Will not give medication as prescribed. Patient is no longer recieving food/water. Should I report considering he is quite obviously suffering because of this?
Does the person appear in discomfort? And if so, how is he exhibiting it - meaning how do YOU know he is in discomfort? Is he at least having the Fentanyl patch applied by his CG’s?
If it’s brainstorm CVA his prognosis is poor.
Why not ask his hospice nurse to call in the hospice SW or chaplain who can speak with his caregivers and explore their concerns. Sounds like the person is relatively young if his mother is still with him. His mother is probably in denial & clinging to any possibility her son may improve. And feeling if she medicated her son she will hasten his passing. I assume brain testing has occurred to determine irreparable brain injury. (Usually several EEG’s done over intervals of days)
I would go through any channel I could think of if I saw a friend in discomfort and treatment being withheld b/o someone’s ignorance about what hospice provides.
His nurse did speak to the family yesterday and put him on a schedule to receive the meds. His breathing was so labored when she arrived that she immediately administered the meds and told them he has to receive them if they truly wanted his last days to be comfortable and ease his suffering. Thank you for your response.
Ok I’ve been in your shoes because something similar went on with my MIL. The difference was, she wasn’t comatose. She was at the end of short battle with pulmonary fibrosis and signed herself up for hospice when the doctor gave her 3 months to live. Her long time boyfriend whom I shall refer to as her partner, was her primary caregiver by her choice and he would not give her morphine (or Ativan. Or a nebulizer treatment) because he though it would kill her. He too, thought it would kill her. He adamantly refused to give it to her. She was willing to take the Ativan and use the nebulizer but had reservations about the morphine. He would not offer her morphine, he did not set up the nebulizer for her. Because they were provided by hospice and to him, that meant they were there to speed up the process and kill her. So she suffered needlessly because of his beliefs and influence over her. It was very easy to see he had her afraid to take the morphine. She knew she was dying but she did not want to speed up the process. She didn’t want to prolong her life either, she just wanted to be comfortable for whatever time she had left.
I too had a real problem with the lack of morphine. I posted about it here and I ran the situation by a old friend that is a hospice nurse who said that as long as the meds weren’t necessary, there wasn’t really any wrong doing going on. As long as she wasn’t being denied basically. If the nurse felt her partner was denying her the meds and that there was something wrong, she could intervene but in our case, the meds were there for comfort only and as MIL wasn’t asking for them and being refused, there wasn’t much that could be done. I was seconds from calling APS one day regardless because her partner kept reiterating his anti-hospice beliefs to me and how he refused to give her the very meds that would help her breathing and ease the suffering. I didn’t call because as soon as I started to dial the number, a major panic attack struck, one that mimicked a heart attack! In the end, My SIL got her on Ativan which helped a little and my husband spoke to her privately about the morphine situation and felt comfortable with her response. About 5 days before she died, the nurse did finally intervene when her breathing got really bad and my husband as POA had to tell her partner to either give her morphine regularly or step aside and let us take over, meaning that we (we as in, her children and their spouses) would take turns staying over in shifts & administer the morphine on the schedule the nurse recommended. Giving her morphine was the lesser of the 2 evils go figure so he started giving it to her.
If the nurse feels there is any wrongdoing, she has a duty to report it. You can ask her if she did. You can call APS, tell them the situation and request that they investigate for themselves and determine whether or not your friend is being harmed. My question to you is, did your friend ever communicate his wishes to you? Do you know for sure that he wants pain meds? For us, we knew what my MIL wanted because when she went on hospice and got her final affairs in order, she filled out a health care POA and said she wanted pain meds and comfort measures, no DNR, nothing to prolong life. Everything her partner did, was with the intent of prolonging her life. If your friend ever discussed this kind of thing with you and you know what he would want, then I think you know deep down what you should do. It is a very difficult position to be in when you are an outsider. For me, I too was an outsider but I also struggled to decide what was worse-suffering because of no morphine or having APS come in and put her in a nursing home! She was very clear-she wanted die in own home. And I feared that if it got out that *I* was the one responsible for them taking MIL away, that I would lose my marriage/my family! It was an awful time and I am so very sorry you are in this situation. I hope your friend gets the care he needs.
His wishes were always to not be kept alive if anything like this were to ever happen. He has a DNR in place at this time. It has been so difficult to see such a young man(41) go through this. I am hopeful after his nurse came in yesterday and talked to the family members caring for him that he will receive those meds now.
He was sent home on hospice care and is supposed to be receiving morphine, ativan, and a fentanyl patch. He does have a G-tube to receive medications. His nurse came in today and was visibly shocked by the condition he was in because of meds having been withheld.
As a rule of thumb, if you ever have any concerns about a person's wellbeing, and the person is unable to communicate so that you can't ask his permission and he can't speak for himself, then it cannot be wrong to speak up on his behalf.
Having said that, it is rather difficult to understand from your description what is happening to your friend. What medication has been prescribed for this patient who is in a coma? How can a person who is in a coma take food and water, unless he has a PEG feed or similar? What sort of caregiver is looking after him, and where is he being looked after?
