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Hi, I need advice , my 82 yo dad , who has copd and fairly newly diagnosed lung cancer recently had another exacerbation , 2nd one within a year, he was hospitalized and put on bipap and ultimately we had hospice evaluate and determined he was eligible to go to hospice house, this is his 2nd night there, I went to visit today and he was quite out if it, obviously drugged they gave him morphine and ativan , for breathing , they said he had trouble in the night, my visit was hindered as he was sleepy/ delirious so not quite aware.


The admitting person who I chatted with told me he did not appear to be active stages of dying, i inquiref how then was he approved to go , she had no answer.


I will be going today and meeting with social worker who will talk about his options etc. But I've started to get uneasy about the process of this , they give breathing treatments so i question the morphine ativan route...I know he's got terminal diseases that are not curable , but fear this morphine/ ativan , anyone have any advice?


Thank you

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Be very careful. That’s my advice.

My father had pretty advanced Congestive Heart Failure and after about a month of palliative care was switched to Hospice.

My dad still lived with my mother in their Independent Living apartment and he had a private pay caregiver(s) for about 16 hours a day - he was sleeping through the night okay at this point.

The Hospice folk just kinda swept in and took over. They very heavily pushed the Morphine/Ativan cocktail. Very. I was unhappy with this route as my father didn’t react well to morphine - never had - so as a pain reliever we avoided it. Like the plague.

Even the tiniest bit of
morphine would make my dad totally delusional. At this time my father wasn’t doing too badly with his breathing and was not in any pain. But hospice still pushed it. My dad wanted to stay mentally clear so he could still actively interact with his loved ones. I really, really wanted - needed this too - so I finally stood up to the Hospice folks.

To be clear - when the time came and my father was in physical and emotional distress over his not being able to breath - when he eventually worsened - I had no problem with the morphine and the Ativan. The last thing I wanted was for my beloved father to be in any pain. But for as long as he could - and it was what he wanted - I wanted my dad with us, mentally clear.

As well - I’m not one of those Hospice Conspiracy people. I DO NOT think hospices are out to kill folks or drug them into easily managed zombies. I was grateful for the Hospice help and when the time came I called them for help with my mom.

Just be be sure to ask questions and if you think it’s too soon for that level of medication - do not be afraid to speak up and stand up. All the time you have left with your dad is all the time you’ll ever have. Don’t let anyone beside your father tell you how he is going to spend it.
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anonymous876072 Apr 2019
I up still, it's 2 am I am having palpitations over this, I live 1200 miles away and came to visit him at his alf , all of this unfolded within the last 11 days , I'm leaving on Thursday, I am not comfortable with this , what are my options?
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Let me add, although my dad has progressive and terminal Co morbidities , they were managed with treatments , his sats with 02 were always 95 ish , they claimed he had elevated co2 and needed bipap , but his last abg's showed c02 that was ok, he had just completed 2 months in a PT rehab 3 weeks earlier from the last exacerbation with clearance to go back to his alf. I feel kind of confused as to him being accepted into a hospice house when he wasn't actively dying and fear the drugs will change that status ...
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Sorry you are going through this. Can be very confusing as to what is best. God bless you. Hope it’s resolved soon and you will be at peace. Hugs!!!

Sorry I can’t be more helpful. Just offering support. I hope others have answers for you. I like what Rainmom said.
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If Dad doesn't want Hospice he doesn't have to have it. You say "Hospice House". He can have Hospice at his AL.
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Hang in there. Many of the hospice workers are merely experienced volunteers who have been through the process themselves, but not medical professionals. Hospice nurses are reluctant to answer too many questions (fearing they may answer incorrectly). Doctors breeze through very quickly—it can be logistically difficult to meet with them. If you are able to spend more time at the facility, your dad will receive better care. Do your best.

Does your Dad have an advanced directive or Medical Power of Attorney? An individual with medical POA can refuse treatment that is contrary to your dad’s wishes or deemed not to be in his best interest.

Regarding your emotional support network, ymay be disappointed in people who you perceived to be part of your support system. The best news is, you aren’t alone. Under these circumstances, you will learn who your best friends really are.

If you are not happy or comfortable with the services at this hospice center, you may be able to get your dad transferred to hospice at home.

I wish you the best. You will be in my thoughts.
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