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Was he right is trying to give the right of choice to suffer or die with dignity?

Our dogs had to be put down- they didn't understand what was happening. 30 second shot, and their sufferig was over. My poor lab had cancer, again. took friend who s nurse antheistist with me to vet, Cab put his head on our kness and just laid there. Very peaceful and dignifieid. Very much loved, went with us everywhere.....Pets our our family too.

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Caring for my dad for quite some time now made me wiser xD and I changed my prayer to “Please God make my heath as long as my life! Ameen” instead of wishing for a long life.
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As an addendum - my mother is nowhere near considering end of life options. She has good days and she has bad days. A few months ago she a VERY bad episode with pain that landed her in the hospital and nursing home to get it back under control. During that period of time, she signed a DNR, because it was so bad. Now she is back to her normal again, which a pain level that averages around 4-5 most days with her medication.
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I actually didn't much care for Kevorkian. I thought he inflamed the general public. I do believe in the right to die with dignity, and I like Oregon's law in that respect.

I have been on Neurontin for my fibromyalgia and had bad reactions to it as well. The Utram (Tramadol) I can only take 1/2 tablet of about every 6 hrs. The oxycodone and hydrocodone are absolute no-no's for me.

People that have bad pain for anything (cancer, bad arthritis, etc) that have the same type of issues I do, will find it difficult to get treatment that allows them to remain comfortable. My mother has had many back surgeries. She has rods and screws and 4 levels of fusions in her back. She's bent over almost double. She's got enough arthritis and osteoporosis in her back she sometimes breaks things just sitting wrong. She's got a spinal cord stimulator implanted to help with pain. She takes oxycodone and oxycontin daily and she's still in pain. I shudder to think what would happen if I had her back, because I couldn't take the medication she does. I think I would lay in my bed and cry and hope Dr. Kevorkian would come by with his cocktail.

I lived with horrible pain for 2 years (I still have fibro, so deal with pain on daily basis, but this was worse). I had a syndrome called frozen shoulders. It was in both of my shoulders. Both of them were literally frozen to my sides. If anyone accidentally jostled me, or tried to pull them up, it was agonizing. One time I was trying to cook dinner, and some grease spattered me, and I instinctively tried to jerk back, and the pain was so intense that I fell to floor vomiting. That was before my intolerance to narcotics. At that time, I was taking 2 vicodin 4x a day. At night, I was washing it down with a drink, and it still wouldn't touch the pain. Horrible. At one point, I put a gun to my head. But I couldn't do that to my family. I knew it would end eventually - I just had to wait it out. If I was terminal and going through that? I'd expect my family to understand that I didn't need to suffer for them.
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Equillot - I've been told that aspirin and Neurontin can work really well for post-op pain, but have not seen or experienced that personally. My hubby just did have a hip done and they did a little Ultram but mostly used IV acetaminophen, aka Ofirmev, and that was completely awesome. He had way better pain control on that than when the IV as out and they sent him home on oxycodone and hydrocodone.

In general, about the Kevorkian approach - I ethically favor the position of not removing ordinary care and absolutely not hastening death by any primary deliberate means, but consider it very permissible to omit burdensome care that limits quality of life with the intent of prolonging it. Some people do better without some interventions - in some studies, patients switched to hospice or comfort care live longer than those doing "everything possible." "Everything possible" to prolong life should never be required. And giving enough medication to manage pain or psychiatric distress even if it shorten life is also permissible.

I do think that assisted suicide is too easy to abuse - one it is an easy solution and cheaper than thoughtful, top-notch medical care or physical assistance, and there have been horrid examples of people in states where it is legal being denied "experimental" cancer treatment (in quotes because it actually wasn't, except form the point of view of the insurance company who wanted to deny it) and getting letters that reminded them that assisted suicide would be covered if they wanted it. And I have seen people with disabilities whose quality of life given appropriate support would have been excellent offered withdrawal of tube feedings instead. Doctors and nurses and even the general lay public vastly underestimate what people can do using technology - I've hear people assume a feeding tube in place mean a person will be unable to SPEAK, and a ventilator meaning a person will be bed-bound.

