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I want him out , they are giving ativan morphine around the clock, he has no pain ,but they give it


He is either totally drugged and can't speak correctly or sleeping, he has now missed 2 meals and is obviously not drinking , I have him being transferred to skilled nursing facility , for rehab as he's been bed bound for 11 days, no one got him out of bed at the hospital. He can't get transferred for 4 days , I requested the hospice facility STOP giving morphine ativan , but they said the dr here won't revoke the order !!!! What can I do ???

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I am very sorry for your loss, monimom.
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Oh, so sorry for your loss.
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Oh, Monimom - I’m so sorry for your loss. Know you did the best you could for your father and were a good advocate.

I lost my father seven years ago this
July. I can hardly believe it’s been that long as I still think about him nearly every day.

You must be feeling torn up and raw. Especially after your recent fight to see that your father was cared for properly. Know that with time that feeling morphs into something that becomes easier to live with.

Please try to find comfort in the love you and your father shared.

I tend to quote movies - movies were my escape from a rough childhood and still my break from life’s challenges. Anyhoo...

One of my favorites. It’s from the movie Ghost:

"It’s amazing, Molly. The love inside - you take it with you".
~ Sam Wheat, Ghost
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Thank you to you all for your replies and advise sadly my dad passed away yesterday afternoon now I am in the process of trying to facilitate his final arrangements.
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shad250 Apr 13, 2019
I'm so sorry for your loss.
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This must be just awful for you.

I suppose about the best thing you can get done today is make sure your brother has a good To Do list and all the contact numbers. Is he pretty reliable about keeping in touch with you?
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Monimom Apr 10, 2019
We are in constant contact, he does as best he can , at this point I have spoken to the hospice dr and no more meds will be given , I want this to clear out , I'm not in denial I realize my dad has terminal comorbidities, but this mixture of drugs has completely put him out , I guess if he previously existed pain etc I would take comfort in this care , and perhaps one day this will be an asset but right now , it felt like we were channeld in one direction only, I will see what these next two days bring, thank you for your kind words
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I’m so sorry you are going through this pain. I hope it is resolved soon.
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Monimom Apr 10, 2019
Thankyou, leaving tomorrow is going to be excruciating, but I can't afford to be here any longer, as I stated I live 1200 miles away, I came to see my dad again while I could because I know his condition , I did get to visit with him for a few hours the first day I was here before all if this unfolded, it happened at 130 in the a.m , I suspect it was his sleep apnea, he has a cpap, it recently broke, and because he had a history of non compliance the pulmo won't order a new one until a sleep study is done again
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I think CM is referring to the end stage COPD. Not the cancer.

https://www.medicalnewstoday.com/articles/314657.php
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Reply to BarbBrooklyn
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Monimom, has anyone shown you the lung imaging and talked you through what it shows?

I understand that it might feel to you that everything has happened so fast it can't possibly be just the disease doing this to him, but though I hate to say it - and obviously I don't know about your father himself - actually yes it could.

It makes my heart sink that yet again bad communication on the medics' side is doing this to a family, but that is what it sounds like. Has anyone talked to you helpfully yet?
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Monimom Apr 10, 2019
Yes he has a 2 cm mass on one lung and a 4 cm on the other , , the pulmo said it is stable
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Monimom-
Im sorry this is still happening. But it does sound like you’ve made some progress by way of getting your dad transferred to a rehab.

In the mean time - kick up a fuss and keep fussing until you speak to the doctor. As well - fuss until you speak to the head administrator at the hospice. Neither the hospice nor the doctor can force treatment by way of the morphine/Ativan if you have the authority as POA to ask for it to be stopped.

You seem to be knowledgeable regarding the tests and procedures- and their results as they apply to your fathers current condition. So, I’ll assume you are sure your father isn’t in pain or distress. If you’re positive that discontinuing these comfort meds is the right choice - then follow your gut. I think sometimes doctors get use to giving orders and don’t respond well when they’re questioned. But as your fathers POA - that’s your responsibility - asking questions, challenging orders that seem wrong to you - looking after your father and ensuring he is getting the appropriate level of care.

However...

Just be a sure as you possibly can be that your taking this in the direction that is what your father would want - not necessarily what you want and hope for - for him, yourself. Know what I mean? Just because your father is not “actively” dying - which is a specific process with specific symptoms- well, that doesn’t mean he’s not in pain or distressed.

