What is wrong with sedating a dying patient into a coma? A coma is not death. Doctors induce comas all the time to aid healing.
I did not want my mother, who was in terrible pain, and agitated, to die in that state. I wanted her to die peacefully. Because she WAS dying. She had dementia, chronic heart failure, had fallen, broken her wrist, smashed up her face and developed pneumonia, which was treated with antibiotics. She wouldn't get out of bed and lay there with her face screwed up in pain and horror. Doubling her regular pain meds did not help. Morphine eased her breathing and restored her calm.
If she was meant to heal and live, taking away her pain would have helped. She died, but not because of morphine.
Prolife, Here it is again; """Other experts recommend consulting a pain management specialist ""BEFORE"" exceeding a dosage of 80–120 mg daily."""""
This means you CAN exceed this doseage but should be done under a pain specialist's (MD) watchful eye.
I can only speak for the hospice I work for. We do NOT give huge doses to our patients with severe pain. The dose is "titrated" to keep the patient comfortable-not comatose! If it takes giving them meds every hour, then that's what we do. But not in ridiculous doses.
I had a patient who was 55 years old, (younger than me 😢) dying from cancer. Her partner had witnessed her parents die in pain and told me to keep her out of pain. When I had given her everything I could and she was STILL writhing, I called the doctor. I got new orders for medications. The Sig Other wanted me to keep giving her more but I explained medication takes a few minutes to be absorbed. If after 15 minutes, she's still restless, I'd give her more. OUR GOAL IS TO RELIEVE PAIN AND ANXIETY. She calmed down and was able to rest with slow, easy breathing. Her SIg. Other sat with her for a couple of hours and was relieved that she was finally comfortable. The patient died many hours later that day. The spouse was immensely grateful that she didn't thrash around suffering in her last hours.
I did not kill her-cancer killed her. I made her as comfortable as I could with the little time she had left.
I'm not saying every hospice is perfect-far from. But to clump ALL hospices in the "killer" catagory is wrong. We provide a needed service to the dying and their families.
Prolife, here's what I think you should do. Instead of posting on these threads about folks who are already dead and sowing doubts about the hospice care they/we got for our parents, why aren't you posting on threads of folks who have parents who are actively dying, in pain and agitation, the way my mom was back in August.
You should be using your talents to tell folks who are watching their loved ones die that they should prolong the suffering, don't you think? Really, you might extend a few days of agony for everyone, which I think is what you want.
Let the doctors try that experimental treatment that might give mom another week. Force them to do another round of chemo, another round of injections, another lung tap.
This is a statement on the Brad Harris "Hospice Boss" case.
"Nurses gave high doses of drugs such as morphine, regardless of whether patients needed it, to justify the higher payments, prosecutors said. In some instances, these excessive dosages resulted in serious bodily injury or death."
CM, I tried to access the BMF website but I couldn't find a way to look up anything. (?)
This is from drugs.com; "CDC (Center for Disease Control) states that primary care clinicians should carefully reassess individual benefits and risks before prescribing morphine sulfate dosages ≥50 mg daily for chronic pain and should avoid dosages ≥90 mg daily or carefully justify decision to prescribe such dosages. Other experts recommend consulting a pain management specialist before exceeding a dosage of 80–120 mg daily."
I understand patients developing a tolerance to opioids but I have NEVER seen 300 mg. of Morphine being given AT ONCE. I would bet you a weeks pay that there never was an order that said to give 300mg. at once.
You wrote 30 mg. every 4 hrs., up to 200 mg. every 4 hours (or 50 mg./hr.) Then; 100 mg. every 12 hours, up to 600 mg. every 12 hours. (or 50 mg. hr) for a maximum dose of 1200 mg. in a 24 hour period.
I think you'd be hard pressed to find that amount being given in most hospices or written by most doctors.
At the hospice where I work, our orders; Give Morphine 15 mg. every four hours. For "breakthrough" pain, give Morphine 5-10 mg. every hour as needed.
Let's suppose the patient needed breakthrough pain medicine (Morphine 10 mg.) EVERY hour.
Morphine 15 mg. given 6 times in a 24 hour period plus Morphine 10 mg. given 18 times in a 24 hour period. 90+180=270 mg. for a 24 hour period.
I'm not saying huge doses can't and don't happen, but I think it's a lot less common than the lower doses.
