Does anyone else feel less than 100% for Hospice principles regarding end of life treatment?

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Regarding Hospice principles: I have Hospice for my 93 year old husband with either Alzheimer's or Vascular Dementia (not sure which it is). I'd say he is in late stage of either one. He is sleeping more than he was a few months ago (16-20 hours out of 24), and eating very little solids (and only when I spoon-feed him). Otherwise, he exists on about 600-700 calories from shakes, nutrition drinks, etc. Hospice tells me that when he refuses all food and drink do not coax him to take some because his body is telling him it's time to shut down, and that he will not feel hunger or thirst. But how do we really know this? To me, it seems that the natural human response is to do everything to sustain life, and that the Hospice approach seems to come down to simply watching my husband starve to death. I'm not sure I can do this. I don't think I would drop Hospice in order to allow a feeding tube, just for the sake of keeping him alive a few more weeks or months, but neither do I want to see him die slowly of lack of food and fluids. I'd so appreciate some input on this from anyone who has struggled to make peace with this difficult issue.

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Ice chips are an excellent way. Excellent.
God Bless to all.
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I wish I would have known not to push liquids/food on someone who is dying. I do think that even in last stages of life that if someone desires food or liquids that are available to them, they will take them, and if they are refusing then there is a reason. I wish I would've known that before I, rather insistently, bottle fed my grandmother in her last weeks of life. I think it was more agitating for her than it was nourishing in any way.

One thing I read on here that sounded like a good idea is ice chips - to put small ice chips on the lips and in the mouth of the person so they get some moisture in their mouth.

It's such a difficult thing for the living to do, to watch our loved ones dying, but Mother Nature does seem to know better than we do about how that process is supposed to go. So if he doesn't want anything, I wouldn't try to push it on him. I very much regret that I didn't know better and did just that in my situation. Love to you both as you go through this process.
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disclaimer;
dont pop anybody in the head with a hand sledge. we have professionals with meds to put them out . im trying to make the point that theres a time to let them go . hospice professionals are watching vitals , they know when its over . dont argue with them , youre medically unqualified to do so .
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i can say , having experienced the last moments o fterminal agitation . its so fn obvious whats happening that in the absence of meds i would pop a loved one with a hand sledge . i mean that from the heart -- its that damn obvious..
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oh my . i was the first post - er on this thread in late july 2013 . mother died on aug 1 . whatever feelings i was writing were definately coming from someone faced with letting the patient go in peace . mom was indeed in the active dying process . my feelings are unchanged here a year later . why tf would you let a patient remain alert to experience organs failing each other in sequence ?
so what transpired after that first post ? mom began a few days of terminal restlessness , wandering from one place of comfort in the house to the other . this was followed by about 2 days of terminal agitation . when the agitation reached the point she was distressed and clutching at the air it was drug induced lights out time with mine and hospiss' blessings and approval . she was trying to climb up out of her dying body . stopped eating or drinking two days before death . i knew she was bloated with undigested food , surely wouldnt force more in her . i remember walking up and giving her an ice cube a couple of times . she gratefully accepted it to quench her thirst . hospice is a wonderful science and i can imagine loved ones bringing various natural narcotics to dying people since man has walked the planet . its the humane thing to do .
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Anyone who does not accept the principles of hospice care should not place a loved one on hospice care, if it is their decision. It really is that simple. If your loved ones wants hospice care then you should respect that choice, of course, but if it is your decision to make, follow your own beliefs.

I embrace the principles of hospice. I would want that for myself..
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I just buried my mother today. I too had questions about hospice care and this was my first experience with it.

My mother had vascular dementia and it became too much for me to handle alone after 8 years and I broke down. I was told not to return to caring for her unless I wanted to die of a heart attack or stroke. So I left and went to live with a sister and start taking xanax, ativan and zoloft to stop my panic and anxiety.

Mom had in home care and my other sister living with her but more help was needed so she was placed in a "good" skilled nursing facility for those with dementia. She was there two weeks and fell. This supposed fall the young man told me the next morning was her falling out of bed...15 inches from the floor. They did not seek medical help for 16 HOURS. My mother had 3 bleeds on the brain, a huge hematoma on the forehead and a huge one on the back of her head, broken ribs, pneumonia and MRSA.

I was not called until the following morning and was reassured she was PERFECTLY FINE, NO PROBLEMS WHATSOEVER. Just a bruise that they were holding ice on. They kept telling me at each call (4) that she was fine and ABSOLUTELY NO NEED FOR ME TO COME TO THE HOME. The story changed 4 times from the staff.

