A new hospice nurse come in and gave my mother 2 mil adavain and 1 mil hydromorophone. Every 4 hrs.
She was at the end of life from COPD. My mother was alert and not in agony.
We never knew it would make her unconscious and she would die in 4 days. After 2 days I asked him to lower the dosage but I wasnt there ( I left thinking she would be ok.) So I don't know what he did. She never woke up. Isn't their job to keep my mother conscious at the lowest level of pain possible? Thats what we were trying to achieve but this time I could not wake her up. Should he have told us. Should he have started with a lower dose.

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My FIL was awake, talking and sipping tomato soup 12 hours before he passed.

There is no set 'rule' about death. It is what it is.

Hospice nurses know the nuances of impending death--as family we ae usually in some kind of denial.

I'm sorry for your loss, and I hope you can come to terms with it.
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I’m so sorry. Its not their job to keep the patient conscious. It’s their job to keep them comfortable. In all honesty what happened sounds totally normal. Slipping in to a comatose state happens in the final days of life. It happened to my MIL and it wasn’t the medication. She was alert on Monday and Tuesday she was asleep until she passed early Friday morning. Again it wasn’t the meds that made her unconscious. It was her body shutting down in its final days. Hospice should be explaining everything that is happening as it happens and they should be preparing those who are present for what is to come. They gave us booklet called “gone before my sight” that explained common symptoms & occurances during the final weeks of life. It is a must read for anyone with a loved one on hospice. Again I’m so sorry for your loss.
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Drteelbo, my heartfelt sympathy to you and your family.

When it comes to the end of life phase, a patient can rally and we all think this is a good sign. Then the next day or a couple days later the patient may go into a coma type state, which is not unusual.

Hospice is very experienced, this isn't anything new to them. But for us, this is all brand new and we are not experienced enough to know what is normal or not. Each case is a bit different. We just need to let hospice guide us though.

The hospice group that both of my parents used handed to me a 3-ring binder with a lot of information which answered a lot of questions. My Mom was on hospice for many weeks. My Dad was on hospice only a few days. Both passed peacefully, and yes, both were in a coma state. For me, that told me neither were in pain.

I realize we want our love ones to continue on for us, but would it be fair to them? Anytime my Dad would be in pain, he would say everything was fine, as he didn't want to worry us.

When my Dad slipped into his coma state, I read that one can say to the patient "I will be ok, Dad, you had taught me well, it is ok to go to Mom [my Mom had passed a year prior]". In the wee hours of the next morning Dad had passed. Honestly I didn't think he would go so quickly, but that was ok. That was 2 years ago.
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The hospice nurse was certainly required to keep complete records of any medications given to your mother. Ask to see them. If you're still not happy, ask a medically qualified person to talk you through your mother's end of life care.

Then, what would you like to happen? It does sound as if communication could have been better, and you should tell the hospice provider that you and your family felt unprepared and left in the dark about what was happening.

We on the forum can't possibly second-guess your mother's treatment. We're not qualified, a) and even if we were we don't know anything about your mother's medical history, b).

But we are entitled to have an opinion about what we would expect from the people who are caring for our loved ones and supporting us. Whatever happened, your mother's hospice provider did not do that second part of their job well.

I'm very sorry for your loss, and I hope that someone will take the time to explain in a way that sets your mind at rest.
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