I'm only one person working with one hospice. I have worked more than 2 decades in acute care hospitals. If this is happening, it flew past me. 🕊
P.S. Vicodin is prescribed for moderate pain. It contains 300 mg. Acetaminophen (Tylenol) and therefore can't be given after the acetaminophen doseage has gone over 2 Gm./day or liver toxicity could result. The dose instructions are to take one tablet every 6 hours, not to exceed 6 tablets in 24 hours. Is that going to be sufficient to relieve pain in a dying person? I doubt it.
I'm not sure it's wise to tell people they can't have seen what actually they might have seen. Mama cat's loved one was being given morphine either orally or p.r., and as a bedbound MS sufferer could have been a long-term opioid user.
So I looked it up and found this in the BNF:
Pain in palliative care (following initial titration) By mouth using immediate-release medicines
For Adult Usual dose 30 mg every 4 hours; up to 200 mg every 4 hours, higher dose may be required for some patients (occasionally more is needed); for management of breakthrough pain and other general advice, see Pain management with opioids under "Prescribing in palliative care".
By mouth using modified-release medicines
For Adult Usual dose 100 mg every 12 hours; up to 600 mg every 12 hours, higher dose may be required for some patients (occasionally more is needed); for management of breakthrough pain and other general advice, see Pain management with opioids under "Prescribing in palliative care".
It sounds as though there was maybe some kind of reaction to the morphine itself? - if her pain was uncontrollable in spite of the increased dose, but then able to be controlled with Vicodin instead.
But then isn't that the point anyway? That hospice are not death squads who, once you invite them over the threshold, will kill your loved one come what may. Mamacat decided on a second opinion on her sister's behalf. I'm very glad, good catch, good outcome. That's what's *supposed* to happen.
What you witnessed was real and is happening widespread, in every state.
I recommend the Hospice Patients Alliance. It is a pro-life, patient advocate organization. It was founded by a hospice nurse, turned whistleblower. He saw these things happening and couldn't take it anymore.
Their website is filled with information and first hand accounts that could answer many of your questions.
You can email them, tell them your story and ask questions.
They also have a phone number you can call to get help and advice.
"Mamacat123", I'll play along just so some new innocent poster doesn't really believe your crock of cr*p.
*She received 300 mg. of Morphine. •Again, there is and never has been a doseage of Morphine that is 300mg. That would cause death instantly. Like I've said, the doses vary from 5-15 mg.
*They were trying to get her off hospice because after 6 months, they loose money on her. •Wrong again. The Medicare program (federal government) funds hospice. Some patients have been on hospice for years. If they improve (which occasionally is the case), they come off. If they need pain management, nausea/vomiting control or breathing assistance or anxiety control, we can put them back on hospice.
* Vicodan is controlling her pain where Morphine didn't? • Wow, that's ridiculous. Morphine is much stronger than Vicodan. And Vicodan has Acetaminophen (Tylenol) in it, so the patient would receive too much of the Tylenol in trying to get rid of the pain.
I think this thread, like the other anti-hospice thread, should be put to sleep. Let's give it 300 mg. of Morphine! 😝 💉
I don't believe some of these are real posts. If you look at the profiles of these hospice-is-murder posts, most of them are brand new profiles, with only a couple of comments. Usually the ones in these threads.
I think "prolife" is making multiple personalities up, or else calling in other activist friends to invade the forum with their b.s. Maybe both.
Mamacat, I need to use tough love here, but you are not paying attention.... another writer and I have told you it would be impossible for your daughter to have receive a dosage of 300mg of morphine and live through it. I'll say it again, IMPOSSIBLE. The dosage was maybe 30mg, nothing more.
Hospice called you in to make funeral arrangements? Here in my area, Hospice is only responsible for having the telephone number for the funeral home for when, and if, the patient passes. Hospice needs to know whom to call.
I know during this time everything is highly emotionally charged. Family members are like deer in headlights, and not processing everything that the doctor and nurses are saying. It can be easy to get facts mixed up.
My husband had metastic colon cancer for nine years, he had a surgery to remove the right side of his liver, then 5 months later he had a bile duct leak into the cavity of the right liver that was removed. A procedure was performed to insert the drain and an infected area was hit and he went septic, the trauma team brought him back. Long story short, he didn't recover and we went home with hospice care. Yes, he had the morphine and yes he died peacefully in his sleep. There is no quality of life at the end stages, it is better to let your loved one go, although it is so hard to do this. He was dying without the morphine, the septic shock undermined his health so that he could not undergo chemo treatment anymore. I am not bitter, just sad.
she was on for about 6 mo at that time. She has M/S and has ben bedfast for 11 yrs. She was in extreme pain. She was given 300 mg every 4 hr and if she wasn't awake to take it they were giving it rectally. My opinion , they were trying to get her off hospice because after 6 mo they are loosing money on her. She is still bedfast, her pain is being controlled with vicodin now. Hospice called us in to make funeral arrangements and said she had hrs to live. I guess if we would have blindly followed their orders she would have died. but it would have been from overdose, not the M/S.
