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My mom and I met with the hospice case manager yesterday, and Hospice sounds like assisted suicide to me. Mom has congestive heart failure (she just told me that yesterday) end stage of COPD, asthma, cronic asperated pnemonia, panic attacks, etc, so we meet with the Hospice case manager, at the encouragement of Moms hopsital case manager. And they want her to be a DNR, and if she has trouble breathing then they will help her work thru it. If she gets to the point she cannot breathe, don't call 911, but for ME to administer the meds... are they serious !!!! So let me understand this... Mom can't breathe, so I am supposed to be ok with giving her a medication that will relax her so she can stop breathing...? ! ? I don't think I'm ok with this at all.
Everyone said "oh hospice is just wonderful." What I see is assisted suicide, and everyone else standing on the other side of the fence saying oh look, she has hospice, her daughter will be so supported we don't need to do anything to hel[ now...

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Hospice is the last resort. I have dealt with 5 in hospice. Watching someone die is not a pleasant experience. Lets face it no one gets out of here alive. Watching someone with Alzheimer's have their body deteriorate quickly and no way to communicate is excruciating. Watching them convulse and take on sever pain is horrible. What ever can be done to help them with their pain is what hospice does. They do not cause the pain they help to reduce the pain. Very few people die in their sleep sounded by their loved ones. Many die in pain and alone. I watched my grandfather and held his hand while he went through high fever and seizure for days until he passed. He was in tremendous pain. I watched my sister in law go from normal to bedridden and unconscious in a matter of weeks due to brain cancer then fevers and seizures and no way to take on food. I watched friends in severe pain with cancer riddled all over their body. Dying is a horrible thing. All the hospice facilities I have dealt with were angels on earth. Yes morphine is the drug of choice but it is really one of the few things to help their pain. My mother suffered a stroke, she was unconscious. Once the vent was removed it took some time for her body to give up. She was in pain and she was given morphine. Did it speed up the process? It may have by a tiny bit but the end result was the same. Was it the hospice benefit? No. Was it the family benefit, no. I wanted more time with mom but no one wanted her to be in pain. Drugs were given to calm her body down. Hospice is about helping people at the last moment. If it were me and I had a choice I am sure I'd say give me all you got until I can take it anymore. Healthy people do not enter hospice.......
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This post is 6 YEARS OLD folks! I'm sure her mother has long passed away--with or without hospice.
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I am sorry for the impression. But with all those conditions when there is no other cure, you should agree to comfort measures agreement, although it sounds like you are in denial about her condition which is a normal reaction in this case.
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#mylovedonetoo
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Er, because you make it sound that way?
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Many hospices do practice a form of stealth euthanasia. I have witnessed this myself.

The Hospice Patients Alliance website has a wealth of information about these things and how you can protect yourself and loved ones.
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LilMonkey - depending on the circumstances morphine can be the greatest blessing or the worst curse. When you are facing unendurable pain as my brother was from pancreatic cancer, you will bless that drug. Believe me. Why deny a person in agony relief from their pain? Couldn't that be considered torture?
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Seeing someone take their last breath was really messed up for me and having to administer the poison morphine into someone's veins is atrocious and I had to get out of the medical field. It really troubled me to the point that I feel like a murderer, although the dosage was administered according to the doctor's orders. I can't sleep or function properly. So, I believe in having a DNR, without poison running through my body. I'm not shaming anyone for their choice.
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Find a different hospice organization!

My mom didn't have cancer, but she had dementia and fell, fracturing her wrist. She wouldnt/couldn't get out of bed and developed pneumonia which was treated. She began to express through facial expressions, horrible pain or anx9. Doubling her regular pain meds did nothing to alleviate.

We called hospice and the came, evaluated and stated her her on a low dose of morphine and the next day added Ativan. She had stopped eating even the ices we brought her the day before.

Her facial expressions and breathing eased and she passed peacefully two days later.

Get another hospice group in.
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Asked a question 9/21/2017 at 2:58 am


Has anyone had a family member with Alzheimer's and cancer?

I FIRED HOSPICE !!! The Hospice nurse wouldn't consider Morphine for my Mom and she was in terrible pain. It was an ordeal.