And on here, we all know that sometimes QOL for caregiver and caregivee can both really suck - but we also know about greed and desires to see things end before potential inheritances are used for care. Respect for life ultimately matters to all of us, and the Kevorkian approach was not respectful of the value of life and did not seek non-lethal solutions in many of his cases.
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Jstmealone..... I have had numerous occasions to be working with Hospice.... yes they know when to give Morphine....I wouldn't say that Morphine is the ultimate killer.... but when they are anxious, struggling, it does ease the transition.....but I have also seen where it was not used at all.... so ultimately it depends on the patient , their end of life struggles, and how the family feels about this......
And end of life does not always mean a matter of days..... it can be months.... One of my charges only lasted 5 days, another ,3 months....so please talk with the Dr about your concerns and any questions you have... the Hospice nurses are also able to answer any questions you have..... Utilize the staff of the Hospice, that is what they are there for... not just the patient, but the family as well..... sending you hugs while you are in this part of your journey.
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This conversation has blown me away! A couple weeks ago my mom had pneumonia. She was taken to hospital n was half dead when she got there. 7 days of antibiotics n back to nursing home. Admin called a meeting. They advised me that end if life is here. That was 50 days ago! Hospice is in etc. Hasn't eaten in forever. Of course family has been visiting much more often. She's done a 360 physically. Alert, talks talks talks. Lol. Of course she's in London in WWII ( she was a nurse during the war and is from Ireland ). Also she's 90 yrs old. Reason I'm writing is that all I've been saying is if Mom was lucid for 5 minutes n asked me "Kathleen what's wrong w me ?" If I was given just 1 chance to tell her she would ORDER me to call Dr K ASAP. So I'm happy to read all your posts n comments re: end of life! They have her on morphine as needed. N she hasn't needed it I guess cause she hasn't it. I have a question. Does hospice know when it's time for the morphine? Like I never realized til then and now that morphine administered properly is the ultimate killer? Maybe I'm wrong but quite interested.
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About choosing suicide -- I've read of the times when elders walked into the woods or out onto the ice when their time came. A while back I read that walking onto the ice was legal in Alaska all the way into the 1980s, when public outcry caused an end to the practice. I thought about what would happen now if an elder wandered into the woods or on the ice. The authorities would "rescue" them. They would be locked in a memory facility and given Haldol for the rest of their lives.

I am not Catholic, but I do feel that suicide is a bad thing. I do feel, however, that refusing treatment is completely okay. Sometimes it sickens me to see a person of advanced years unable to get out of the bed to poo, yet being given drugs to prevent high cholesterol or osteoporosis. And don't get me started on giving mammograms or pap smears to a 90-year old. I think it is totally okay for a person who is ready to cross the bridge to quit taking medicines and refuse treatment of any kind. I think that family members often keep trying to keep their elders alive because they fear looking like they didn't try hard enough.
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With Jeff, the swelling in his brain was horrible. They were discussing putting in a shunt when he died. Something burst.