Mamacat, I'm sorry your daughter was sick. You say she is alive 3 YEARS later? Sounds like her doctor misdiagnosed her having a terminal illness and the length of time she had left to live. (In order to enter hospice, the patient is terminal and has around 6 months to live.)
I believe you have your mg. strength wrong on the Morphine. There is no way someone could be alive after receiving a 300 mg. dose. Maybe she was on 30mg.? Even that is a very large dose UNLESS she had been taking Morphine for a long time and had built up a tolerance to it.
Usually antibiotics would not be given because it would be considered a "lifesaving" measure (hospice is for the dying) but Tylenol definitely could be given for the patients comfort.
Mamacat, oh dear, if your daughter was given 300mg every 4 hours, she would have died right after the first 300mg was given. No doctor nor a nurse would EVER give that deadly high dosage. Morphine is highly regulated, thus that amount of morphine used would have raised many red flags.
Curious, why did you place your daughter on Hospice, you mentioned she was in pain? It is not unusual for a patient to graduated from Hospice to continue to live more months or even years.
Chances are the dosage was more like 5mg to 15 mg. The amount is no different than what is given to hospital patients who have had surgery. I have had 2 major surgeries where I was given a morphine pump for the pain.
Make sure your daughter has a legal document stating that she refuses to have Hospice, and refuses to have Morphine should she need surgery. Make sure it is signed, dated, and Notarized. And have one drawn up for yourself.
My 31 yr old daughter was on Hospice they were giving her morphine 300 mg every 4 hr for pain, Refused to give antibiotics or tylenol for 103 fever. We threatened to call an attorney because she was showing signs of morphine overdose. within 15 min antibiotics was given tylenol brought the fever down. 3yrs later she's still alive and Hospice is no longer allowed around her...
And where were you Mary, while all this was taking place? A drunk caregiver that robbed his cash, gave meds early, force fed a sleeping patient....wow. Was no one observing what was going on with him?
FYI, 1 mg. of Morphine wouldn't be enough to even be felt, let alone kill anyone. I normally give between 5-15 mg. every 4 hours with my hospice patients.
Yeah it takes pain away except my dad wzs told its for pain only not death.and when they uped it to 1 mg. After .05 witch he could function on.he was out of it.his care giver was a drunk and gave him his doses early and also when he was allready asleep also she forced fed him he choked.then she stole his cash and he died.i told senior dervices my conserns.nothing done.
Yeah it takes pain away except my dad wzs told its for pain only not death.and when they uped it to 1 mg. After .05 witch he could function on.he was out of it.his care giver was a drunk and gave him his doses early and also when he was allready asleep also she forced fed him he choked.then she stole his cash and he died.i told senior dervices my conserns.nothing done.
Has anyone on here heard of the insane "Macdonalds triple cheeseburger and double fries cocktail" that has contributed to high cholesterol and killed numerous loved ones? Shall we start a conspiracy thread about that?
Then there's the" Burger King Double Whopper with fries" cocktail.
Scary stuff people! The subliminal messages in the ads "buy us", "eat us"........." stuff your face with us." Scary. Close your eyes, plug your ears boys and girls.
I watched my brother die from a long battle with cancer and wished there was something I could have done to end his pain. I watched my father lie in the hospital in pain telling everyone "He was going home soon" which he meant that he was going to heaven. The hospital said they needed the bed and put him out and nothing for the pain, and he passed in the hallway of a nursing home. I am caregiver for my mother and when it comes time when my mother has inconsolable pain, I pray that someone will see her need and take away her pain, and if I am condemned to hell for taking away her pain; so be it. If my mother passed as a result, I would thank them for letting her go in peace; and I will sleep at night knowing I did the right thing.
Prolife, the Catholic church advocates hospice care to include any medications to keep the patient comfortable and pain free. Please take your ignorant philosophies to a website that welcomes ignoramus prolifers.
I did not want my mother, who was in terrible pain, and agitated, to die in that state. I wanted her to die peacefully. Because she WAS dying. She had dementia, chronic heart failure, had fallen, broken her wrist, smashed up her face and developed pneumonia, which was treated with antibiotics. She wouldn't get out of bed and lay there with her face screwed up in pain and horror. Doubling her regular pain meds did not help. Morphine eased her breathing and restored her calm.
If she was meant to heal and live, taking away her pain would have helped. She died, but not because of morphine.