My Mom, who is 88 years of age, has had Alzheimer's Disease for 10 years. She currently resides in a nursing facility (8 years). She had breast cancer about 15 years ago and the breast was removed and chemo. One year ago, she had a small lump appear on her chest. Now, she has the lump the size of a small fist and it is cancer, has begun to ooze. She had a directive in place for no heroic measures. When the diagnosis came as cancer, I made the decision not to treat or surgery. With Alzheimer's and she hasn't know me in over 4 years, it just seemed cruel to put her through such an ordeal. She had pain - facial expressions and movements, and was prescribed Percoset. The last few weeks, she's been more agitated and appears to be in more pain. Hospice came and I signed up. BIG MISTAKE for my situation. I fired them and I've finally convinced the doctor at the nursing home to consider low doses of Morphine. That helped, but now had to prescribe more Morphine and Ativan. At this time, she is still drinking Mighty Shakes. She is much calmer and seems to be in not much pain with the scheduled an PRN drugs. Alzheimer's Disease patients cannot tell or express pain. What can I expect later from these drugs? My goal is to keep her pain free and comfy. I'm an only child (65) and I'm extremely devoted to my Christian Mom. The only thing I'm hoping is that God sends his best ANGEL to take her home and she can be whole again. The hardest thing I've had to do is watch her suffer. With the new meds, I hope we can stay ahead of more agitation and pain. Your opinion will help, please give it. I do want to be with her when she passes. I understand even if I'm there all the time, that one moment that I step away, she can go. PLEASE HELP! Thank you in advance. God Bless You.
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There is no doubt to me that Hospice is assisted suicide, better yet- murder. Try and get a straight answer form Hospice. You cannot. All answers are are responded with- 'thonk of it like .." or some euphemism or metaphoric phrase.My brother past away last month after going into hospice. I would never suggest hospice for anyone. From what I gathered in Florida, a DNR, means no one can administer or do anything that may sustain life aside from the patient-ie feeding, eating, breathing, even an aspirin if it would increase your life time. Second, hospice requires a DNR. The DNR legally and willfully allows Hospice to NOT attend to your medical needs in any way shape or form. Hospice does not provide care medically in any way shape or form. There is nothing medical about hospice. Hospice from my experience showed the staff as confrontational, non-caring, not compassionate, liars, and do not perform pain management or any type of quality of care. My brother would have undoubtedly lived longer at home. He would have had better care. Hospice only came around every 12 hours or so, basically to check if my brother still had a pulse. My brother was to what I call nothing less than murdered. It took hospice 8 full days to murder my brother. My brother was in agony and torment the whole time. Hospice care never showed up and did little to nothing to alleviate his pain. There was no dignity nor quality of life in my brother's last days. Family tried to take care of his needs the full 8 days around the clock while in hospice . Hospice did nothing. Hospice did have a plan to what they said was for pain but did not make adjustments to handle pain as it occurred for 8 days. i figure that 'pain' medicin is really the killer drug. Hospice lied to the family every time a question was asked. Hospice responses were lies and never answered even the most simple of questions. To me Hospice is required to kill you in x number of days. My brother was strong and it took several more days for my brother to actually die. I realize my brother's decision was his own and respect that, but wondered how many lies he was told before choosing hospice and the family knows of a few very big ones from the hospital and Hospice in Cape Coral. I am sure my brother expected more quality care and dignity than what this Hospice provided. I urge anyone thinking about going into Hospice to read up on what Hospice really provides.PS- Of course it is paid for by medicare. The government would rather see you dead than to have to pay out on your medical bills.
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My brother past away last month after going into hospice. I would never suggest hospice for anyone. From what I gathered in Florida, a DNR, means no one can administer or do anything that may sustain life aside from the patient-ie feeding, eating, breathing, even an aspirin if it would increase your life time. Second, hospice requires a DNR. The DNR legally and willfully allows Hospice to NOT attend to your medical needs in any way shape or form. Hospice does not provide care medically in any way shape or form. There is nothing medical about hospice. Hospice from my experience showed the staff as confrontational, non-caring, not compassionate, liars, and do not perform pain management or any type of quality of care. My brother would have undoubtedly lived longer at home. He would have had better care. Hospice only came around every 12 hours or so, basically to check if my brother still had a pulse. My brother was to what I call nothing less than murder. It took hospice 8 full days to murder my brother. My brother was in agony and torment the whole time. Hospice care never showed up and did little to nothing to alleviate his pain. There was no dignity nor quality of life in my brother's last days. Family tried to take care of his needs the full 8 days around the clock while in hospice . Hospice did nothing. Hospice did have a plan to what they said was for pain but did not make adjustments to handle pain as it occurred for 8 days. i figure that 'pain' medicin is really the killer drug. Hospice lied to the family every time a question was asked. Hospice responses were lies and never answered even the most simple of questions. To me Hospice is required to kill you in x number of days. My brother was strong and it took several more days for my brother to actually die. I realize my brother's decision was his own and respect that, but wondered how many lies he was told before choosing hospice and the family knows of a few very big ones from the hospital and Hospice in Cape Coral. I am sure my brother expected more quality care and dignity than what this Hospice provided. I urge anyone thinking about going into Hospice to read up on what Hospice really provides.PS- Of course it is paid for by medicare. The government would rather see you dead than to have to pay out on your medical bills.
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People die on the same time table whether Hospice is there or not.

