How can hospice (in-hospital) legally withhold food and water from a patient?

Please note that EMT's are NOT doctors, yes her vitals might had been strong, so was my Mom's at 98, but Mom was going into a downward spiral after a bad fall.

Hospice doesn't stop food and water. It's the patient who refuses to eat or drink as they know that death is coming soon. There is nothing one can do to reverse that, except make the patient very comfortable. You wouldn't want your friend in terrible pain and COPD can make a person feel like they are suffocating.

Just curious, who did sign the DNR?

You don't get hospice without PROOF of a terminal illness.
If home care results in a fall, you are better off in a hospital where multiple people can move the patient and a hoyer lift is available.
The DNR is signed by the HCP and the doctor. It is not up to the HCP alone.
It is not easy to sign that paper, but watching someone suffocate without morphine to help the breathing would be unbearable.

I don't agree with freqflyer. My father was told he was going to hospice for a week or so, until he got a little stronger, and then would be discharged home. We all realized there were no more treatment options but thought he would just finish out the last months or year of his life at home. He was ravenously hungry when he was put in Hospice and begging us for cheeseburgers and fruit smoothies, which we happily got for him. He had moderate pain in his legs but seemed to be handling it fine. He was joking, laughing and enjoying his family. His cognition and memory were 100% intact. In come the steady stream of nurses with morphine. The intervals between morphine doses got shorter and the syringes got larger. After 2-3 days, he was sleeping 20 hours a day. After 4-5 days, we couldn't wake him at all. At this point, the staff said he could no longer have water or food, because he could aspirate. This experience was heartbreaking. A DNR, to me, means no heroic or resuscitative measures are to be taken. NOT to drug someone and starve them so that the bed will be available for the next victim to be starved and drugged to death.

Gina, sorry to read that your Dad had passed. While both of my very elderly parents had passed on, I did a lot of medical research regarding their separate situations... this was a goldmine of information as to what to expect and why certain things were happening.

Remember, with Hospice this is our first time viewing such a situation, but the Hospice doctors/nurses have been around dying patients many times over. They know what to look for, what is needed, and what would be dangerous for the patient [such as food/water]. Aspiration is like choking to death.

With Hospice, the morphine is between 5mg and 15mg. In order for morphine to take down a person it would need to be 200mg. Nurses know when it comes to pain how the patient reacts. The pain in your Dad's legs could have been an indicator that he was on the path to his final chapter.

Patients also rally for a couple of days before falling into a coma, that is normal with or without Hospice. Giving a dying person food or water could be very painful for them because the stomach stops working.

Important to note, one's timetable for passing is the same with or without Hospice.

My mom lives with me. She has been on hospice for 10 months. While they did give me morphine in the starting stuff they brought, I have only given it to her once... didn't like how it made her "out of it". I have never given it to her again and none of the hospice people, CNA, nurse, social worker, or doctor have pressured me in any way to give it to her. My mom is continuing to decline at about the same speed as before. Hospice has been helpful.

As far as withholding food and drink? If that is happening, take your LO home. We have had to offer and hand feed my mom for over 2 years.

I truly think that there are many who either do not read the hospice agreement and/ or do not at all understand hospice. Their purpose is to keep the patient as comfortable as possible, to alleviate pain as much as possible and it is up to the family to seek appropriate counseling regarding the patient's need for the palliative only care that any hospice groups I have encountered offers. These are caring compassionate people who are there only to ease the transition. There have been several comments declaring that they put their loved one in hospice and the loved one has been deprived of food and hydration. I have recently experienced the deaths of several family members and three friends in three states and every family member was deeply appreciative of the care their loved one received. Please do not make this decision without complete knowledge of the purpose and the process.

Opioids such as morphine can cause side effects such as difficulty swallowing and loss of appetite. These symptoms are increased when other drugs, such as Ativan and Haldol are added.

Morphine also shuts down breathing.

medlineplus.gov/druginfo/meds/a682133.html

Ah, a link to side effects.

They can create the conditions to stop them from eating, such as side effects from medication. They then tell the family that they are dying and at this point can not tolerate food and water. They also sedate them without providing IV fluids etc, thereby denying food and water in that state. This is what I have seen done and have heard from many others, who have also experienced this.

There seems to be a mass misunderstanding of Hospice and opioids...secret agendas and conspiracy theories seem to abound as well...it's sad very sad that people are basically spreading lies about Hospice...and confusing and mudding the waters for newcomers...people need to do research before bandwagoning...I'm sorry your loved one died but they were not murdered...get some therapy and move past this...

