My mom has stage 4 non operable NSCLC and was given 6 months. She has been on hospice for 4 months and recently developed pneumonia. I am worried that this will kill her. Am I right or should I not worry?
Levoquin is a big hitter antibiotic. If your mother wanted to go out without the pain of cancer, this drug should eliminate that possibility at this time. If it were me or my mother, I would decline antibiotics. I expect your mum's better now. Keep us posted.
I have nothing much to add but just wanted to give you a little support. This is such an overwhelming time for you. It is so hard to lose your mother. Please know that you are doing the best you can. That’s all you can do, plus pray for a peaceful death for your mother. I am sure that both of you are going through mental anguish as this is an unsettling time.
My FIL died of Pneumonia while on Hospice care for Lung Cancer in our home and it was very swift and peaceful, so every situation is different. There were no pain or gasping, just fever and he drifted off while I was on the phone with our Hospice nurse, asking her what to do about his fever, he just waited until I stepped out of his room, and then he was gone in those few minutes, so again, everyone is different.
We were giving him pain meds and Ativan for comfort measures, and he had been conscious, speaking and taking in small amounts of food and fluids the previous day, so not "drugged out" or anything, it was only that morning when things had taken a turn for the worse.
I am of the camp that if the patient is on Hospice, dying of a disease beyond treatment options, and an infection comes along, it is up to the patient to decide whether or not to treat, but if they are so far along in their disease and unable to make those decisions and that you are now in the position of POA and have hopefully had those tough conversations about how they would have like to be treated, then it is only fair to let them succumb to the kindest and most humane way out, and that is to not treat, to give them dignity and respect, assure that they are comfortable as possible and to let them go with God.
IMO, waiting until the primary disease reaches a place of severe symptoms and pain is not my idea of kind nor gentle. To me, an infection is the bodies way of saying (in these cases) that their poor old bodies have had enough, and they just cannot fight these symptoms off any longer, so the loving Caregiver in me says to let them go. Now in the situation where the patient desires antibiotics, then that is in their right to choose that, and then my power is not yet in effect, but again, hopefully you have had these difficult conversations and the reason why the patient has given you this power in the first place, to make these difficult decisions.
It isn't necessarily right to force a parent through agonizing treatment, to only have to go through it over and over again, and very often (my gut feeling), the patient cannot fight off an infection even with treatment as they are just too weak, its just their time to go. We aren't meant to last forever, and saying goodbye is the hardest thing.
Difficult times for you and your family, be easy on yourselves, there is no one answer.
People like to trot out that old saying about pneumonia being the old mans friend but I want to point out that while it may be an easier death than others it isn't necessarily what you might envision as a peaceful passing away in their sleep. My mom had aspiration pneumonia and laboured for 3 days at her dying, once it became clear she wasn't going to recover the "peace" came with zonking her into unconsciousness with haloperidol and dilaudid. ((hugs))
No, it was a friend only in that it was the end. Dying of pneumonia is very bad, because of all the secretions. They are impossible for someone to move out, and they are either thick and sticky or thin and gurgly, and often suction equipment is needed at the bedside in order for there to be less air hunger. It is not peaceful. You are absolutely correct. On a personal note, I miss the white rat.
Both dad and FIL passed from pneumonia while in Hospice. The difference was, they weren't actively txing the pneumonia, since they were in Hospice with the understanding that there would be no heroic end of life aids.
The morphine slowed the painful breathing. Also gave them comfort, as they weren't gasping for air.
Neither died on a "timeline'. In both cases we were just fortunate to all be there with them. Often they wait until they are alone and quietly pass. Dying is a personal, spiritual matter. They are NOT alone...I believe people come to get them. When my Gma died, she was talking to the 'angels' all day--and not us.
As said, your Mom is on Hospice because no more can be done for her. Hospice will keep her comfortable and pain free. Morphine will be used to ease her breathing. It is common for pneumonia to set in when a person is bed ridden or no longer active. Be aware that she may seem confused and out of it. This is a side effect of pneumonia. Medication helps but the confusion can last a while.
I really don't think Mom should be reminded she is dying. She excepted Hospice so she must know what that means. Why do you need to worry where ur on a timeline. Your Mom will go when her body starts to shut down and she is ready. Make sure she sees or talks to everyone she needs to. And don't beat yourself up if you are not there when she goes. They tend to go when no ones around. Just love her while you can.