With Hospice you know that your love one had a peaceful passing with very little pain. I use Hospice for both my parents, and everyone was so helpful and caring. They were an extra set of eyes and ears in the facilities where my parents had spent their final times.
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I read through these posts....and everyone seems to have missed the OPs original point.

Hospice wasn't going to be there....they were just going to have the medication to her and she would be left to administer drugs. Yeah, I wouldn't buy into that either. Hey....if hospice is there to help...then they need to BE THERE...not leave it to the daughter to handle it.

I have read a lot of posts from people who had a loved one on hospice...yet, at the end...it wasn't hospice there...it was just befuddled and bedraggled loved one...with hospice (maybe) on a phone.
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It sounds to me like you have a very bad consultation. I'm a chaplain in hospice. It is not about shortening or extending life. It is about pain management and grief management along with maximizing quality of life for patient and family. Typically, with the hospice I'm with, nursing visits increase with each downward change in the patient's normal. My chaplain visits increase if I see a downward change in psycho-social issues in patients and or families. At some point, the RN/Case Manager will observe that death is becoming imminent. He or she will, in consultation with the hospice medical director and/or the patient's primary care physician (if they are different) begin continuous care. An LVN will be bedside 24/7 until death to maximize comfort to administer the best palliative medicine course necessary for the patient's condition. The only time I've seen patients unresponsive during this time is when they were already unresponsive when the regimen began.