Here it is again;
"""Other experts recommend consulting a pain management specialist ""BEFORE"" exceeding a dosage of 80–120 mg daily."""""
This means you CAN exceed this doseage but should be done under a pain specialist's (MD) watchful eye.
I can only speak for the hospice I work for. We do NOT give huge doses to our patients with severe pain. The dose is "titrated" to keep the patient comfortable-not comatose!
If it takes giving them meds every hour, then that's what we do. But not in ridiculous doses.
I had a patient who was 55 years old, (younger than me 😢) dying from cancer. Her partner had witnessed her parents die in pain and told me to keep her out of pain. When I had given her everything I could and she was STILL writhing, I called the doctor. I got new orders for medications. The Sig Other wanted me to keep giving her more but I explained medication takes a few minutes to be absorbed. If after 15 minutes, she's still restless, I'd give her more.
OUR GOAL IS TO RELIEVE PAIN AND ANXIETY.
She calmed down and was able to rest with slow, easy breathing. Her SIg. Other sat with her for a couple of hours and was relieved that she was finally comfortable. The patient died many hours later that day. The spouse was immensely grateful that she didn't thrash around suffering in her last hours.
I did not kill her-cancer killed her. I made her as comfortable as I could with the little time she had left.
I'm not saying every hospice is perfect-far from. But to clump ALL hospices in the "killer" catagory is wrong. We provide a needed service to the dying and their families.
You should be using your talents to tell folks who are watching their loved ones die that they should prolong the suffering, don't you think? Really, you might extend a few days of agony for everyone, which I think is what you want.
Let the doctors try that experimental treatment that might give mom another week. Force them to do another round of chemo, another round of injections, another lung tap.
That's the natural way to die, right?
Sue what you copied and pasted, warns against exceeding 90mg to 120mg DAILY.
"Nurses gave high doses of drugs such as morphine, regardless of whether patients needed it, to justify the higher payments, prosecutors said. In some instances, these excessive dosages resulted in serious bodily injury or death."
dallasnews.com /news/frisco/2017/02/28/frisco-man-15-others-indicted-medicare-hospice-scheme-used-human-life-vulnerable-stage
Just the tip of the iceberg. I hope they all get caught.
I tried to access the BMF website but I couldn't find a way to look up anything. (?)
This is from drugs.com;
"CDC (Center for Disease Control) states that primary care clinicians should carefully reassess individual benefits and risks before prescribing morphine sulfate dosages ≥50 mg daily for chronic pain and should avoid dosages ≥90 mg daily or carefully justify decision to prescribe such dosages. Other experts recommend consulting a pain management specialist before exceeding a dosage of 80–120 mg daily."
I understand patients developing a tolerance to opioids but I have NEVER seen 300 mg. of Morphine being given AT ONCE. I would bet you a weeks pay that there never was an order that said to give 300mg. at once.
You wrote 30 mg. every 4 hrs., up to 200 mg. every 4 hours (or 50 mg./hr.)
Then;
100 mg. every 12 hours, up to 600 mg. every 12 hours. (or 50 mg. hr)
for a maximum dose of 1200 mg. in a 24 hour period.
I think you'd be hard pressed to find that amount being given in most hospices or written by most doctors.
At the hospice where I work, our orders;
Give Morphine 15 mg. every four hours.
For "breakthrough" pain, give Morphine 5-10 mg. every hour as needed.
Let's suppose the patient needed breakthrough pain medicine (Morphine 10 mg.) EVERY hour.
Morphine 15 mg. given 6 times in a 24 hour period plus Morphine 10 mg. given 18 times in a 24 hour period.
90+180=270 mg. for a 24 hour period.
I'm not saying huge doses can't and don't happen, but I think it's a lot less common than the lower doses.
I'm only one person working with one hospice. I have worked more than 2 decades in acute care hospitals.
If this is happening, it flew past me. 🕊
P.S. Vicodin is prescribed for moderate pain. It contains 300 mg. Acetaminophen (Tylenol) and therefore can't be given after the acetaminophen doseage has gone over 2 Gm./day or liver toxicity could result. The dose instructions are to take one tablet every 6 hours, not to exceed 6 tablets in 24 hours.
Is that going to be sufficient to relieve pain in a dying person? I doubt it.
So I looked it up and found this in the BNF:
Pain in palliative care (following initial titration)
By mouth using immediate-release medicines
For Adult
Usual dose 30 mg every 4 hours; up to 200 mg every 4 hours, higher dose may be required for some patients (occasionally more is needed); for management of breakthrough pain and other general advice, see Pain management with opioids under "Prescribing in palliative care".
