My 93-year-old grandmother who has all timers and dementia has spent the last seven years of her life in a nursing home. My mother and her sister take turns visiting my grandmother daily. Other family members visit my grandmother as well. I visit my grandmother every other Sunday with my mom. My grandma's health has been diminishing because of her loss of appetite. She's always been a little bit chubby but she has been losing weight drastically because of her loss of appetite. My mom generally feeds her fresh fruit Jell-O and thickening liquids that the nursing home provides. We've all discussed that my grandmother probably gets no other nutrition besides when someone comes to visit and spoonfeeds for lunch or dinner.
A few weeks ago a hospice representative approach my mother and told my mother that their services would provide comfort for the family and my grandma as my grandmother's health continues to deteriorate.
Last week when I went to visit my grandmother I noticed that she had a brand-new chair that seeded her a lot better and she seemed more comfortable.
today when I arrived I thought my grandma was dead. I've never seen her look so poor and not in control whatsoever of her body functions.
We proceeded to the nurses station and found out that hospice has been administering morphine since Friday at midnight every six hours but the nursing staff could administer more every two hours if they felt my grandma was in pain. I asked the head nurse how has this happened that the family has not consented to morphine yet my grandmother has been given morphine for the past 48 hours... The head nurse said that hospice is supposed to contact the family to let them know but in order to stop giving her morphine they would have to have a doctors order faxed to them immediately... Where they would have no choice but to give her the dosage. I am mediately called hospice and left a message on their Emergency number. My mother said by the time she got home hospice had already called she return your phone call and they agreed they would call the nursing home and tell them to stop. This evening around 630 we were called by the nursing home letting us know my grandma's blood pressure was 74 and they said she may not have much time left to get to the nursing home immediately. Grandma was itching her skin and hair... The majority of the time she seemed disoriented and confused and still highly medicated. Her mouth was wide open and it looked like she desperately needed water or something moist to quench her thirst. A hospice care worker was there as well and said she would be willing to meet with me in the hall to discuss my grandma's condition. I told her I was not interested in speaking to her about my grandmother's condition and they have already caused enough problems. Miscommunication could be detrimental to my grandma's condition... And no one in the family had consented to my grandmother given morphine.
My question is do you think my grandmother will survive after having morphine in her system for more than 48 hours? The nursing home also told us that hospice had change the doses of some of her medicines and in fact she was placed on another medicine for anxiety; one that is not recommended for Alzheimer's and dementia patients- we were told the drug makes patient very lethargic.
Seroquel 25 mg -- is the drug and dosage.
My grandmother hasn't had food or liquids for several days now. I'm actually ticked that hospice could be so negligence and not inform the family about the morphine and we had to find out through the nursing staff at the hospital.
The nursing staff knows my grandmother for seven years -- it's not like no one came to visit her-- family was constantly surrounding her-- now hospice has come in and in within one weekend has caused her to be incoherent, non-responsive in a coma like state.
My Mom [97] is on hospice care.... hospice usually calls the POA and not the rest of the family members as they just want one person to make the decisions. I was told about the morphine and agreed it would help if my Mom had any discomfort. If hospice called everyone in the family, half would say yes, half would say no, and hospice would be at a standstill until everyone in the family comes to an agreement... and that is not fair to the Grandmother.
ConfusedHoosier, you are visiting your Grandmother once every two weeks, thus you are not seeing the ups and downs of what your Grandmother is going through. With my own Mom one day she would be alert, sitting in her Geri Recliner, and being chatty... the next day she would be in bed totally zoned out... next day back to being alert, same the following day, then the day after back to being zoned out and again the following day. My Mom also had her mouth wide opened and that was because she was breathing through her mouth, that does happen. Then there is delirium which is frightening to watch unless given a certain medicine to zone the patient out. Then the picking at one's clothing, the bedding, one's skin, etc. Whenever I see this in my Mom, I want her to close her final chapter sooner than later. The quality of life is gone.
My suggestion for you is to call your siblings and whoever to tell them you all need to support your mom and aunt through this. Trust in them that they are doing as grandma wanted. Do not make this harder for mom and aunt than it already is. Then all of you call your moms and ask what you can do to help and let them know you love them.
to me watching my Mom, knowing in her lucid moments which at the time were very few, that she was probably thirsty and so on. I would imagine her thinking why are they doing this to me. But in retrospect I don't believe she was thinking much of anything. However I was suffering big time watching someone I love wither away.
There is no easy way to let go of someone. She has been gone almost six mths. now and it still feels like it was just yesterday. I think they should have courses that teach people how to let go.
They used to just show rosey pictures of childbirth, too. Life, death, birth; they are all messy and painful. I'm all for making things better through science.
My husband died on hospice in our home. They gave me the drug kit, explained what each thing was for, and I was in charge of what to give when.
When my mother went on hospice in the nursing home, we understood that Hospice, rather than the NH, would be in charge of what drugs she would be given and when. That is kind of the point in bringing them in. Their goal is to keep the patient comfortable and pain-free. They did a great job. Mother graduated out of that program in a few months. That was a year ago. She is doing well. When her time comes, I would certainly have her back on hospice care.
It is always hard to say how much of what you are seeing, if any, is due to the drugs, and how much, if any, it might be worse without the drugs. Hospice has A LOT of experience with the dying. That's why they insist on that comfortable chair immediately, and demand and get different mattress pads or beds. And it is why they make the drug decisions they make. They are all about comfort care.
Remember, hospice is for persons expected to die within the next 6 months or so. People who are actively dying don't look and behave like they did before they were actively dying.
You say "My grandma's health has been diminishing because of her loss of appetite" but it is probably more true that her appetite has been diminishing because of increasing and accelerating loss of health. People who are on the last leg of their journey are often not interested in eating. And at the very end, eating when their body can no longer process food may make them suffer.
It is so very hard to see our loved ones' health decline before our very eyes. My heart goes out to all of you.
Not all hospices live up to their mission. Maybe you got a bad one. But I think it is very likely that you had/have a misunderstanding of what hospice was going to do. It can be extremely stressful to see a loved one in the final stages of life. I suspect that is really what is so upsetting to you. And it would be upsetting whether there was any morphine involved or not.
Who is in charge of medical decisions for your grandmother? That person can cancel the hospice program at any time. Personally, I think that would be a mistake, but it is perfectly possible to do it.
The hospital that discharged her to hospice care thought my mother might not live out the week. That was 18 months ago. She's still enjoying bingo. Hospice thought my husband had at least several weeks left when he died. All anybody can do is give a best-guess.
I think you will find this article about morphine use by hospice very enlightening: http://www.hospicenet.org/html/pain_myths.html
And no one needs to be told to read anything before signing. This is in fact one of the problems with online shrink wrap agreements; people don't read the terms and conditions of websites they use.
If you were pressured, all you had to do was tell them to take a seat and you'll sign only if and after you've read everything. You have no legal obligation to sign w/o reading, and in fact it is your legal obligation to read everything you do sign. It's called "informed consent.
I do it every time and make people wait until I've read everything, regardless of whether they like it or not. If they make a remark about the time required for me to read everything, I hand them the papers and tell them I won't sign without reading.
We each have rights but won't enforce them if we allow ourselves to be pressured into signing something without reading.
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