I am so sorry that you had such a bad consultation. It sounds like you were consulted by a company that minimizes care in the name of maximizing the bottom line. Of course, I'm with a company that is willing to sacrifice a few bucks for the sake of patient care. We always ask (and only hire people who will ask), "How would I want my own husband/wife/brother/sister/son/daughter" treated and treat them in that way. If a doctor makes hospice referral to a specific company (without asking you) is also medical director of that hospice stay far far away. It's not only violating the Stark Act, but it shows me a hospice company that will engage in deceptive practices to get patients instead of letting their patient care speak for itself. Look for a company that has a robust and well paid chaplain and social worker staff who are not merely contingent labor. These are non-billable yet required (by Medicare) services. A company that values these roles values patient care.
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My Dad was definitely killed by palliative care. He was given Dilaudid/morphine and died from fluid in his lungs. He couldn't communicate in the days before his death because the morphine makes it impossible to talk, or even move when it's given every few hours. The only time he semi woke was when he was gasping for air, drowning from the fluid in his lungs, he died a horrible death, struggling to breathe and looking into my eyes. I wish I'd never transferred him there. If this is the serene death some people are expecting, your loved one won't get it if they die this way, and if you're there to see it, you'll never never forget it and you'll never be the same. The elderly are written off, overdrugged and killed regularly in palliative "care" it's legal murder.
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I believe a lot of people misunderstand what hospice is, even my own mom in reference to my dad. Bottom line, hospice means the following: 1) a doctor believes you have about 6 months to live and/or 2) it is understood that that person does not want heroic or curing measures, but only to be kept comfortable. Now it does happen that people get better and then get "released" from hospice. My dad went to hospice last December, we thought he was a goner, then he got better in March, so he was off hospice, but then recently, two weeks ago, he had a lung infection, went to hospital, and while he was in hospital, was offered a feeding tube bc of his swallowing issues that he was told are too serious for any special diet to help (thickeners). The reason I give all this back story is that I think even my parents misunderstand hospice. When dad went in to the hospital, he was asked about his end of life stuff. He already has a DNR and knows he does not want heroic measures: no heart compressions or paddles if his heart stops, no breathing tubes, etc.. "to be kept comfortable" is the phrase docs use. This basically means you get a super low dose of morphine around the clock -or however you need it-to help you with pain and let you sleep. Also for my dad it helps relax his breathing airways. At the final end of things, what they give is not an overdose, just enough so that if you are about to die, you don't die anxious, in pain and fear, and feeling every bit of however you are dying. My dad will likely die drowning by fluid in his lungs. My most sad imagining is for him to die gasping and feeling like a drowning person, and anxious and afraid. I wish for him to be asleep and serene. He may not wish this, and I won't impose my way on him. They also provide, for my dad at least, people who come maybe 3x per week to bathe him in bed, which he really loves and appreciates. Ok, so.... flash forward to the day in hospital he was offered the feeding tube. He said NO. Just NO. Ok, so, at that point, he essentially invoked palliative care, since he's refusing the next doctor's orders regarding the next step to keep him alive. So he came home with hospice. Ok, so, then, my mom starts complaining about how the morphine makes him dopey and sleepy all the time. Well, that's "keep him comfortable" "palliative care" which is opposite of "curative care." So in my view, mom does not understand hospice either. "They just want to keep him doped up" she says. Again, Palliative care means doing no medical curing interventions and just keeping pain and discomfort at bay. Morpine and Ativan for dad. Ativan is for anxiety. Cause he's dying and that might make him anxious. If he weren't in pain, he would probably not get the morphine, but if he were anxious about dying he'd get the Ativan. _Of course_ the patient can change their mind about their decision to not have invasive procedures at any time. Dad did. But that excludes you from hospice. Dad decided he did want the feeding tube after he was described what it is--he hadn't even let the docs explain it in hospital. You have the right to change your mind till the day you die. But again, _not a hospice service_. He had to fill out a form today to get released from hospice so his insurance will pay for the medical procedure. Be sure you do this before you schedule a procedure if you're in hsopice, or you may fall through the insurance cracks and pay a whole bill! Once you get back to wanting to be cured of something, that's not hospice.
On a tangent, I had another set of relatives who believed hospice had "killed" their patient with a morphine overdose. But again, they misunderstood that, when a person is drawing their last breaths, the hospice way is to ease them unto death in a gentle way. The dose they give is not enough to kill a person who would not be dying. This is why it's such a controversial thing to legalize assisted suicide. If hospice were doing that, we wouldn't need to lobby for it, those who want it for themselves when the time comes. So in my humble opinion, as they say, Hospice is not at all assisted suicide. It is a gentler path to inevitable and imminent death. I hope I haven't stepped on any toes here, but I just have been dealing with this with mom and dad. One other thing: when you go into hospice, they discontinue a lot of the patient's meds. Not all, but many. I think anything that they feel is no longer helping, or crucial is eliminated, and they keep only those that would cause a sudden death sooner than the original disease from which he's dying. My parents ended up continuing some of the meds the hospital had canceled, and hospice still provides them. For free. So in his case the hospital seemed more aggressive in their expectation of his demise than our hospice. PS. I'm not a hospice worker or manager or in any part of that profession, I've just been so impressed by the level of care and compassion that my dad has received from them. and also the rest of us.
