Follow
Share

Mom (78) has been in and out of hospital and rehab facilities for months now -has back pain due to compression fractures-she also had covid. She’s very frail and has a feeding tube now-muscle atrophy and osteoporosis but no other chronic condition.


She’s in a group home assisted living facility now-and she is starting to walk again and dress herself but she complains constantly of pain. They tried gabapentin and she is using Tylenol-and on an anti anxiety drug. I fear that she has built up a tolerance to norco (opioid) and needs more. They offered her morphine- I don’t like the idea of my mom being on morphine and I’m not ready for my mom to be addicted to pain killers. However, many have suggested she already is addicted. Is it really fair of me to suggest she not be put on morphine?


I think she has built up a tolerance to the norco and it’s just not working anymore. She has asked for morphine multiple times when she leaves the hospital and first enters rehab-it’s very typical-and they don’t give it to her (they did in the hospital).


I really like the care she is getting and the place is very communicative -this was not the case previously. they asked me if it is ok to give her morphine-they are involving me in the decision process.


Her primary care doctor won’t prescribe any more opioids-she is concerned about addiction. She is no longer using her primary care doc since she is now Under the care of the assisted living doc.


She has been through a lot- she fell from the hospital bed the very first time she was in the hospital-this led to a lot of her current issues. She’s been uncomfortable for months-and depressed.


Does it really matter at age 78 whether she is addicted to pain meds? Is the goal just to make her comfortable and happy? She doesn’t have cancer or any underlying condition. She used to be on very little medication prior to this whole experience. My personal approach is less medication, fewer tests, minimal doc visits-but this is me and my approach to health care for myself-is it really fair to use this approach for my mom?

Find Care & Housing
I have no personal experience but people on the forum have mentioned pain patches as being very beneficial.
Although 78 may be old for some people many, many seniors are living well into their 90's so she could have many years ahead of her, I think I would be focusing more on getting a consult from a spinal specialist to see if there is anything that can be done to treat the root cause - I've learned here that there are treatments (Vertebroplasty and kyphoplasty) that can be used to stabilize the spine in some cases.
Helpful Answer (4)
Reply to cwillie
Report
MaryKathleen Aug 22, 2020
I had Kyphoplasty. It is an outpatient procedure and painless. It did help the problem I had. It helps fractured vertebra. Mine fractured but didn't heaI. I would find a good Neurosurgeon to do it. If someone is thinking about it, I recommend do your homework. Everyone seems to feel it is safer than Vertebroplasty. I still have a LOT of pain if I stand very long. A walker or rollater helps, but I am having a problem with my ego. I have backpacked, done a little climbing, jumped out of helicopters. I just have a hard time walking in my neighborhood (with in my mind anyway, people peeking out their windows looking at me) even with my super fancy, penstripped, Nitro, Fire Engine Red, Drive Rollator.

I agree treat the root cause. Physical Therapy might help.
(1)
Report
My questions are, has she tried spinal injections to deal with the pain? And if she does morphine what comes after it loses its effectiveness? The spinal injections can be highly effective, done by the right doctor, guided by live X-ray to target the exact source of the pain. It can take a couple of tries to find the correct placement but the injections can be done 2 weeks apart and it’s a quick procedure in office or outpatient facility. My concern with going to morphine isn’t so much addiction, but considering her relatively young age and lack of other health conditions, it may not leave much room on where to go next when she’s addicted to it, but it’s also built up a tolerance
Helpful Answer (3)
Reply to Daughterof1930
Report

You've gotten some good suggestions here; I would also make sure that her depression is being treated adequately.

There are certain antidepressants that are used specifically for folks in chronic pain; in addition to seeing a spinal specialist to see if her back can be better stabilized, consider seeing a geriatric psychiatrist and/or a pain management specialist who can coordinate with her other doctors.
Helpful Answer (3)
Reply to BarbBrooklyn
Report
Isthisrealyreal Aug 22, 2020
A good pain management doctor will address the pain, anxiety and depression. They know that they go hand in hand in many cases.
(0)
Report
Why is your mom on a feeding tube?
I would discuss the pros and cons of getting on morphine with your mom.

To be placed on Morphaned is used for dying patients to try to keep them as comfortable as possible.

If that is not the case and she wishes to continue living, then I would switch to her having therapy, massage, using a heating pad, sitting and sleeping with her feet propped up. Ect.

If she has no major health problems then she could live another 20 years but not on Morphine!

Tall to the Dr again, Di your Homework and let your mom make an informed decision as it is her life.

She may want to live linger and agree to not take pain pills for a month and do other things instead and see how it goes.
Helpful Answer (2)
Reply to bevthegreat
Report
Isthisrealyreal Aug 22, 2020
Morphine is not just used for dying patients.