My Dad died just a few days ago under these same circumstances, in the hospital they had him so druged up he was eating
fine until they started with, Ativan, Haldol, and Morphine.

Who are these people....Russian trolls?

Windy, maybe campaigns aren't the only thing the Russians are meddling in.

I’m done here. These people , or bots, or whatever they are, deserve no response.

Forum members should ALL quit engaging this crap on all the Hospice hater threads. Over and out.....

shameonthemall, look up aspiration then you will understand why some patients no longer can take in food or water. Also when the organs start to shut down, food would just sit in the stomach, painful.... and water would sit in the kidneys, painful.

The more you know about how the body works, the better it is to understand what is happening to your love one.

I disagree. My mom was in the hospital and given every chance to live. At the end the doctor called me and told me she was only taking in small bits of food and she had difficulty swallowing which started years ago before she ever went into hospital! We agreed on palliative care and yet they still allowed her whatever food she was able to take in, they did oral care and tried to keep her hydrated even when she had ripped out her IV multiple times which was giving her the fluids her body needed. It was me who chose palliative care, as to not put my mom through anymore suffering. The only time they used morphine was when I told them to disconnect her from the vent! It was to keep her comfortable and not be in pain as she left this world. If it wasn’t for the hospital and those doctors and nurses, I may have lost my mind. In the end, they asked me, what I wanted for my mom, it was my choice, not theirs! I also agree that no one fully understands hospice and should be educated better as to understand what will be happening. I in the healthcare field already knew what it entailed. I had one specific nurse that got me through the whole ordeal with my mom and was by my moms side the whole time. I know in the end I made the right decision.

The patient and their caregivers/POAs always have the final say in the treatment of their loved one.
If you don't agree with something and can not get an understandable explanation of the situation, request a second opinion and refuse if it seems the right thing for you to do and you are prepared to live with results of your decision. No one can stop you taking a loved one home again if you feel it is the right thing to do. Hospice will never
refuse to let you take your loved one home as long as the situation is acceptable and the family is capable of taking proper care. it is not unusual for a patient to be taken home and realize their heart felt wish to die at home.

Veronica, I know of a case where a patient dying of pancreatic cancer was taken home, per his request. The medical staff warned the family that pain control would not be workable for him. They were right - the patient had to be rushed back to the hospital in agony. Sometimes the medical staff do really know what is best.

My husband was alert and oriented times three, went to the emergency room because he had been given Lasix when he was already dehydrated.   He was on Lasix for 10 days to counteract a side affect of a drug. The first thing they did in the emergency room was double the dose of Lasix that he had been given four days before. Without any discussion with him or me, he was made comfort measures only, And a nurse wrote an order to change him from full code to do not rescuitate. They withheld water even though he repeatedly was asking for something to drink, they withheld food and nourishment, they stopped his blood pressure medicine and Coumadin need it for his artificial heart valve. Even though he never had pain he was drugged with lorazepam and fentanyl until he was unconscious. He died four days later. Three "gray team" hospitalists repeatedly falsified medical records to cover up what they were doing. I find it difficult to believe that they would risk their medical licenses to drug their patient to death if it was not condoned and accepted by the hospital.

Respectfully I ask you Ashley, why didn’t you speak up? I am a RN & would never ever change the status of anyone to a DNR. That is determined after much discussion with the entire care provider team & the family. A physicians must provide a written order. It’s not an arbitrary decision.
I am sorry you lost your husband and it sounds like he was very ill. I just don’t understand how you did not intervene. 

If you do not have a POA this kind of stuff can happen. A hospitalist put DNR on my dads chart when he was so sick he didn't know up from down. This was supposedly what my dad said in a conversation only the 2 were involved in. I knew my dad wanted full code so i raised the roof on that hospital, told admin about that sorry sob dr. He is still alive after 9 months and talking about moving to Vegas. So as loved ones, we need to advocate and question, my personal experience is that if a so called dr gets butt hurt about 2nd opinion, they need to go. All good Drs are happy to have a colleague give their professional diagnosis. It is unfortunate but reality that we must NOT take anything as a given anymore, ie M.D. means they have answers or even care, some are sociopaths with white jackets. Very small percentage but enough that ALL patients need advocates and we ALL NEED TO COMMUNICATE with our proxies in writing and verbally what are wishes are.

I have experienced hospice to be kind, compassionate and NOT drug pushers, when my sister said no morphine, they said okay. I'm sorry for all of you that watched unscrupulous medical staff harm your LO and did not advocate for them, it must be a hard burden to carry. You can still act, turn these people into the appropriate authorities and get them out of the medical field before they do it again. Evil prevails when good people do nothing!