Just be sure, okay? I would think the last thing you’d want is for your father to suffer. I can tell from your posts that you love him very much.

Last thing - I’d call the head of the rehab that your father is transferring to on Friday to give them a heads up that your father may arrive medicated. They might have a great deal of concern if he shows up totally out of it. Ask that he be given a couple of days to clear the morphine/Ativan from his system so they - and you - can get an accurate picture as to his current condition and level of needs.

I truely hope you can get this sorted out. Like I said - it’s obvious how
much your father means to you. I loved my dad so much and miss him every day - so I can understand where you’re coming from - wanting to have him with you - both mentally and physically for as long as possible. But sometimes the hard decisions are the best ones. So just be sure, okay?
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Monimom Apr 10, 2019
Im here. He's still out of it replying ridiculously, they have not given any meds since tues 10 am and are trying to tell me it's his disease , he's likely hypoxic, I won't try to pretend to know everything but I know drugs don't leave the system the moment you stop giving them , although the morphine is short acting the ativan has a 12 to 18 hour half life , I told them we won't know anything until this clears out of his system ...also I know my dad is dnr also I know he doesn't want aggressive treatment, today I come in to have them tell me he's declined !! I said of course he has !! You're giving him meds and no food no fluids and no movement he's 82 !!!,
I need peace .... praying for it
Getting on my flight tomorrow is going to be brutal, I called the rehab and begged them to get him outta here ... soon
The hospice told me he can't do rehab , i know that i just want him outta here ! On top if all else now his right hand and arm has swelled up , no idea why ...hospice says it's his disease ...this is becoming damn near unbearable
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Monimon, I can't imagine that you have not been sitting at his bedside 24/7 to ensure that he is not being given these drugs.

They are fighting tooth and nail and you are leaving hoping that they comply.

Flights can be changed and most employers understand situations that require additional time off. I think you are looking at trouble not staying to ensure that no meds are given and that he is transferred. You are putting a lot of faith in people that have proven themselves to not care. Yet you give them more time to administer more drugs before you call the ombudsman, at what point do you step in and put a stop to this bs?

I personally can't imagine that he was transferred to a hospice facility without the family agreeing, that's not how it works. POA has the say so if treatment in hospital is discontinued and no more life sustaining treatment is administered. Something is missing.
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Monimom Apr 10, 2019
How do I reply to this, as it seemms like youre attacking me ,let's see, I have changed my flight 3x $$ im living in a hotel and im not wealthy, I have a brother who is here, i am his POA and we agreed to begin hospice, as we both know this will eventually be a part of his care, when i spoke to the intake person the administration of morphine had been presented differently than what they began doing ,else I would never had put him here, he has not had any meds since yesterday at 10, he is getting discharged from hospice care hes going to skilled nursing/ rehab , what's missing??
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If you are his legal POA, everyone legally HAS to abide by your wishes. You can direct/manage his healthcare. Hospice must comply with your wishes but, they may discharge him from care also.

