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....

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My experience with hospice for my special needs brother was this. They gave him a fentanyl patch that was appropriate, for the most part. They did not try to dope him up with morphine or kill him prematurely. If anything, we had to encourage them to increase the strength of his patch toward the end.
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I hope that you get some rest, it is so hard to cope when we are sleep deprived. Get some good nutrition in yourself. My prays and thoughts are with you and your family. Hugs and love 2u!
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Mom was a little anxious this afternoon. She was breathing heavy, her heart rate was up a bit (high normal). So, I (and my brother) decided to try the lorazapam to see if it would calm her down. It didn't calm her down at all, and may have made things worse. She was shaking. Her heart rate remained high. Her speech was bad. I called the on-call hospice nurse and she said that it happens sometimes, especially when it is the first dose. I did look at the side effects beforehand, and nothing like that was listed. I don't know if she would have been the way she was without the medication (because she was the same way the day before without it), but I am not taking any chances. I'd rather do without it. So, I sit at Mom's again keeping an eye on her until 9 p.m. when the night aide comes. Another day of a double shift for me....
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jeannegibbs, You would think they would know the affects of the medication they prescribe on the conditions they are treating.... What's up with that? They leave it up to the clients to tell them? The nurse told me that she wouldn't give both the lorazepam and haldol together initially so that we can see which one works. But, we could eventually do that. Then I read where there are worse effects when those two are given to the elderly.... I asked my friend if her mom (who had vascular dementia) had taken them. She said they made her nutty and hallucinate.... Weird since that is what haldol was supposed to treat.... Sounds to me that haldol is out.... I may try lorazepam on a limited basis if we need it, just to see if it treats agitation. The dosage is .5 mg. That doesn't seem like a lot. I could also cut that in half... Today, Mom is weak walking (has to be in a wheelchair), but she is happy. I will go with happy and no drugs today.
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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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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.
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When my Father was in hospice which wasn't long he refused morphine...no one had an issue with that, nothing was forced or argued about...
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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.
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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.
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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...
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