I am working through different problems/issues with my grief. My Mom died in May - hospice in the hospital - CHF/decompensated cirrhosis from autoimmune hepatitis, cachexia, osteoporosis, stroke, etc. She was on a glucose IV drip since admittance due to hypoglycemia and liver disease.
She was admitted to the hospital on Saturday - the hospice decision was made Wednesday afternoon. I did not ask enough questions about the process. Mom had said her pain was 8/10, she could not take any suffering and was "ready to go". The GI doctor said without a feeding tube, she had a week or so to live. She did not want artificial hydration and nutrition per her advance directives, and the doctor said with ascites, etc., a feeding tube would cause more suffering and the life extension would be minimal.
The nurses started morphine while I went home to get clothes, etc. to stay with Mom. When I got back, she was semi-awake and able to talk, but not as alert as she had been before I left. The nurses said part was due to morphine, part to the dying process ( we ere told her ammonia levels, etc. were rising as her liver was failing, making her sleepy, lethargic, as well.) She stopped eating much a few days before her hospitalization and was having trouble swallowing. Anyway - by Thursday, she was seeing and talking to relatives who had passed, and went through several periods of restlessness - asking me to help her stand, sit, etc. continuously...after a while of this, she was given another medication to ease restlessness.
She passed on Tuesday - death rattle, changed breathing, etc. started early Monday morning. I fought with the hospice nurses because I wanted her to try to eat, drink and take some of her medicines...since she was on "comfort care", they did not want to - but I made such a commotion - they let me try to give her yogurt, ginger ale and her heart medication ... it did not go well...I got the pill down, but she almost choked - she pushed away the yogurt and got 1-2 sips of soda down. I kept the IV drip on the whole time, because that was the thing that had kept her from going into a coma-I felt like removing it was my killing her. The doctor said would not keep her alive, but it was ok as long as her body did not experience fluid overload or she had trouble breathing (she was on low dose oxygen).
Anyway, in hindsight, I am worried, that the morphine which made her sleepy/unresponsive, also prevented her from being able to eat, drink, etc. I worry that my not slowing it down, or demanding that she be more awake those last few days expedited her death by starvation, etc. As far as I can remember, the morphine started out being given about every 6 hours, then every 4, then 2-3 hours the last day or so... Being tiny ( 98 lbs) and having liver failure, I worry that this was excessive, and kept her mostly asleep from Thurs-Tuesday. I did not want her to suffer or be in pain as she was, but I did not want to expedite her death either. I worry that I did not tell them to slow/stop the morphine, or wait until actual death was closer before starting (they started w/o letting me know and said she was in pain and would suffer if the morphine was stopped). The nurses and I monitored her for signs of pain, etc.-if there was none, we skipped the dose, if she seemed in in pain, they administered. Please give me your input as to how "normal" this is, and if in fact, my Mom's death was premature due to her not being able to swallow, eat, drink or take her other medicines. I have a lot of anxiety and pain having been through the dying process with her - she passed peacefully in my arms the Tuesday after hospice started. Any help understanding if this process was normal would be appreciated...I worry I was not "aggressive" enough or allowed bad care, sped up her death, etc. by allowing the morphine.