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It is not assisted suicide. But when you are ready, they do not prolong it at all! When you reach that stage, you want to be with your maker as soon as possible. At least that's how I feel about it. And it was discussed with my husband about 20 years ago when his first wife had a major stroke. He's children kept her alive. We decided then that was not what we wanted and we made out our living wills right away. I am so glad we did because it might have been more difficult as we drew a few years into Alzheimer's. But he always said the same thing. That was what he wanted and it is what I want too. He is now in his 12th year of Alzheimer's. And still basically strong and healthy! Just not much mind left. But the other day while I was visiting in the home, he looked at me and said, "What?" I looked at him and said, I just love you so very much!" He doesn't have much vocabulary, but I could see he understood. His eyes showed me. He managed to say, "Love you." What a treasured moment!
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I agree with you about hospice as my own mother was left to die alone there with no family members wanting to go there to somehow make a better difference for her as everyone was informed that she was to die soon and also there was her bank account and a house and car to be up for grabs by my sister who cunningly tricked my mother into giving her the power of attorney over everything financially and medically ,so I did go to stay overnights there with my mother but I found out my mother was being drugged continuously with morphine every two or four hours non -stop and my mother could not speak nor move any part of her body afterwards but I believe she could hear me talking to her cause she moved her arms at one point back and forth together at the same time as if telling me to get her out of there then her eyebrows also were moved up and down but she could only have done this action after I had told one of the nurses to skip the dose of morphine for that time so I could at least try to speak with my mother before she died so she agreed to that dose of morphine being skipped for that time.I tried after that skipped dosage to get the next dosage of morphine stopped also after a few hours past from the first skipped dosage but to no avail this other nurse would not cooperate with me and went so far as to start an argument with me that she is the nurse and she is going to give her another dosage of morphine since she believes she is the only one trained to know the signs of pain and not me.so I told her if there were any signs of pain that I being my mother's concerned son would have heard and recognized that pain also and that there is no such thing as her being the only one to know signs of pain, but after that she still administered the morphine shot to my mother against my wishes and after that my mother was never again able to speak nor move and was also not given any food nor water for all the time of the three to four days she was there at hospice sedated with large doses of morphine shots and then she died a day afterward.
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I personally can't wait until my husband gets to this point of needing Hospice. They are wonderful and they do ease the patient's pain and comfort that person. He is in last stage 7 all but he is still walking around and eating. He is basically healthy. But has every other symptom in Stage 7. It is probably going to be a long time in this stage for him! ( sigh)
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Plus, I have to say, Hospice is in some sense "a racket" in that they often times show up at the last week or so, hold a hand during the final passing, and then are the recipient of generous donations requested "in lieu of flowers..." etc., because people are so grateful for ANYBODY who isn't afraid in the face of death. But meanwhile, the caregivers and friends and community and wonderful medical professionals who cared for the person for years -- where are donations and gratitude for them?
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Yes! And YES everyone THINKS Hospice is so supportive, and that lets other family off the hook. That was my experience with my Father's death as well. I agree with you! First, Hospice took away any hope. Then they provided oxygen, with no monitoring of it, or training of us, just said, "if it looks like he's laboring for breath, just turn it up. Oh, by the way, if you turn it too high, he'll stop breathing at all." Also, once you have Hospice, you can't have anything that will "prolong life" like exercise rehab, breathing and throat/swallowing experts, you are all on your own for anything that will IMPROVE or even HEAL the various conditions. I tell my Mother, when I give her herbs, homeopathy, and tinctures, that yes, you have to die some time, but you don't have to lose all your faculties, and you don't have to go out in pain or with a confused mind.
