Auntie is so very weak, refuses food liquid, moaning in pain, spits out everything I give her to try to help her. Any ideas?

Call the hospice line now and tell them what you've told us here. You may need to use a suppository or some other method for getting pain meds in.

Do you have liquid morphine that you can give with an eye dropper in the side of her mouth?

((((((Hugs))))))

It makes me cross on your behalf that the nurse tells you to give your aunt morphine but doesn't tell you how. I agree with BB that you should ask the hospice team to show you the right technique.

I'm sorry that your aunt is struggling and in pain; but it may be that battling with her is more distressing *to* *her* than leaving it and trying again later. How aware is she? If possible, offer her food, drink and medication and let her choose. Don't try to force anything.

I don't think anyone can judge better than you whether it's best to sit by her or to let her have privacy; but certainly if you need a break then take it, and ask a family member to listen in - you can use a baby monitor for this - and call you if she needs help.

You are a brave and strong person to stand by your aunt through this. I hope your family can support you even if they're not close to her.

When my mom was on hospice, the nurses used a long syringe type of dropper that they were able to shoot the liquid morphine into the back of her throat. Ask for the hospice nurse to come out and demonstrate the best way to do this.

Food now will prolong her suffering. Just a little food can keep someone going for much much longer. So see if food can be avoided. Speak with hospice about your inability to get in the medication and have them show you how to do it. Often medication can be shot in with a little syringe without a needle and is put on the buccal membranes, under tongue, side of cheek, and absorbed without need to swallow. There are also patches which would mean that your Aunt doesn't have to swallow at all. The most important thing now is that she is medicated to a point of comfort. She is likely taking no nourishment now and will pass soon, and nourishment would in fact prolong this agony. Dying is not an easy thing, and there are some three days in which agitation, picking, confusion can be very acute with lots of restlessness. Hospice was ever so much better in my day with more support at the bedside or with the senior in hospice facility. Speak with them about how to give the meds, about the agitation, about how long you can expect it, about what to watch for when death is more eminent (mottling and cooling in extremities, and etc). Do know that your presence and your attempts now is all that you can provide. I am sorry for all you are going to and please throw yourself upon hospice folks with desperation so they give you all they got to help now.

It sounds as though the food spitting really is last stage. The last time they encouraged my BIL to swallow food, it was followed by projectile vomiting. Cleaning up was very distressing to everyone, including him. Perhaps if you stop trying the food, her reactions will change. BIL liked having his lips painted with cold sweet liquid sorbet, and then he licked it off. Could you put a lot of sugar in the morphine and try that?

Do request the comfort care packet if you haven't already received it. There should be meds in it for her agitation and pain. I just recently did end of life Hospice care for my FIL in our home, and we had the liquid morphine which we delivered via the syringe into his cheek. I did not mix it with food, just pushed the dose into the inside of his cheek, and yes it tasted nasty but you could perhaps gently hold her mouth closed until it rolled back into her throat (it was only a few drops in my experience) or maybe gently tip her head back for a few moments for it to be absorbed and follow it with a drink. None of this is easy, especially when you have an uncooperative patient. Keep reassuring your Auntie that the medicine will soon work to ease her pain and suffering, and hopefully yours too!

I would definitely stay on your Hospice Nurses tail about getting educated about how to deal with all the issues that come up, as there are many and often. I know that there are other medications administration options, such as the patch or rectal suppository, and perhaps the pain patch might be best for your situation, but it sounds like you need to get this worked out ASAP for everyone's sake.

Lastly I would like to say that we had the most amazing experience with our Hospice provider, establishing good communication is essential and keeping good records saved my bacon as I was so busy and so tired that it was easy to forget things, I also kept a list of questions so I wouldn't forget to ask them.

You are doing great, this is such a difficult job and people don't realize just how hard it is on the Caregiver. You are an Angel for taking this on. I hope you soon get your medicine issues solved and that your Auntie's end of life journey is swift and peaceful for the both of you. Take Care!

i am so sorry to hear of your struggles. Sounds like she needs a further assessment - there’s liquid nutrients if she will still drink. My aunt wouldn’t eat and that’s what I used to ensure she had, as it provided all the essential nutrients needed.

Medication can also also be provided by IV pump if she can’t/ won’t take them orally now. The hospice staff or doctor should be able to advise if your aunt has reached a point where either a nutrient drink or stopping all bar water is appropriate for her. The same re IV pump for her medication.

I provided their favourite music and freesias, due to their aroma, but it depends whether your aunt likes them. Whether responsive or not, I’d chat to them normally about events past and present. Though that might be slightly harder if your aunt didn’t bond with family.

if you need a break, being human the answer is yes, put some music on for your aunt, and take one, or get another family member to sit in with her whilst you do.

Take care of yourself too, and remember to be kind to yourself at this difficult time.

One other way - doctor or end of life team should be able to provide them - is small sponge on stick that can be dipped in water and used to wet the mouth. The end of life care team can help with care - mum hated being moved but looked a lot more comfortable afterwards. Small things like adjusting the pillow so supports the neck, they were very good.

Doctor only sent them for the last 2 days out of the week we knew mum was dying but they were very helpful all the same.

Mum bit Dad when he tried to remove her dentures- first reaction we had! At first she would suck the sponges but later we just would wipe around the inside of her mouth regularly.

Think the reaction is just, that a reaction to suddenly suddenly being disturbed with food or liquid. Not to be taken personally even though it’s a bit of a shock when they do. Partly as you can’t believe they still have the energy to react!

Hope you are looking after yourself too - tend to forget whilst focus is on a LO at that stage.

Lorraine, great big hug🤗🤗🤗🤗

Your little tiny aunt spitting like a machine gun made me laugh. You are doing an awesome thing for her. Laughter doeth good like a medicine. I am happy for you that you can see the humor it her spitfire ways, that alone cracks me up. Spitfire apple sauce.

THANK YOU ALL ; I'M HERE to update all of you Auntie still hanging in there now she is so weak even when she tries to spit she can't, she's forgetting how to swallow ,can not move arms or legs ,We have do everything for her she still gets mad when changing her ect...she can take VERY SMALL AMOUNTS OF water or at a time shes soooo tiny ...I feel very helpless poor little spitfire ,whitty, Auntie ....