I call what I have an allergy to keep the docs away from me. It's actually an intollerance. It causes more pain than it cures, and it's with all types - synthetic and non-synthetic. Anything that acts on the opiod receptors in the brain. I can now take tramadol, but only 1/2 tablet. If I take a whole one, I get the same reaction. Even though it is not an opiod itself, it binds itself to the same receptors in the brain. Lucky me. And it makes no difference how the medication is given - IV, Patch, oral, whatever. I will get horrible, horrible pains in my abdomen that will lead me to the emergency room. Screaming type pains. I was able to take vicodin, but not codeine for years, then I developed that sensitivity too. I now have Fibromyalgia and can take very little for the pain, and live in fear of not being able to take anything if I get cancer. I will have to have my hips replaced within the next couple of years, and I don't know how I'm going to handle that without painkillers. Maybe let them keep me unconscious for the first week while they work my hips for me???
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hmmm.
yesterday edna told " that woman " that as far as that goes shed just as soon bobby be here as sharon kay .
it makes me wonder who " that woman " was , and how much chatter like that it would take out of edna to have MPOA changed with one court document .
cappy may already be mpoa and not even know it . edna is not comfortable with PIA and everyone can see it -- from the moment i intervened and took edna to er 8 months ago with pneumonia ..
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wow equillot . thanks . my aunt is complaining about her head hurting and the back of her eyeballs , then she rubs the sides of her head way around to her ears . it doesnt take much imagination to visualize whats going on there . i hope NH medicates as they wish despite pia cause shes an emotional train wreck with no thoughts for anything but her own interests . i trust the docs here . they know pia is flaky , theylle sidestep her .
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My husband had excruciating pain for 7 awful weeks (cancer0 and hospice gave him all pain meds allowed. I never left his side and never asked them to lighten up meds so that he would wake up. BUT he did wake up anyway for about 30 minutes the day before he died. He was able to talk through the pain and I am very grateful. His suffering was horrific but I never left him alone. He was the light of my life.
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Equilott I am so sorry you had to endure that with Jeff. it must have been a horrible experience for all concerned. the lesson here is not to let someone wake up like that, not only does the pain hit them but also the withdrawal is very bad as you witnessed.
You may not be allergic to the synthetic ones like oxycontin. That works just as well as morphine and can be given in the same way. I don't know if it is possible but they may be able to do an allergy skin test to see how you react.
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Captain - In 1998, a friend of mine was in the hospital with terminal cancer. I was by his side most of time. He had been estranged from his family for 10 years, but through this ordeal, reconnected with them. They wanted me to be the family spokesperson when they weren't there (they were from out of town), and asked my advise frequently, since I knew their son better than they did at that point.

His cancer was stomach cancer, which had spread throughout his body, including his brain. He had been unaware of any of it until he'd gone to emergency and been admitted. The last day, the day he died, he'd been there for 16 days. They'd done a pretty good job of keeping him comfortable. The last 5 days he'd been unconscious because of the morphine. They didn't give him longer than a week. When I walked in that morning, however, he was awake and agitated. His sister was there, and told me that they'd been talking. He wasn't talking then. He couldn't. She was happy that he was awake. I believe she asked the asked the staff to let him wake up so she talk to him. Then he grabbed his head and started screaming. And kept screaming and screaming and screaming. Until he died. His sister and I were both sobbing.

That haunted me for a long time. When my mother told me that she wanted to stay with my Dad, that she had to be with him when he died, I discouraged her from doing it. I didn't want her to have horrible images in her head if his passing wasn't peaceful like I did when Jeff died. Mom wasn't going to listen to me, but I think Dad heard me, because he did it while we were gone anyway. He always did protect Mom.

