to be the one administering to your mother. She was made so comfortable it was like night and day.

So, just a positive note about hospice. This was a private hospice by the way.
Can't say enough about them and all their support. My thoughts and prayers are with you - difficult decisions - trust your instincts.

 
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