Hospice question, what in the world happened?

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Has anyone ever heard of someone being put on hospice and given morphine evry 4 hours, when they only had broken a rib?


Dear lady we love and tend to often. fell and broke her rib at AL. They sent her to hospital. Hospital fixed her up sent her back to AL.


Then her oxygen was a little low, sent her back to hospital. She was alert and she has Alzheimer's, but she was able to talk and just was in some pain with rib and all. They put her on some oxygen. She was doing fine. Then they sent her back to AL put her on hospice. She has not been able to wake up for 6 days, so that means 6 days of not eating. They give her morphine every 4 hours.


WHAT IN THE WORLD HAPPENED?


She was fine until hospice got involved, now she is dying. What in the world, it is the saddest and most confusing thing.


Anyone else?


Sorry I really didn't know what category to post this in.

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What a great family of caregivers effort! Thanks to everyone, keeping it real.
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Reply to Sendhelp
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Does anyone know if this is true. Her daughter was told that they could not do a feeding tube, unless they removed her from AL to a NH. Does anyone know if that is true?

Thank you all for your answers. I am leaving it in God's hands. Much prayer for her. She will not be long now. Such a sad thing to watch. Watching her husband grieving is horrible.
I apologize for my wording I did not know that there was so much talk of hospice, or I wasn't paying attention. I sincerely was inquiring and I sincerely was apologizing if I caused offence.
I appreciate you all taking the time.

You all are my second family, I would never want to cause trouble.
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JoAnn29 Jul 25, 2018
True, on Hospice there is no feeding tube. My daughter is an RN and Mom was in her mid 80s when she could no longer care for herself because of the Dementia. My daughter said never to put Mom on a feeding tube. Once inserted, it takes a court order to remove it. If the person is elderly, you are just prolonging the inevitable.
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Dear Smeshque,
As you know, I was a hospice nurse until I resigned early this year. (Couldn't handle working 2 jobs.)

In the hospice I worked for, there were specific criteria we had to have to admit a patient. One of them was, the doctor believes that the patient has less than 6 months to live (for whatever reason/illness). So, for your friend, a broken rib is not going to end her life in 6 months and she would not qualify for hospice.

Busted ribs are darn painful, so pain meds would be given around every 4 hours. Usually Morphine is not the first drug of choice if you or I broke our rib but it is the first (and so far-the best) pain med that hospice uses for terminal pain.

So for your 1st question, "Has anyone ever heard of someone being put on hospice and given morphine every 4 hours, when they only had broken a rib?" the answer would be "No." She would not qualify for hospice with only a broken rib.

List of events;
1.Alzheimer's
2.Fall
3.Broken Rib
4.Hospital
5.Back to AL
6.Low oxygen level
7.Back to hospital
8.Back to AL on Hospice.

There seems to be a "large chunk of info" left out between the two hospitalizations.
Something must have been discovered on the second hospitalization that put her in the hospice catagory. Could she have been diagnosed with a terminal respiratory condition?

Her family MUST talk to the doctor who wrote the hospice order. SHE could NOT have accepted hospice treatment due to her dementia. A family member or POA MUST have been informed of a terminal illness and signed her into hospice.
Who is the person responsible for signing her up? Find them and you will find the answer as to why your friend seems to be at the end of her life.

Unfortunately, YOU have no recourse to act. But her husband or adult children have every right to know what is going on.

There's more here than what you know or what they have told you.

Your friends' family have the right to dismiss hospice at any time. They can also pick any other hospice. They also have a right to look at the records. It sounds like they need more information. They can refuse to have her medicated and see if she will "come back".

The only answer the family (and you) need is, "What's the diagnosis that has made her hospice eligible?"

I hope you and they get your answer. I'm sorry for all of you.
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Reply to SueC1957
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Just to clarify. 1 No one is just put on hospice. A doctor has to initiate and there are forms to sign. I've gotten mortgages with less paperwork. Either the person or the POA signs. 2 You get to pick the hospice and you can change your hospice choice any time. 3 Somebody, the POA or guardian, should be closely monitoring the situation. If you want to get involved, talk to them gently.You really don't know what's going on. 4 If you are not privy to the medical info, you really don't know. My relative was 68 when she broke her hip. Once the doctor did an exam, the untreated breast cancer was discovered. The cancer was in that bone that broke and the brain. It could have been elsewhere, but she exercised her right to stop the diagnostic activity. In to a nursing home and then gone in less than a year. A week before the broken bone, I would have said she was not the picture of health, but I would have never thought all that was going on. Thank you for caring about your friend.
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Reply to Toadhall
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Medically speaking, a broken rib brings pain when breathing in.
If one cannot take a deep breath when breathing in, one's oxygen stats will be low.
So low as to require hospitalization. Then what....