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Hi, I am also going through an end of life phase with my mother and am having mixed feelings about the 'process'. I am suspicious about the 'science' behind palliative care as at times, I must admit it seems to be more about ideology than medicine. Unlike, some of the other replies here, I am pushing to have more say about my mother's end of life care. For instance, When I have to push for even routine measures like the use of antibiotics, I'm reminded that we're not trying to prolong her life and I even find myself fighting with hospice, to allow her to sit up in bed ( even when she expresses the desire to do so). I can't help feeling that this is really about falling into line with the establishment, and the lack of real consultation is frightening. My strategy is to keep a close eye on all her interaction with 'professionals' and make them feel accountable for all their decisions.
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I completely agree with you, my dear Dad died because of being over drugged with dilaudin/morphine as well as being denied a feeding tube. He couldn't swallow because of a "mass" in his esophagus, which I believe wasn't even properly diagnosed. They immediately said it had to be cancer, from one ct scan.
It's inhumane the way our innocent, trusting elders are being ushered to their deaths by the very people who we trust to care for them. Of course a person will die if they are not fed for 3 weeks and given ever increasing amounts of morphine.
The way society is going, letting hospice/palliative kill off our elders is just barbaric. My Dad told me he wasnt in any pain but they said the morphine would make him more comfortable, when actually it made him unable to breathe and I too will never forgive myself. I think they took advantage of our trust in Drs/palliative and that we were under extreme stress. Its barbaric that they wouldn't even treat your Mother's UTIs, etc. except with morphine. It's Drs/palliative/hospice that should suffer the guilt over their selective extinguishing of the elderly. Just because they feel the elders lives aren't as valuable as a younger person's. I wonder if they'll feel that way when it's them lying there being drugged, and in my Dad's case starved, to a much hastened death. This slow death by sedation is nothing short of legalized murder and I don't know why we, as a society are not challenging it in the media. At the very least it would make people who have yet to deal with it not to be so trusting. I'm very sorry you are feeling so guilty, the guilt should be felt by those responsible, Drs/hospice, not you. I feel it every day too and its been almost 2 years. You did your best, please remember that. I'm so sorry about your dear Mom, and I'm so sorry for how they mistreated her. I hope you can find peace of mind knowing that we are only guilty of trusting the wrong people.
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I agree with "assisted suicide" or even "accelerated death". They do not treat things that are treatable - UTI, fever, headache - except to increase the Morphine. If I had it to do over, I would NOT have put my mom in Hospice. It is a decision I regret and cannot undo. May God forgive me.
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My families experience w/ hispice wa incredible!! Our Mam was suffering and dying of Uterine CA, which had metasticized to her pelvic bones. She lived w/ my sister, for 5 mo.'s, with Hospice, aides, bathers, and Catholic clergy, as well as All the other 5 siblings helping, and Grandchilderen. I know, we had it really good w/the BEST possible support system, more than anyone could ask for, and still it was very difficult on us all as we knew we would lose her eventually, as we had just 14mo's before, lost our dear Dad (and my MIL), and were still grieving. At the 5&1/2 mark the Hospice nurses noticed subtle mental and physical changes in our Mum, and told us it was time to transfer her care to Hospice hospital, (I believe, sparing us seeing her die at my sisters home. (Its so painful at the end) our Mum was now ACTIVELY DYING. An absolutly lovely, caring, and comfortable place, w/a nice long couch for each of us to take turns, staying w/ her through the night. On day three, Mam slipped into a deep unconcienceness, and the Dr's and all family had a meeting to discuss now how to proceed. Their reccomendation was that they would discontinue all fluids and nutrition, except pain IV. This was it, time to wrap our heads around that we were losing her, that this would be her desire, as it had all been discussed by all, w/ Mam, when she was clear thinking and on DNR , and that is what we did. At first I had the most difficalty w/ it as I had worked in Medicine as a Medical Assnt. X 25yrs. Witholding fluids sounded cruel, but they assured me that it is in fact the most Humane thing to do, as she Was Clearly ACTIVELY DYING, and her poor body was clearly shutting down. They said, when a person's Kidney function ( BUN & CREATININE) WAS SO ELEVATED, as hers was, that it actually causes obvious confusion, But also actualy a significant pain relief and euphoria, that the pt. Benifits from, that it is well studied and doccumented, and I felt they truly were sincere, and would trust their word. Mind you, The long standing Morphine for her pain would continue. Our Mum was kept comfortable, turned, mouth swabbed w/ water, loved on, music, and all her six kids any all her Grandkids constantly around. The happy noisy she so loved, We had picnics, and I hope/know she knew we were all there for her. Mam was completely out for five full days. On day 8, at 6:00am ( Labor Day, No traffic into downtown Seattle) my little Brother 42, called us all, TO GET THERE QUICK, Mam had woken up and he was'nt sure how long she would stay awake. We each said Our Love and Goodbyes to her on the phone, and raced down there. Indeed she was still awake long enough to see our faces and tell her it was OK and to now join our Dad in Heaven, that we Loved Her for being the most Fantastic Mom, that we would all stay close and support one another, she could'nt really talk, but her eyes were filled w/expression and the Love she had instilled into each of us. And w/ all six kids hands on her, she slipped away. As hard as it was to lose her, it was a most Beautiful experience for us all as a family who rallied togather til the end to give back a little of what she deserved! We had a very simular experience w/ our Dad who had died just 14 mo. before, all togather at the end, he in hospital, dying from PSP, complicated by Pneumonia. NOW I have my Grumpy, cold, argumentary, hermit, Narcisistic, FIL living w/ my husband & I, in our home, X 10+ years since his wife passed away, and are at our wits end trying to figure what to do w/ him, and to get some quality of life back!!! YOU CANT WIN EM ALL!!! LOL. Which is why I am here, learning, as much as I can from all you folks!!! I so appreciate you all, everyone has Valid point of view!!! Hang in there, SINCERELY, staceyb1960