It is cost effective and many times is the 1st drug used for chronic pain.
(0)
Report
So happy that you are included in the decision-making process. So many times we are left out. That shows her current living arrangements are in her best interest!

Does it really matter if someone is addicted to a medication if it works? We talk about addiction to opioids, but leave out all the other addictive meds. My granny was addicted to a med, and when the doc changed it all hell broke loose - we argued and my stance was "Who cares - at her age what harm is it really doing?" The doc relented and put her back on the med.

Your mom should be as pain-free as possible. I fractured my back in three places and can tell you back pain has an effect on quality of life and I do not worry about being addicted to the opoid - better to be addicted and comfortable than not addicted and totally miserable!
Helpful Answer (7)
Reply to anrean
Report

Dear Rebeccaal
My mother also had immense pain due to very bad arthritis. After she broke her hip, it added to her pain. She couldn’t communicate her pain in words because of her dementia and instead lashed out and became aggressive. She was in an assisted living and then in nursing home. The facility first prescribed Tylenol 1000 mg 3 times a day, and Gabapentin 600 mg 3 times a day. It worked at first but she was still wincing in pain. The facility recommended methadone. I first didn’t want to put her on that but did agree after talking to doctors and nurses at the facility. They started off with 1 mg two times a day and reduced it to .5 after she was getting too sleepy. Eventually it was increased to 5 mg two times a day and her body got used to it in her system. After she was on it for a while, we noticed a tremendous difference, she was calm and comfortable and a lot happier than before. It took a lot of trial an error because she could not tell us what was wrong. I finally accepted the methadone and happy I did. It is so hard to accept these drugs, but sometimes they do work wonders. 

Maybe you could ask about methadone instead of morphine, which is much stronger.

My best to you.
Helpful Answer (4)
Reply to Aprildp
Report
cetude Aug 22, 2020
Methadone is very dangerous for elderly people, but I'm sure doctors will prescribe it without batting an eyelash.
(0)
Report
See 1 more reply
I wish you had a pharmacist who you trust to confide in. I know younger adults who needed oral morphine to control back pain but then ended up on fentanyl pain patches, a high level controlled prescription. The morphine can suppress respirations.
Reading below I agree with some injections at a pain management clinic to start with. My dad had terrible trauma to his back, had injections and was fit with a wonderful supportive back brace that he loved. Her back needs to be immobilized when she is up and moving. The best of luck to you and mom. My dad also was on anti anxiety meds and a mild anti depressive that helped.
Helpful Answer (1)
Reply to InFamilyService
Report

Be mindful the more narcotics and psychotropics a person takes, the more likely they will fall and get complications which may even include bowel incarceration (twisted bowel)--they can die from all of those things. It sounds she is headed straight for DNR/hospice route. Get funeral pre-arrangements done, if not done already, Power of Attorney, and estate planning.
Helpful Answer (3)
Reply to cetude
Report

Seems that your mom may need 3 different types of doctors to help her: a primary care doctor for her chronic physical conditions, a psychiatrist to deal with anxiety and depression, and a pain management doctor. Since she has a lot of musculoskeletal issues, pain is not uncommon. She needs to understand that the goal of pain management is to drop her pain levels to one that make it easier to function, and that usually means feeling a little pain throughout the day. She needs better pain medication management to achieve this - long-acting pain medication and short term pain medication. A pain management doctor is good at prescribing and managing this. Do not be afraid of opioids. Yes, she can develop physical dependence and emotional dependence on these drugs. She is not taking them for the "high" or to cope with stress. Also suggest that non-medication pain management techniques: heat or cold pads, supporting body parts with pillows, more frequent position changes... can all be helpful. I use those as a nurse and do not need a doctor's orders for these.
Helpful Answer (3)
Reply to Taarna
Report

I Have a friend on the morphine drip and it seems to help her with chronic nerve pain. She also has morphine lollipops and for some reason I continue to find that funny (I have an active imagine). I believe in making our LO as comfortable as possible.
Helpful Answer (8)
Reply to Cyninflorida
Report

I would ask what is her quality of life without the pain medication? If she’s able to be pain free and happy, is that more important than the worry of her being addicted to pain medication? Best wishes.
Helpful Answer (7)
Reply to Franklin2011
Report

Just want to add that any medications, including methadone, could be dangerous to the elderly. My mother had very competent medical care who knew what they were doing and very experienced with medications. I went in with my eyes open and also did much research myself.

Having my mother on methadone gave her two years of a comfortable life. There were no adverse reactions for her. I know it is different for each individual. I was happy to have had her pain free for those two years. She still would have been here if it wasn't for the Covid virus that took her away in May.