Talk with the hospice doctor in regards to the meds you have concerns about. Ask him/her to order a smaller dose or discontinue altogether. However, IF he appears in pain or is agitated, you may want to restart meds at a smaller dose.
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I agree, I don't understand this aggressiveness either. From what you post his oxygen levels are good. I am assuming that normally Dad would be able to tell the nurse when he is in pain or is having trouble breathing. You said, I think, the orders are "as needed". To me that is when the patient requests them.
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My dad had an exacerbation he has COPD and and recently and recently diagnosed lung cancer that that he that he wishes to that he wishes to not seek treatment for, when he was hospitalized with this last exacerbation they checked his co2 levels and found them slightly elevated, although his ph was fine, they decided to use bi pap, a hospitals knee jerk reaction to a person wanting air is to increase o2, but in a copd patient that is never the correct answer, because they cant expel 02 properly it then turns to c02 hence the elevated levels, when they repeated his blood gases, his levels were fine, he was stabilized, he has chest xrays and all was found stable.i was told he woulb be getting discharged to a rehab and was in thr process if choosing 3 facilities when suddenly i was informed he could not go to a rehsb that he had no choice but to go to another step down hospital because he would need to use bipap and rehabs dont do that i later learned this was a lie,they the dr he had gave him a med 3x his normal dose and he had a terrible reaction, very psychotic and breathless they discharged him to kindred hospital, where they then gave hin xanax, he was in a coma like state , i requested fluids during this time, he looked near death, although his 02 levels were 93-98 on 02, the i went to see him his 2nd day of kindred to find him stiil out cold but now with a bipap on with the 02 delivery set to 10l with his sats at 100% his normal 02 level is 2.5, when i requested info on this they removed bipap and put cannula on him, it was then that pulmo dr came in and basically said i needed to contact palliative /hospice, they came reviewed everything and dtermined he was eligible to go to hospice facility, bear in mind howat this point im feeling kindred is NOT a good place, i spoke with hospice intake and inquired about the use of morphine and wss told ig would only be used in severe breathing episodes, but they would utilize his duoneb treatment first, this is NOT what they are doing, i am his POA and i feel i have been railroadedinto this , i have been in touch with the rehab facility he was in for 2 months he just got relessed in mid march, they will have a bed for him friday, and he will be transferred, the hospicefacility hes in has told me he is not actively dying(yet), so he would need to transfer, but during this drug induced state hes inhe isnt eating/ drinkingthis 6ft 187 lb man has a healthy appetite always so this is absolutely the morphine/ativan ..... i have told yhem NO MORE, and what i was told was they will try to avoid administering but if he has difficulty breathing they will adminstef, and i asked ehy they cant use his duoneb instead, she said they do, apparently they claim dr. Will nit allow tge meds to be discontinued, and to use only if they have to, mind you that what i was told initially but that didnt happen. I will add, i came here 1200 miles from my home to surprise my dad almist 2 weeks ago, i was only suppposed to be here 6 days, the middle of the night onyhe day i arrived is when his exacerbatiin occured, i am flying home tomorrow, butmy dad will not be transferred until friday, i have a brother who lives here so my dad will have someone here, i am going to see my dad shortly i am praying they did not give anymore meds but if i find they did i will be contacting ombudsman
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Monimom I'm so sorry to read what you're going through. Would it be possible for your brother to meet you there when you visit your dad, and for all three of you (your Dad being present, that is) to ask the attending physician to come and explain?

Take deep breaths and look after yourself. I hope you get better answers today. Please keep in touch.
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Monimom Apr 10, 2019
My my brother and I are there with my dad my dad is completely out of it he can't even form correct words he hardly opens his eyes
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Who put him in hospice? He did it himself? If so, and you are not POA, there is nothing to be done but respect his wishes,

In hospice, a person is not expected to get up and exercise, walk around, engage in long meaningful conversations or even eat or drink.. that can actually be painful.

I'd much rather have seen my dad serene and calm as opposed to sobbing in pain through his last few weeks on earth.

If you are dad's POA, then this should not have happened. Is someone else a POA also? My mother has 2. I don't look forward to the day these two butt heads.
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worriedinCali Apr 9, 2019
She is his POA. He is not able to make decisions for himself so her POA comes to in to play now. There is more info on her other posts.
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I am just wondering why you feel correct in ordering medication ceased. Patients are put in hospice for a reason. Would you prefer to possibly see or hear him cry out in pain? Perhaps you are correct but if he is removed what will his care be then? Will it be correct for his diagnosis? Is the condition he is suffering from going to be solved in a different setting without medication he may need. People in hospice are not generally energetic. It is common that they may no longer wish to eat. I hope this situation is resolved but I also hope it is solved with the best interests of the patient as difficult as that may be for you to witness.
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Reply to Riverdale
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It would be good to talk to the doctor. It is possible that the reason your father is not in pain is actually because of the medication. At end of life (particularly with cancer), many people receive heavy medication to control pain and as a result are not completely conscious. Just check.
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Reply to MargaretMcKen
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You call the Doctor. And tell him you are requesting Dad not be given the medications.

Where I live, Hospice can be given at the NH. We don't have "Hospice Houses" as such.
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You are your dads POA according to another post and since he can’t make decisions for himself at this time, YOU make the decisions for him. Call the Ombudsman immediately and I would also go to whoever the heck is in charge of the facility!
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Do you have POA? If so, they cannot disregard your wishes. Every patient has the right to refuse and if you are POA, it would be the same as your dad refusing.
Call your local Area on Aging and ask to speak to the ombudsman. They are there to look after patient rights.
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Isthisrealyreal Apr 9, 2019
Like right now.
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