By mouth using modified-release medicines
For Adult
Usual dose 100 mg every 12 hours; up to 600 mg every 12 hours, higher dose may be required for some patients (occasionally more is needed); for management of breakthrough pain and other general advice, see Pain management with opioids under "Prescribing in palliative care".
It sounds as though there was maybe some kind of reaction to the morphine itself? - if her pain was uncontrollable in spite of the increased dose, but then able to be controlled with Vicodin instead.
But then isn't that the point anyway? That hospice are not death squads who, once you invite them over the threshold, will kill your loved one come what may. Mamacat decided on a second opinion on her sister's behalf. I'm very glad, good catch, good outcome. That's what's *supposed* to happen.
What you witnessed was real and is happening widespread, in every state.
I recommend the Hospice Patients Alliance. It is a pro-life, patient advocate organization. It was founded by a hospice nurse, turned whistleblower. He saw these things happening and couldn't take it anymore.
Their website is filled with information and first hand accounts that could answer many of your questions.
You can email them, tell them your story and ask questions.
They also have a phone number you can call to get help and advice.
It is one of the best resources for these issues.
I'll play along just so some new innocent poster doesn't really believe your crock of cr*p.
*She received 300 mg. of Morphine.
•Again, there is and never has been a doseage of Morphine that is 300mg. That would cause death instantly. Like I've said, the doses vary from 5-15 mg.
*They were trying to get her off hospice because after 6 months, they loose money on her.
•Wrong again. The Medicare program (federal government) funds hospice. Some patients have been on hospice for years. If they improve (which occasionally is the case), they come off. If they need pain management, nausea/vomiting control or breathing assistance or anxiety control, we can put them back on hospice.
* Vicodan is controlling her pain where Morphine didn't?
• Wow, that's ridiculous. Morphine is much stronger than Vicodan. And Vicodan has Acetaminophen (Tylenol) in it, so the patient would receive too much of the Tylenol in trying to get rid of the pain.
I think this thread, like the other anti-hospice thread, should be put to sleep.
Let's give it 300 mg. of Morphine! 😝 💉
I think "prolife" is making multiple personalities up, or else calling in other activist friends to invade the forum with their b.s. Maybe both.
Hospice called you in to make funeral arrangements? Here in my area, Hospice is only responsible for having the telephone number for the funeral home for when, and if, the patient passes. Hospice needs to know whom to call.
I know during this time everything is highly emotionally charged. Family members are like deer in headlights, and not processing everything that the doctor and nurses are saying. It can be easy to get facts mixed up.
I'm sorry your daughter was sick. You say she is alive 3 YEARS later? Sounds like her doctor misdiagnosed her having a terminal illness and the length of time she had left to live. (In order to enter hospice, the patient is terminal and has around 6 months to live.)
I believe you have your mg. strength wrong on the Morphine. There is no way someone could be alive after receiving a 300 mg. dose. Maybe she was on 30mg.? Even that is a very large dose UNLESS she had been taking
Morphine for a long time and had built up a tolerance to it.
Usually antibiotics would not be given because it would be considered a "lifesaving" measure (hospice is for the dying) but Tylenol definitely could be given for the patients comfort.
I'm glad that she survived.
Curious, why did you place your daughter on Hospice, you mentioned she was in pain? It is not unusual for a patient to graduated from Hospice to continue to live more months or even years.
Chances are the dosage was more like 5mg to 15 mg. The amount is no different than what is given to hospital patients who have had surgery. I have had 2 major surgeries where I was given a morphine pump for the pain.
Make sure your daughter has a legal document stating that she refuses to have Hospice, and refuses to have Morphine should she need surgery. Make sure it is signed, dated, and Notarized. And have one drawn up for yourself.
A drunk caregiver that robbed his cash, gave meds early, force fed a sleeping patient....wow. Was no one observing what was going on with him?
FYI,
1 mg. of Morphine wouldn't be enough to even be felt, let alone kill anyone. I normally give between 5-15 mg. every 4 hours with my hospice patients.
Then there's the" Burger King Double Whopper with fries" cocktail.
Scary stuff people! The subliminal messages in the ads "buy us", "eat us"........." stuff your face with us." Scary. Close your eyes, plug your ears boys and girls.
Sorry,............couldn't resist.
I doubt that this poster really wanted answers-only to stir up **it,
just like the other insane anti-hospice thread.
Some have called them trolls.
You clearly had a bad hospice team. It is NOT the norm to ask family membets to leave. I hope you reported this. If not, DO IT NOW!!!