If you'd like to outline the situation, perhaps forum members will know whom you should contact about your concerns.
I don't understand. Someone in a coma would I think be in a hospital, perhaps in an ICU. No one outside of hospital staff has the right to determine or administer meds.
If this person is at home in a coma, why? And I don't think any caregiver, especially someone who's not a medical pro, has the right to administer any medicine.
If there are meds being given, I would think they're by IV.
He has a G-tube to receive morphine and ativan. He was sent home on hospice care. Nurse came today and was visibly shocked by his condition. Spouse and mother are caregivers and believe morphine is going to "kill" him even though they have been told he will not recover. A caregiver can administer meds when the patient is on hospice care.
I agree his body is shutting down. His brain stem was the location of the stroke. Caregiver refuses to give morphine thinking they can keep him alive longer by doing so. His meds are to be given to make him comfortable and they are not being given.
Does the person appear in discomfort? And if so, how is he exhibiting it - meaning how do YOU know he is in discomfort? Is he at least having the Fentanyl patch applied by his CG’s?
If it’s brainstorm CVA his prognosis is poor.
Why not ask his hospice nurse to call in the hospice SW or chaplain who can speak with his caregivers and explore their concerns. Sounds like the person is relatively young if his mother is still with him. His mother is probably in denial & clinging to any possibility her son may improve. And feeling if she medicated her son she will hasten his passing. I assume brain testing has occurred to determine irreparable brain injury. (Usually several EEG’s done over intervals of days)
I would go through any channel I could think of if I saw a friend in discomfort and treatment being withheld b/o someone’s ignorance about what hospice provides.
I too had a real problem with the lack of morphine. I posted about it here and I ran the situation by a old friend that is a hospice nurse who said that as long as the meds weren’t necessary, there wasn’t really any wrong doing going on. As long as she wasn’t being denied basically. If the nurse felt her partner was denying her the meds and that there was something wrong, she could intervene but in our case, the meds were there for comfort only and as MIL wasn’t asking for them and being refused, there wasn’t much that could be done. I was seconds from calling APS one day regardless because her partner kept reiterating his anti-hospice beliefs to me and how he refused to give her the very meds that would help her breathing and ease the suffering. I didn’t call because as soon as I started to dial the number, a major panic attack struck, one that mimicked a heart attack! In the end, My SIL got her on Ativan which helped a little and my husband spoke to her privately about the morphine situation and felt comfortable with her response. About 5 days before she died, the nurse did finally intervene when her breathing got really bad and my husband as POA had to tell her partner to either give her morphine regularly or step aside and let us take over, meaning that we (we as in, her children and their spouses) would take turns staying over in shifts & administer the morphine on the schedule the nurse recommended. Giving her morphine was the lesser of the 2 evils go figure so he started giving it to her.
If the nurse feels there is any wrongdoing, she has a duty to report it. You can ask her if she did. You can call APS, tell them the situation and request that they investigate for themselves and determine whether or not your friend is being harmed. My question to you is, did your friend ever communicate his wishes to you? Do you know for sure that he wants pain meds? For us, we knew what my MIL wanted because when she went on hospice and got her final affairs in order, she filled out a health care POA and said she wanted pain meds and comfort measures, no DNR, nothing to prolong life. Everything her partner did, was with the intent of prolonging her life. If your friend ever discussed this kind of thing with you and you know what he would want, then I think you know deep down what you should do. It is a very difficult position to be in when you are an outsider. For me, I too was an outsider but I also struggled to decide what was worse-suffering because of no morphine or having APS come in and put her in a nursing home! She was very clear-she wanted die in own home. And I feared that if it got out that *I* was the one responsible for them taking MIL away, that I would lose my marriage/my family! It was an awful time and I am so very sorry you are in this situation. I hope your friend gets the care he needs.
Having said that, it is rather difficult to understand from your description what is happening to your friend. What medication has been prescribed for this patient who is in a coma? How can a person who is in a coma take food and water, unless he has a PEG feed or similar? What sort of caregiver is looking after him, and where is he being looked after?
If you'd like to outline the situation, perhaps forum members will know whom you should contact about your concerns.
If this person is at home in a coma, why? And I don't think any caregiver, especially someone who's not a medical pro, has the right to administer any medicine.
If there are meds being given, I would think they're by IV.
Something doesn't make sense here.
If he has been “comatose” for a month I would think he should be in a hospital, rehab center or NH.
Is he @ home? Does anyone know if a swallowing test was done? Maybe he can’t swallow b/o the stroke.
Is he on hospice? Does he have Advanced Directives in place? Is he a DNR? Is he breathing on his own or on a ventilator?
Usually the extent of the stroke and what part of the brain was effected leads to the symptoms.
Sorry for so many questions; just trying to get a better picture of this man & his prognosis.
Unfortunately this man may be actively dying and that’s why he isn’t taking in water/nutrients. His body could be shutting down.