It is a personal decision and as long as you can trust the people who are taking care of her.
Helpful Answer (8)
Reply to Aprildp
Report

Yes I would agree to anything that makes her pain bearable. Good luck and all the best at this awful time. xx
Helpful Answer (2)
Reply to wiseowl
Report

Let her have the morphine. At some point, you have to let go, If the morphine works, well, at least she will have some comfort. I sense you have done the best you can.
Helpful Answer (5)
Reply to warkap
Report

No, addiction to pain meds is not now the question. It does not now matter if your mother is addicted to painkillers. In fact she may benefit from a fentanyl patch. Back pain can be very very severe. Think of it as end stage cancer pain, with no near relief of "release" on the way.
Does your mother speak to you about how long she wishes to fight on hard to live ? Did she want tube feedings? (I live in such terror someone would force me to go on with them that it is clearly written in my advance directive that I refuse them and all forms of artificially administered nutritions). Does she express and exhaustion with the constant pain of living now with no relief in site? Are you considering hospice care at any point for her? For me this sounds an utterly fearsome way to go.
If your mother always expressed a wish to go on at any cost, and still does, then I understand. Some people will tolerate any amount of pain to live. Most, however, will not.
I am so sorry for your Mom. If her doctor is speaking, at THIS point, about addiction please request a pain control specialist consult at once. This is the wrong doctor for her. Also consider palliative care, hospice consult may be an option in the near future.
I am so dreadfully sorry. When I started in nursing we did not control pain when we feared its relief might hasten death. Thank goodness this is no longer the case. I could stand ANY amount of blood, guts, sputum, and such, but when my patients writhed in pain I could not relieve it made me dizzy and ill. I have ZERO fear of death, but I know what pain is, and I dread it.
Helpful Answer (4)
Reply to AlvaDeer
Report
worriedinCali Aug 22, 2020
This makes no sense. Mom has a poor quality of life so opioid addiction shouldn’t even be a consideration. and you suggested a hospice consult may be in the near future. Well what do you think hospice will give her? MORPHINE. Hospice should probably be contacted now.
(1)
Report
See 1 more reply
My 74 YO mother has a bad hip and they cannot do the surgery. She has been on 15mg extended release morphine 2 times a day for 4 years. We ‘ve been told that this is a very low dosage. She understands that she might be addicted, but she is doing great. Aside from often being sleepy, she is happy, not loopy, and functioning well.  She uses a scooter to get around, but is living independently. In the beginning she had been on a higher dosage, but then started taking 500mg of Turmeric 2 times a day along with the morphine. She was able to then cut back the morphine by 1/3.  
Find a provider who will work with your mother to lower her pain levels. She will be a new woman. Good luck.
Helpful Answer (6)
Reply to Lamb232
Report
sunshinelife Aug 23, 2020
Thankyou...Ive been saying the same regards tumeric Pain is caused by inflammation. which is in turn (in chronic cases) causes by systemic acidity. Tumeric works nicely to reduce inflammation. Thereby reducing/eliminating pain. Comfrey root tea works nicely also. Tumeric is a food, not a drug..so you can use as much as she needs to be comfortable with no risk of side or after effects. You could include Kratom powder to wean her off the tail end of morphine if she wishes. And Potassium Broth (avail on google) to alkalize the body & give lots of much needed easily absorbed minerals.
(0)
Report
I would probably just let her try the morphine to see if it helps. I’m in a similar situation with my mom. She’s in constant pain. Tried Tramadol, Gabapentin, Steroids, pain patches-nothing worked. Her PCP won’t prescribe Opioids bec he doesn’t want her to get addicted! She’s 78 as well and in the end stage of dementia. My theory is does it really matter if they become addicted if it helps their pain? God bless you, the devious we make are really tough sometimes. Keep me updated please.
Helpful Answer (5)
Reply to Momsonlychild
Report
Rafaela Aug 22, 2020
is your mom on hospice? Surely they would arrange for her to have morphine. I’ve found that some doctors are very nearly terrified of their patients getting addicted to opioids, because of all the bad press. I discovered with my husband, who had FTD, that Medicare wanted him tested every so often to make sure the hydrocodone was in his system. You might want to check around with area hospices and see if there’s not one that would be more compassionate and accommodating than your mom’s PCP. Best wishes to you both.
(0)
Report
See 1 more reply
Ahh Morphine. After taking my MIL home from ALF and then Memory care and all her falls, and trying to get her to sleep at all, the hospice nurse recommended Morphine with her sleeping pills. She also has a broken hip which is inoperable at 99!years of age. I am not exaggerating when I say neither of us has slept more that 2 hours this week. Last Night I gave her a small dose of morphine liquid and her sleeping pills. We each slept soundly for 9 hours. Not a stir! I am super excited and hope this continues. Please, if someone recommends it, try it. Pain is no fun what so ever.
Helpful Answer (8)
Reply to Aprilealp
Report

