How do we keep her from dying in respiratory distress? - AgingCare.com

How do we keep her from dying in respiratory distress?

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Mom is 91, CHF, stroke, vascular dementia, broken hip repair, now has had pneumonia on and off, mostly on, since January. Pleural effusion (tapped 6 weeks ago, nearly died of sepsis) has reappeared and now a collapsed lung. Pulmonologist has advised no further intervention. We are talking to Hospice folks at NH tomorrow. How do we ensure that mom does not die in respiratory distress? When they tapped her in the hospital, she was gasping for air. The ended up doing a bipap, but refused her morphine. Does hospice know how to prevent this from happening?

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Morphine provides relief from the end stage gasping. It's both pain relief and opens the airways. Raise the head of the bed. Near the end, breathing is very irregular, as is the heart. Delerium WILL appear and that is when we added Haldol. And that's when YOU might want the Ativan.
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Baba loo - for my mom hospice brought in an O2 tank, & she had the tubes in the nose 24/7 since summer. Last month went from tubes to 3/4 face mask. Hospice nurse said this is better as mom gets O2 whether mouth breathing or nasal breathing. Makes breathing less stressful. Now it does complicate eating & drinking as whole mask has to be pulled off. So .whatever weight loss is going to get worse. Morphine well that is tricky, some hospice just do minimal on morphine. My thought is the state really looks at the amount of Schedule 1 & 2 drugs used by hospice. Looking for abuse of availability sort of stuff. You may have to press upon hospice to up moms dosagae. My mom has lots of kinetic hand motion, totally uncontrollable, she gets Ativan for this. Now ativan & morphine together can slow breathing. So the face mask helps counteract that. All of what your mom is going through is signs of end stage. Remember their sense of hearing is the last to go. you are a good daughter babalooie.
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Turn it over to hospice. They'll know what to do.

Ultimately, everyone dies of respiratory distress. Just like everyone dies from heart failure. When the heart and lungs begin shutting down they both go into distress. Hospice will get your mom through this with very little anxiety and/or pain.
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I believe hospice will administer morphine for the respitory distress. I am no expert though, but keeping the patient comfortable and out of pain is hospice main goal. My heart goes out to you in this sad and stressful time. You and your Mom are in my prayers.
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Me personally, if it were my mom? I would insist they keep her sedated. In my opinion, if hospice can't do that, they are useless. If she is sedated, her body will automatically do what it does to try to survive . . . but she will be unaware. A very peaceful death, in my opinion.

I am very sorry for the journey you're all taking right now. It's heartbreaking.
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