Your mother is on hospice care now? Hospice care begins when the MD believes that the patient has no more than 6 months to live. Are you aware of this? Generally there is comfort care and palliative care done, only, with full knowledge that the person is/will be dying. Pneumonia is a very common way that people do die when they are disabled and near the end of life. They may aspirate food or fluid into the lung causing aspiration pneumonia; they can actually get pneumonia from a lack of movement and activity and full ventilation of lungs, and then the more common bacterial or viral reasons for a pneumonia. Pneumonia in the "old days" used to be called "The old person's friend" because it was often the way an elder was ushered out of this life when they were very ill and failing. I think, if you are not read, and not aware that Mom is on hospice because indeed her death is "expected" and is imminent in the next months, then things are not being fully discussed with you. Please do use your search engine to look up "hospice care" and what this is meant to help with, what can be expected. I am so sorry for your grief and pain at this time. I hope your Mom is being kept comfortable and medicated so she is below a level of pain and dreaming. You have posted under Cancer, End of Life, and Hospice. So I think you do understand somewhat what is coming. I hope you have family support and that you are all together in making your Mom's last time as comfortable and peaceful for her as it can be. The hospice team can tell you the signs to watch for that indicate that death is drawing more near. Talk with them. They are there to guide and help you. Hugs and support out to you at this hard time.
Thank you for your response. Yes my mother and I have both read all the info from hospice. I don't know what to expect, everything is scary in the fact that she is already dying and I don't know what things to be worried about and what not to. I do not know how to handle all that is going on with her and somethings that I think are not a big deal are and things I think are a big deal are not. So very confused. For the last two months I have been with my mother between the two jobs I work. She has svc syndrome and her heart is jumping all over the place. I know they give you a list of things to watch for and she has some from all three sections, So I really don't know where we are at in this whole time line. I have talked to her Hospice nurse who is also very close to my mother and she is not sure either.
I can feel the anguish and concern in your post, decisions on whether or not to treat infections in the latter stages of life can weighs heavily on your heart, but do remember that your Mother has lived a long and purposeful life, there could be more health difficulties furthur on down in her end of life struggles that may be even more painful to endure, not treating the Pneumonia may be the most gentle way to let her go, of course it should always be her decision, if she is still capable of making them.
A very helpful article from nextavenue.org, "Why infection might be a good way to die":
A Peaceful Death This concept is not new. The saying, "pneumonia is the old man's friend" has existed for years. Left untreated, a person with pneumonia will slowly lose consciousness and pass away in his or her sleep. For some people, fighting until the end, dying in a medical intensive care unit from a third episode of pneumonia with a resistant organism may be what they want. For many others, a dignified and peaceful death is what they would like to plan for.
Any decisions you make in the coming days will be the right ones! I wish you peace in the coming days!
Thank your for your response. I think there are a few things I need to talk to my mom about. She is not accepting the fact that she is dying and so it is difficult to remind her everytime something new happens. I have read where pneumonia is the second reason that cancer patients die and the articles refer to it in patients that are currently being treated. My mother is not being treated for her cancer and last treatment was in April, so I do not know what to think.
I should talk this over with your mother and her hospice team.
What you're going through is enough to worry anyone: there can be incredibly difficult decisions to make. How is your mother feeling in herself? Is she able to talk to you? If she is comfortable, not in pain, and not frightened, then it is best to be guided by what she feels is best for her and try not to influence her choices.
Thank you for your response and advice. I will just continue as we are, she is able to discuss her wishes and I do listen as that is why I am here. To help her with whatever she wants.
Pneumonia used to be called An Old Man's Best Friend, due to the fact that it would often take an elderly person's life with very little suffering. Since your mom's time is limited as it is, this case of pneumonia may indeed cause her demise. Sometimes the antibiotics are sufficient to allow the person to heal, but other times they do not work if a person's immune system is already severely compromised.
I am so sorry for the pain you are enduring right now, my friend. Loss is such a hard thing to bear, I know. Sending you a big hug and a prayer for strength during this difficult time.
Please know that you are doing the best you can. That’s all you can do, plus pray for a peaceful death for your mother.
I am sure that both of you are going through mental anguish as this is an unsettling time.