I sure did wish for something to take the edge off that night - stronger than alcohol, anyway. Unfortunately, I'm allergic to all opiods, which scares the heck out of me. How are they going to control MY pain? How will hospice help ME? Kevorkian is definitely on to something.
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My aunt's morphine was flushed. I thought cousin overdosed aunt, and glad she did, if that is what happened. She stopped suffering. aunt had cervical type cancer. Doc said we needed to see, so he split her gut open, and said, "yes, she has cancer all over, can't do nothing about it" Sewed her up, watch her try to heal from that, chemo, trying to get strong, and we all have to go. She was asleep nad ready to go out with cousin, she steps into the room, and 5 minutes later, steps out, aunt was gone. The last words I said to her was I love you. Glad I got that out, she said it back to me. The morphine went down, I guess they have to go somewhere....
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Thanks Captain.... in all my years of caregiving, I have never given any thought to what is done with the 'left overs in the bag'..... being an ex-addict.... I only think....man, what a waste...... think I will check into what they do here in Texas....but good to hear that Indiana is ahead of the curve....
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ladee,
in central indiana i think most of our trash goes to a big incinerator in indy . smoke scrubber technology and the likes evidently makes the output pretty acceptable . steam is made , electricity produced from the steam i think .
heres a nice change . most of the motor oil in your parts store now is 5 bucks + a quart . valvoline will sell you completely recycled and restructured oil for 3.30 a qt . go usa
i havent a reason in the world not to trust the recycled oil .
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Hi Pam I've got news for you. Very old women have been able to carry a baby these days
Aint modern medicine wonderful!!!!!!!!!!!!!!!!!!!!!!!!!!
Hope you still pocess the necessary facilities. I have hung on to mine. (Surprise every new docter) not planning on using it though.
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Nothing is poured down the drain here.... it all goes into the kitty litter/alcohol bags.... now how they dispose of that is a mystery.... too much confusion to ask.... but now I am wondering..... hmmmm....
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ya notice ( i did ) that they took the morphine soaked bandages away with them didnt you ?
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Coffee grounds? No, someone in the family would be drinking Blueberry Roxanol Folger's. Some dude with a beard and bandana (HA!) Gosh I hope you share it with Edna and enjoy the glow. Give a sip to her daughter too, she might lighten up a bit. We don't get to pick our kids, I had two, but now I am down to one, and he's still deeply grieving. I'm too old to pop out a replacement for him to play with. I'll have to adopt one of those Border Kids.
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our liquids were poured into gauze bandages to be disposed of . there is a real push on to keep meds from being flushed . va encourages destroying them in coffee grounds .
been thinking about mom , hospice , a lot today , what with cuz trying to limit my access to edna . people have flaws . there is no perfect caregiver . parents just choose the kid with the least self interests imo .. edna only had one kid ..
good kid , but wouldnta been my first choice ..
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We threw thousands of dollars of meds down the drain, what a waste. And yes we were making jokes about who could use it for what , or how much money we could make if we sold it, as we poured the pills into a Ziploc bag with kitty litter and rubbing alcohol, and mashed it to a pulp. Liquid morphine went down the sink and I wondered how the fish would like it in the river. Fluid bags were sliced and dumped; meanwhile there is a national shortage of fluids.
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I guess they knew what they were doing capt!
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we had ativan too , pam . they sent comfort meds , they should be real clear on " for whom " .
i have a fond memory tho . as hospice and sis were preparing to have mom taken from her bedroom at home there was a little burst of more laughter than oughtta come out of a deceased persons bedroom . them b*tches were in there destroying the leftovers .
meh ..
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Yeah, I believe that at the end YOU need the Ativan too, for the last few hours, because you don't know it is the last few hours and you don't know how much more YOU can withstand. Thank you for being so candid, Captain. Blueberry morphine for bystanders. Not a bad idea. You are going to pour it all down the sink afterwards anyway.
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then you have yourself a couple of drops of the morphine for yourself , a shot of everclear , and wait some more . ( true story )
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my son and i worked and lived together from his age 12 - 21 ( thereabouts ) . we laughed about " things " . of course i have ( had ) hepc . sometimes when id be a little overbearing while teaching him on the job , hed look skyward and mumble " c ' mon liver cancer " . a time or two weve chatted about terminal illness . i told him once that in my case it would be not very nice, but sensible to cram about 3 grams of heroin in a va parking lot if i were terminal and tired of it . ( that actually happens occasionally ) he snorted kinda like mom usedta do and told me theyd just haul me inside and detox me . i s'pose hes right . people quicker in the head than myself can be so annoying .
it reminded me of the time when i first started staying with mom , i asked her about the plan if i were to find her with dangerous low blood sugar . i told her that barring the proper knowlege , id probably inject her azz full of pancake syrup. grrr , same snort , mom says " the pancake syrup is sugar free " ..
so much for any quick thinking i might ever do ..