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From looking at all this it looks to me like the important thing is to stay in charge. If your goal is not to have death occur as quickly as well as painlessly as possible, you don't just want piles of opioids and antipsychotics around the clock. They SHOULD be listening to you and giving you as much alertness as you want to have, and keeping any meds that help you function or feel better, at your discretion.
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Hospice is wonderful for the individual as well as the family. Not to sound harsh but no one gets out of here alive. My SIL had stage 4 brain cancer a few years ago, we got her here to live with us a few months before the end. Everyone said hospice and she fought it. I am an EMT, in the ambulance on the way to the hospital with her after a fall at home my coworker told me she needed hospice. I felt the same way as most uninformed that it was a place to die. While in the hospital we finally made the decision when she could not. I experienced hospice when a friend died but that was as a visitor and when my grandfather passed I stayed with him all day and the night when he passed. When we arrived at the hospice facility it was a quiet place. The nurses are truly angles, really they are. They cared for her in a way the hospital would not (no attention at all in the hospital still ticked about that). They made her comfortable. There was no going back for her, she lasted 11 days but in as much comfort as could be given to her. For my wife it was very comforting that she was cared for in a quiet and dignified manner. They made sure she was not in much pain (morphine and other drugs were provided for comfort) even though we knew she was. If hospice is recommended then one should look at it, at home or in a facility. It is truly the best for the patient. Yes it is a place to die but in the most dignified manner. If there are any hospice nurses out there you truly have wings on earth!
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I think you're right on about assisted suicide= palliative/hospice. My father was basically starved and drugged with morphine/dilaudin over 3 weeks in hospital. The last week was in hospice where they gave more and more dilaudin. I don't know why they tell you the lie that morphine makes it easier to breathe. Morphine depresses breathing, look up the side effects of even codeine, morphine's weakest form and it says to use it with caution in individuals with breathing problems. Years ago it was advised not to use morphine when someone had respiratory problems! My father was admitted to hospital with pneumonia, then during a "swallowing test" he aspirated. Then he was given a ct scan which indicated a mass in his throat, which the Drs immediately proclaimed was incurable cancer. (He was Never given a biopsy, which is the ONLY way to confirm a mass is malignant, it could have been benign or any number of other conditions) Because of this he wasn't given a feeding tube, even though he recovered in about a week from the pneumonia. By this time he was very weak from fighting off the pneumonia and only being given saline, antibiotics, and dilaudin/morphine. We waited for the biopsy that never came (I later found out the Dr had canceled it a day after the ct scan) They wouldn't put a feeding tube into his femoral artery, which they could have done. They said he was in pain, but he told me he wasn't many times and he had no cognitive problems. They kept telling us to move him to the palliative unit and after 2 weeks we did. He was only conscious for about a day out of his final 7 days there because of all the morphine, he was never given a biopsy, or feeding tube. In palliative it was only morphine and a saline iv.
This sounds a lot like "assisted death", even though he wanted to live. Just about a month before all this he still drove, took long brisk walks, etc. I think Drs and palliative are just writing our elders off. When I met with his Dr a month or so after his death, she said " he would've only gotten sick again" when I asked a few questions about his treatment. Guess we should all do away with ourselves because we might get sick. What's sick is not feeding someone for 3 weeks and then finishing the job with morphine. I don't know why I believed they knew best at the time.
Sorry this was so long. Yes, I believe hospice/palliative care is definitely assisted suicide in many cases, and in many cases it's something even worse. And people who tell you that starvation isn't painful haven't experienced it themselves, so there's no way they can know this for sure. I'm so sorry you are going through this. As long as your loved one expresses a will to live, stand up to hospice/palliative and fight for your loved one's right not to be written off because of their age.
If you don't, you'll never forgive yourself, I know.
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As far as it being financially covered - either you are dying (hospice appropriate) or you can get better (PT appropriate). Medicare won't pay for both. Yes, we could private pay for PT while Mom is under Hospice, and I imagine we would try to get that done if she does go under Hospice.

All of you on here are fantastic. And everyone having a different a range of experiences, different stages of the process that have been experienced, is
invaluable. Thanks and hugs to all!
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