I finally got a call around 2:30pm that they were having to send her to a hospital because her coumadin level was at 5 which was dangerously high. AGAIN THEY REPEATED SHE IS FINE, DO NOT WORRY, DO NOT COME TO THE HOME, DO NOT GO TO THE HOSPITAL, SHE IS FINE, WE WILL KEEP YOU INFORMED.

By this time my sisters and I said BULLS__T we are driving to the hospital. When we arrived she had just had a CT scan that found the brain hemorrhages, she was unable to speak, she could not open her eyes, all she could do was mumble and moan in pain and she was curled up into a fetal position!

My sister had just been with her a couple of hours before this "accident" occurred. They were walking and talking and visiting with each other and Mom was in perfect shape.

The home kept telling us that she was awake and alert when she was taken to the hospital, I do not believe them. When she arrived she was unable to speak or open her eyes.

They assembled a team of doctors immediately including a neuro surgeon...they opted for no surgery "at this time" another CT scan was done and the bleed was getting worse. Still no surgery, not that I think she would have survived it anyway, but I do believe the doctors anymore look at their age and make calls on who to try and save and who not too. Mom was almost 86 but she was in good health other than the memory and A Fib that she took meds for.

On day two Mom was better, although her eyes were closed, she replied to a statement my sister made and even called her by name. Later however when I was there she opened her eyes and began to try and crawl out of the bed, "Yelling It's not safe here, Mary get me out of here, Sharon help me get out of here, this place is very dangerous, get me out, get me out!" I am trying to calm her down and tell her it is alright she is safe, we have her now! She slowly looks up at me then lays down.... this was the last time she ever spoke.

The doctors came to us and told us that we needed to consider hospice, there was nothing they could do to save her. Even if she did survive she would be basically a vegetable, for lack of a better word.

Mom had her Medical Directives all in place and did not want to be given a feeding tube or anything else to be kept alive if she had no chance of recovery. We met with the hospice people and they said we did not have to move her someplace else they would just move her to the 6th floor where hospice patients were.

Although I knew that Mom did not want anything given to her it was still extremely difficult to have her given "Comfort Care" which is putting you to sleep and stopping all medications, food and water until you pass away.

This is not for the faint of heart and honestly I do not think you should stay all day long with your husband, but come for visits. My sisters and I spent 6 days 24 hours a day with her and it takes an enormous toll on you. You will question what you are doing, you will feel it is inhumane..... but let me tell you it is way more humane than allowing them to lay there in pain perhaps. My sisters and I have all had ups and downs, guilt, second guessing what we did. It is painful to you the living to watch your loved one pass away and it isn't fast. You will see them breathing hard but they can be given meds to calm them down. At times I equated it to putting your dog to sleep, doing this would never be easy for anyone.

All I know is that I am glad that my mother had made this decision awhile back and I was glad it was in writing because I knew that I was following her wishes. When I die if I am in her shoes I hope my daughter will do the same for me, although it does take days in many instances or months at least you are comfortable and not in pain. Also what they told you about the body shutting down and not requiring food is correct, their organs are shutting down so they cannot digest the food.

I know you loved your husband but please do not sit by his bedside day and night, the experience is too painful and you may not be able to handle it.
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The gag reflex diminishes sometime before death and if one is still feeding someone with a diminished gag reflex this will cause aspiration pneumonia, where food or drink is sucked up into the lungs, and the person will suffocate to death slowly. When someone stops eating and drinking it's ok to stop feeding them and giving them fluid. The body knows what it's doing. Death isn't a one-time event. It's a process and the body needs to go through that process. The body WILL go through that process.

Also, even dying people respond to painful stimuli so if your loved one was in pain you would know it. No one is sure how much pain there is while dying which is why hospice offers pain medication if your loved one seems to be in pain.
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livelifefull, yes you have more control of the meds at home. However, you need to have the knowledge and confidence to use them correctly. You keep logs so you know what you gave and when. You monitor vitals and fluid output so you can share that with the nurse. Most families can't do this, they are too caught up in their emotions to even write things down.
My girlfriend did not want to give her mother any morphine. I told her OK, give half the dose. Make mom comfortable without making her dopey. But if she is crying and in pain, don't let her suffer. It is supposed to be comfort care.
I have found feeding tubes get you an extra week, but if that week means the patient is coughing up blood from the lungs, why would you want to prolong the agony?
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I'm not impressed with their principles either. How do they know starving people are euphoric?
They seem very liberal with pain and sedating meds. Just because a person looks sedated outside doesn't mean they're not anxious and screaming on the inside as far as I'm concerned.
I personally wasn't happy with home hospice for my motherinlaw.
Here is a link to the discussion
https://www.agingcare.com/discussions/didnt-have-a-good-experience-with-home-hospice-172413.htm
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