I would hope that a hospice nurse (like Veronica) would know more about what is routine, and maybe get some more facts about the patient.

What is the age of the patient Smeshque?

And, of course, you should have asked! This is a frightening experience.
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Reply to Sendhelp
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Smeshque,
Hospice questions do bring out controversy and are an emotionally charged question even before the ink dries on the internet page!

Stiil, your distress is apparent and understandable, and your question is sincere and heartfelt on behalf of this patient. I am sure.

Without blaming, we all need to know what happened, in order to help. . If we focus on the question, instead of getting caught up in whose opinion might or might not be offending others, we can make progress. Before your question, came so many threads about hospice, some with trolls attacking, making this topic extra-sensitive and ready to dissolve the helpful nature of known excellent caregivers/posters.

Your own words, which were necessary to get your question out, were not in error, but seemed to blame hospice. "She was fine until hospice got involved, now she is dying." It is okay to blame hospice, it is okay to want to find out what happened here. However, those previously sensitized to hospice blamers will want to weigh in, and you will need to ignore what is not helpful to you, Smeshque. The very people who know more about hospice may be the ones that can help you! Really. So try not to take offense.

Let's all try to discover what happened, and only Smeshque knows the patient in this case. If the thread devolves into a hospice debate, Smeshque will not be helped. And, I know for a fact that Cwillie would not offend purposefully, and is trying to help, but now is found apologizing, as was Smeshque apologizing.

No offense meant, no offenses taken.

Let us all proceed. However, I never get involved in hospice threads, and carry my own views close to my heart for some of the reasons I stated above.

My purpose is to re-focus back to the poster's concerns, and lend concern to such a difficult situation. My sympathies Smeshque. I will be reading because it is you, and not some lunatic troll disrupting the topic with an agenda. And I hope if someone like that shows up, we will avoid going on a downward spiral, and not engage in attacking each other.

Gosh, I hope I said that right, I hope people understand that we all need to pull together.

Love you all. Good answers so far!
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smeshque Jul 24, 2018
Thank you Send, very much!
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Does her family have POA? The doctor had to recommend Hospice. Her family needs to ask the doctor why he felt it was needed. Since a Dementia patient can't express how much pain they are in, the morphine is probably an estimation. The family has a right to question. Ask about the Hospice's evaluation and what the doctor orders said. If they are evasive, get another Hospice. Question, Question. If it doesn't sound right, it probably isn't. Family needs to be her advocate.
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Reply to JoAnn29
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smeshque, chances are that your friend had x-rays taken of her broken ribs and the doctors could have notice a serious medical issue that cannot be corrected.

For broken bones, which are extremely painful, believe me I know, morphine is usually given in some form. Also, when a person has surgery [I know this isn't the case here], it is normal to give the patient during recovery morphine, I had that for two major surgeries.

Yes, morphine can make you very sleepy but it sure helps to dull the pain. One doesn't feel like eating, either, much less talking. The amount of morphine given is no different that the amount given in Hospice.

I remember when my Dad went into the hospital from Assisted Living/Memory Care, they ran some test as Dad had a really bad cough. Other then the cough Dad was doing ok. Much to my surprised the hospital said for Dad to return to Assisted Living and Hospice was brought in. Dad had aspiration pneumonia, and at 95 years old, he just wasn't going to survive.

So sorry you and your friends are going through this stage.
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Reply to freqflyer
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If you meant me when you mention offending people - I wasn't being sarcastic, after reading the negative hospice threads I completely agree that sometimes the things that happen once hospice care begins are frightening and questionable.

It appears there is no reason to medicate this person to the point of complete sedation, therefor hastening her death. When there are doubts the time to speak up is now, the longer it is allowed to continue the less chance there is that reversing the decision can lead to a positive outcome.
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Reply to cwillie
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Her daughter and husband are very dear friends we have been there with them from the beginning. There is no other underlying condition. The facts I gave are the exact facts that husband and daughter have. They also are confused about this that is why I asked.
I am sorry that I asked as it seems to be upsetting to others if something is negative about hospice. Although, I was not speaking negative about hospice, I was only asking because I thought that is what this place was for.
But, my apologies for having offended anyone.
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Sendhelp Jul 24, 2018
Smeshque,
You can trust all the first ten posts in your question. These are good, known people.

Keep talking. And, I am sure you are also praying.
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