Thoughts on end of life/hospice?

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I am just wondering about how others feel about this. I didn't realize this until my friend's husband was in hospice several years ago. Her daughter told me then that when someone is in hospice, they increase morphine until the person dies. Isn't that the same as euthanasia? My mom is receiving in-home palliative care. A few times when she wasn't feeling well, they kept asking me if I want pain medication for her. I said, "No." The nurse asked me if I was sure... Mom is not in pain, except for one time when she was having intestinal cramps from diarrhea.... Knowing what they do in hospice, it really concerns me that they push the pain medication. Maybe if she had cancer, I would feel different....


No that's not how it works...but a lot of people will lead you to believe this...on this very board will get both believes hospice murders people and the other side will tell you the truth, hospice is end of life care...key words end of life...they make the person as comfortable as possible and ease your suffering as as many personal accounts as you can, I can tell you I've heard way more positive than the few negatives about hospice...get ready for the deluge of murder verses compassionate end of life care arguements!!
Oh, boy, yes, do get ready for the Pandora's box you've just opened.

Hospice was a complete Godsend for my daddy. I was an integral part of the "dosing" and what meds to give and when. His morphine dose was increase over the 2-3 weeks he was on Hospice, but VERY minimally. Even if we had administered the entire bottle he was given at one time, it would not have hastened his death. It was judiciously given, well monitored and that, along with a popsicle or two, and some liquid Ativan, he was always comfortable and I know his passing was peaceful.

What course of action worked for dad may not be the best for your mother. For some, as the pain increases, yes, they will increase the dose of morphine. Nobody with any compassion is going to question the desire to keep a loved one out of pain in their last days.

Now get ready for the few on these boards who just can't be polite about this subject.
Thank you. I do figure it depends on the person and situation. My mother is not in pain, but is not receiving hospice care right now. I had dinner with my girlfriend's daughter tonight. She said that one hospice center where her Mom was, really pushed the morphine. She told them, No. Then, her Mom was sent to another hospice center where she was for 2 months before she passed. They administered morphine the last two days of her life because it calmed her.
If your mother goes on hospice care, will she be in a hospice center, or at home? My husband was at home, and I had complete control over which meds I gave him.

jeannegibbs, there is always a chance that we will put her in a center when she is near death, but we hope to keep her at home for as long as we can. I like the idea of having control over what she gets...
Mapotter I think one of the benefits of hospice is to be allowed to die in familiar surroundings, with loved ones around. I, too, thought maybe we'd have to switch to a hospice house, but that was not the case. Hospice does its best to maintain comfort no matter where the patient is.

I am reading the book "Being Mortal" by Atul Gawande. Last night I read a section about hospice care, which I found very helpful. Dr. Atul has several examples of people on hospice, including his own father. Very readable.
Morphine is given for two reasons. The first is pain control nd the second is to ease the feeling of breathlessness in cases with lung involvement. If your mother is not suffering from either then she does not need the medication. Wherever you mother is at the very end you can refuse a medication if you feel it is harmful.
If Mom has dementia she may need things like anti anxiety meds of which there are many to try.
It is just possible that the nurses were pushing the morphine in your Mom's case because it is very constipating and they were trying to control the diarrhea.
In the case of pain management the closer someone gets to death there is a chance that any pain may escalate which of course will need bigger doses of narcotics to control.
All drug use is centered on keeping your loved one comfortable and anxiety free not speeding up their death. Any medication increases are handled by gradual increases and the hospice nurses may be given some discretion in the amount they feel the patient needs but it still won't be enough to kill someone.
When my Father was in hospice which wasn't long he refused one had an issue with that, nothing was forced or argued about...
I had to have the hospice nurse to the house because Mom was not acting right today. She was asleep (it seemed anyway) when the nurse came. Her pulse was 90 and she was tense. The nurse ended up getting prescriptions from the doctor for lorazepam, haldol, and, yes, morphine. I told her that we are not comfortable with morphine, and she said that was okay. We didn't need to give it to her, but it is better to have it than not.
Mapotter, I told the nurse we would not use haldol (there is a high chance of permanent damage when one has Lewy Body Dementia, and why risk making matters worse?) and she said she didn't know if they would leave it out, but that I certainly didn't have to use it. As it turned out, they did leave it out. The nurse was glad to have the information I could give her about the drug with that particular illness.

You really are in charge of what to give your loved one.

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