We were giving him pain meds and Ativan for comfort measures, and he had been conscious, speaking and taking in small amounts of food and fluids the previous day, so not "drugged out" or anything, it was only that morning when things had taken a turn for the worse.
I am of the camp that if the patient is on Hospice, dying of a disease beyond treatment options, and an infection comes along, it is up to the patient to decide whether or not to treat, but if they are so far along in their disease and unable to make those decisions and that you are now in the position of POA and have hopefully had those tough conversations about how they would have like to be treated, then it is only fair to let them succumb to the kindest and most humane way out, and that is to not treat, to give them dignity and respect, assure that they are comfortable as possible and to let them go with God.
IMO, waiting until the primary disease reaches a place of severe symptoms and pain is not my idea of kind nor gentle. To me, an infection is the bodies way of saying (in these cases) that their poor old bodies have had enough, and they just cannot fight these symptoms off any longer, so the loving Caregiver in me says to let them go. Now in the situation where the patient desires antibiotics, then that is in their right to choose that, and then my power is not yet in effect, but again, hopefully you have had these difficult conversations and the reason why the patient has given you this power in the first place, to make these difficult decisions.
It isn't necessarily right to force a parent through agonizing treatment, to only have to go through it over and over again, and very often (my gut feeling), the patient cannot fight off an infection even with treatment as they are just too weak, its just their time to go. We aren't meant to last forever, and saying goodbye is the hardest thing.
Difficult times for you and your family, be easy on yourselves, there is no one answer.
On a personal note, I miss the white rat.
The morphine slowed the painful breathing. Also gave them comfort, as they weren't gasping for air.
Neither died on a "timeline'. In both cases we were just fortunate to all be there with them. Often they wait until they are alone and quietly pass. Dying is a personal, spiritual matter. They are NOT alone...I believe people come to get them. When my Gma died, she was talking to the 'angels' all day--and not us.
Peace to you. I know this is hard.
I really don't think Mom should be reminded she is dying. She excepted Hospice so she must know what that means. Why do you need to worry where ur on a timeline. Your Mom will go when her body starts to shut down and she is ready. Make sure she sees or talks to everyone she needs to. And don't beat yourself up if you are not there when she goes. They tend to go when no ones around. Just love her while you can.
Pneumonia is a very common way that people do die when they are disabled and near the end of life. They may aspirate food or fluid into the lung causing aspiration pneumonia; they can actually get pneumonia from a lack of movement and activity and full ventilation of lungs, and then the more common bacterial or viral reasons for a pneumonia. Pneumonia in the "old days" used to be called "The old person's friend" because it was often the way an elder was ushered out of this life when they were very ill and failing.
I think, if you are not read, and not aware that Mom is on hospice because indeed her death is "expected" and is imminent in the next months, then things are not being fully discussed with you.
Please do use your search engine to look up "hospice care" and what this is meant to help with, what can be expected. I am so sorry for your grief and pain at this time. I hope your Mom is being kept comfortable and medicated so she is below a level of pain and dreaming. You have posted under Cancer, End of Life, and Hospice. So I think you do understand somewhat what is coming. I hope you have family support and that you are all together in making your Mom's last time as comfortable and peaceful for her as it can be. The hospice team can tell you the signs to watch for that indicate that death is drawing more near. Talk with them. They are there to guide and help you.
Hugs and support out to you at this hard time.
A very helpful article from nextavenue.org, "Why infection might be a good way to die":
A Peaceful Death
This concept is not new. The saying, "pneumonia is the old man's friend" has existed for years. Left untreated, a person with pneumonia will slowly lose consciousness and pass away in his or her sleep. For some people, fighting until the end, dying in a medical intensive care unit from a third episode of pneumonia with a resistant organism may be what they want. For many others, a dignified and peaceful death is what they would like to plan for.
Any decisions you make in the coming days will be the right ones! I wish you peace in the coming days!
What you're going through is enough to worry anyone: there can be incredibly difficult decisions to make. How is your mother feeling in herself? Is she able to talk to you? If she is comfortable, not in pain, and not frightened, then it is best to be guided by what she feels is best for her and try not to influence her choices.
I am so sorry for the pain you are enduring right now, my friend. Loss is such a hard thing to bear, I know. Sending you a big hug and a prayer for strength during this difficult time.