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MIL age 97 in nursing home with very aggressive form of bone cancer. Hospice taking extremely wonderful care to manage her pain: and it was her desire to be out of pain or as she put it “ put to sleep”.
she has had severe pain, and they have continuously changed and increased her pain meds, and now has fentinol patch plus morphine.
but we notice increased confusion, sleeping much more, staying in bad now, not really eating. Also developed Covid and is quarantined.
my question is is this end stage of life or just the result of pain meds?



I was on this forum 4 months ago and lost my mother at that time. She was on hospice and I saw her breathing change and skin mottling as she neared death. However my husband and I are recovering from Covid ourselves and unable to visit her but we wonder if symptoms are result of meds or if she is in a last stage of life. We call her but she rarely can talk, but when she can , sounds so confused and really doesn’t know who we are. Hospice hasn’t told us a time frame but did say they would know more in a few weeks.
we have seen rapid deterioration in two weeks.

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I would say that COVID probably did not help her condition.

The pain meds are for her comfort. Her sleeping is part of the transition. Her wanting to stay in bed is part of the transition. In the last two weeks of life anxiety stepped in, she closed her eyes not to open them again and then would not get out of bed.
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I’m living in a situation replete with similar pain and similar question marks, but at least we’re able to visit.

I try to force myself to stop overthinking her circumstances as much as I can, tell her how much I love her every time I’m there, and appreciate every second with her.

She isn’t receiving any of the “end of life” meds, but is in bed all the time now.

I’m not sure you’ll be able to get much by way of time frames and I’m not sure either that any guesses at this stage of the game are anything more than guesses.

My sincere sympathy to you and your family. I understand only too well the situation you’re in.
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It could be any of the things you mention and is probably a combination of all of them. Pain meds can certainly cause more sleeping and confusion so can pain itself and COVID is likely to hit an infirm person who’s immunity is weak harder. Pain in itself can lower your immunity and zap your energy because you body and mind are working so hard to deal with the pain. That’s without cancer attacking your body. I doubt the medications keeping her more comfortable are hastening her death any more than bone cancer and COVID are at 97 and it’s exactly what she requested really, make me comfortable at let me go to sleep. Not that she meant today or tomorrow but she probably means sleep is better than living with this pain. My thoughts are with you and your spouse because this is probably harder on you rite now than it is on your MIL and your pain is very real too. I hope you are getting some support from hospice even if it’s through virtual conversations.
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The nurses are usually very good at recognizing the signs but sometimes they seem to be reluctant to tell the family what they are thinking. Talk to the nurse in charge and ask, explain that you need them to be as forthright as possible.
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Between Covid and extremely aggressive bone cancer at work in the poor woman's body, I would imagine she's approaching the end of her life now a bit faster and that's what you're hearing with increased confusion and more sleeping. Thank God hospice is keeping her pain managed, which is the main thing right now.

My mother rapidly deteriorated and passed away within a one week period back in February after taking to her bed one day. She was socializing as usual in her memory care ALF, then felt tired, went to bed and fell into a semi comatose state and pretty much never woke up again. At first I thought it was due to the Ativan being increased, but she stayed the same even after it was decreased. She passed one week later, exactly. I was relieved it was quick and she didn't have to suffer anymore.

I know how tough this whole situation is. Sending you a hug and a prayer for peace. Also a quick recovery for you and DH.
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You answered yourself in your first question. Remove pain meds and she may suffer. Although when near the end and with inability not to swallow, she may still be Ok. Follow directions from hospice. They are also trying to not allow a "bad" death in discomfort.
Your separation from her and your brain thoughts and anxiety may be clouded. I am so sorry that you have to be separated
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