when mom was knocked out from comfort meds at end of life , sis and i discussed letting her return close enough to conscienceness for communication purposes but below pain or agitation state . sis said that hospice nurse did not want mom anywhere near conscienceness , it would be cruel to let that happen for any reason . we both had to agree with the nurse on that after thinking about it for a moment . we realized that we were possibly being nudged towards administering the meds ourselves so no one could later howl about how hospice dispatched our mom . well , good thinking on the part of hospice if that were the case . the death by morphine overdose / organ failure from dementia , became a family decision . it was an azzload of liquid morphine , to be increased as needed to keep mom unconscience , with no max limit set ..
later as the three of us kids chatted i jokingly accused oldest sis of killing mom . she sheepishly said " so you didnt have to " . the three of us just grinned rather wryly at each other ..
screw terminal agitation . the hospice air bed brought for the terminal phase was , in looking back , an inflateable " playpen " designed to keep a terminally agitated person from clamoring out of bed and hurting themselves . watching them clamor to escape their dying organs will convince a compassionate person to make with the comfort meds pretty quickly ..
you drop some meds and sit back and contemplate if your indeed killing them or if your keeping them comfortable while organ failure kills them . the latter of the two thoughts wins out . the " common sense / compassion one " ..
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I have an asenal of pills stashed in cash I need it. I don't want my child suffering hrough this. zi just hope i will get it figured out when I'm ready....my family is great, beautiful child, new rescue dog. she had imprinted on my daughter. It's cute. trhying to fin dthings to stay happy for....Have a good weekend everyone. WE all deserive it, more so that some others.
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Capt I know you did what was best for your Mom and at the very end your agreed with the medications to keep her comfortable and ease her fear. You are a man to be admired for caring for your mother, very few sons do that. Those that do are exceptional men but then we all know you are unique.
Most MDs see the death of a patient as a failure on their part and many relatives want " to do everything they can " for their loved one. What the patient wants or needs are frequently ignored in the relatives denial of reality. They can not be blamed for that it is part of the grieving process. No one educates us about death. It is final, the end of life and something to be dreaded. Why can we not celebrate it as a joyful ocassion (not because the old witch has finally left us in peace to get back to our lives) but to honor the achievements of the person who has just died and remember their good qualities as well as the bad ones and find it in our hearts to forgive them so we are able to move on with our own lives. We are full of joy when a new baby comes into this world and take extaordinary measures to keep them alive. Maybe that is also something we should consider while we are thinking about quality of life. I am not going to open that pandora's box as it has no place on this site.
We all know Capt you face life with good humor and compassion for others even when facing great adversity yourself. You don't sit home asking for handouts and you are out pounding stone when others would have taken to their beds. No, cutting Edna's bangs does not count as great adversity unless it results in jail time for elder abuse. well back to the cooking chanell. I canned peaches today!!!!!!
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Tex I began nursing in England in the late 50s and the modern hospice movement was just begining. My only contact was escorting a patient to an inpatient facility which seemed little different from a N/H. I knew nothing of the philosophy untill i became a hospice nurse 17 years ago. Earlier in the UK I was a staff nurse on a professorial medical unit. the professors specialty was kidney disease and some of our patients were admitted in the final stages of kidney failure. This was before the days of dialysis or kidney trantsplants. The medication of choice in those days was injections of heroin. The dose was generous and had to be given every four hours as prescribed so the patient was still rousable but avoided the terminal agitation. Some nurses did not want to give this medication when the patient appeared to be comfortable and drowsy but it was essential for a peaceful end. The concept of dying at home did not seem popular at that time but all my grandparents had passed in their own homes but that was before socialized medicine so a hospital stay would have involved considerable expence and Drs still made house calls.
What did I learn from this? I am sorry to say not too much at the time but when I started working for hospice so many years later and was given the means to keep my patients comfortable at the end of life I had no problem being generous with their medications.
Assisted suicide? I know a family who did just that when their loved one decided the time was right. Adults and children gathered at the bedside for an evening of family togethernes and were able to say their final goodbyes. The loved one simply did not wake up in the morning.
Suicide has such a harsh sound to it. I wish there was a better word to describe ending ones own life. Mine and my husband's wishes are written and our children know what we want. Recently I saw a new Dr who turned out to be 83 years old. After being diagnosed with dysphagia and asthma I was prescribed two steroid inhalers which I was reluctant to use because I felt the steroids might impact my heart conditions. He pulled his chair closer and said "Now Veronica I am just a little bit older than you " patting my knee "Now what do you want quality or quantity of life?" I smiled back and said "I was a hospice nurse I choose quality" he nodded and told the nurse to go and find me some sample inhalers.
My stepmother had colon cancer and had surgery and chemo. The chemo did a lot of damage to her body and she siad she wished she had never had it, The last ten years of her life were miserable as she became able to do less and less for herself living alone.
I have arranged for many animals to be euthanized. It is sad when it is a small one but to see a horse fall to the ground as the drugs take effect is something else but always the right decision.
So when my time comes I hope I am still able to make the decision to leave under my own steam but if not I hope someone who loves me will guide my hand.
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