And btw. Morphine is short acting. 4 hours.
Helpful Answer (0)
Reply to Aprilealp
Report
Rainmom Aug 22, 2020
There are extended relief morphine.
(0)
Report
Let her be comfortable. She may not have many more years. The dose can be kept at manageable levels. Monitor her ability to cart on a conversation and do routine activities. Partner with the assisted living caregiver doctor and staff. Trust that you all have the same goal for her. Good luck.
Helpful Answer (2)
Reply to Pr0f3ss0r
Report

By all means let her have the morphine. There is no need for her to suffer because someone else is addicted. She is not going to become an addict, she can barely get around now. My wife (age 87) has been on morphine because of her back for several years now and there have been no problems.
Helpful Answer (10)
Reply to OldBill
Report
Rafaela Aug 22, 2020
I agree 1000% with your first two sentences OldBill!
(2)
Report
Rebeccal,
Does Mom have a Pain Management Doctor??
If not, it might be worth a conversation with her ALF.
Because of the "opioid crisis ", PCP's will not give pain meds on a long term basis.
They refer chronic pain patients to Pain Management.
Best wishes!!
Helpful Answer (1)
Reply to xrayjodib
Report

78 is not that old. But, your description sounds as if she is in hospice. You should talk to her doctor about what recovery is expected for her. If she is in hospice, you just want to make her comfortable. You're not trying to fix things.
Helpful Answer (4)
Reply to NYCdaughter
Report

My dad, now 90, has cancer, rheumatoid arthritis, blown out knees, etc. Other drugs worked for quite awhile, but don’t now. I fought against using morphine, but it’s the best thing for him. With the lowest dose needed he feels no pain, isn’t sleeping all the time (I’d feared) and is not having constipation. He gets a minimal dose 4x day and is a new man! Technically he probably is addicted, But he’s able to live w/o crippling pain and enjoy what’s left of his journey. The nurses will have you document how your parent responds to it. I’m now a believer! Good luck.
Helpful Answer (9)
Reply to DadsGurl
Report
sunshinelife Sep 3, 2020
it was the best solution you knew of at the time...there are others..with all due respect...
(0)
Report
Your first option is to examine what is your ideal of quality care and life. Make a decision within that scope of thinking, Remember you are doing your best. Your not a miracle worker you are a caregiver. I know sometimes you feel that's what you must be but you don't. Maybe also look into some alternative option for pain management that can be add to traditional pain therapies. All the best for you and your family.
Helpful Answer (0)
Reply to Cares365
Report

Have they suggested fixing her fractures. Kyphoplasty is a simple out pt procedure where the surgeon “glues” the fractures. I work recovery room and all my patients say how much better they feel. Not saying your mom is a candidate but it is worth investigating. Opioids can cause all sorts of problems such as constipation (which would make her miserable) to respiratory depression. Good luck in whatever you decide.
Helpful Answer (2)
Reply to Gouk00
Report
Isthisrealyreal Aug 22, 2020
Daily magnesium supplements take care of the constipation.
(1)
Report
See 1 more reply
I would be careful with opiods.
They are very addictive and you have to keep getting stronger and stronger does. It can be fatal.
Have you tried using electro therapy like Dr. Ho. ? Many of moms elderly friends use it, mom uses it as do I with great relief. It is very easy to use.
Helpful Answer (1)
Reply to Christservant
Report
sunshinelife Aug 23, 2020
Is the electrotherapy used an at home or clinic device? or both? thankyou
(0)
Report
My mom was on Norco & Gabapentin for years. It never hurt her. At some stage the Norco wasn't the best fit anymore & they prescribe something else that would work better. Make them as comfortable as possible, no matter what it takes.
Helpful Answer (1)
Reply to Labmom
Report

Does her injury warrant morphine? What I mean is, is her injury bad enough that anyone else with that same injury need morphine too? A Pain Management Specialist needs to decide that.

It could be that depression or anxiety are factors at play, if so that requires different medication, but would still help with the pain.

As others have mentioned, once she’s in morphine, if she reaches a tolerance point, what does she go to next? What if she bounces back and lives another 10-20 years? Not unheard of.

I would ask for a Pain Management consult.
Helpful Answer (2)
Reply to BeckyT
Report

Morphine is what the less than honest hospice folks use to basically "put the patients out of their misery--- permanently!" Don't do morphine-- it's addictive and easy to abuse. Look for natural means-- check with local wholistic doctors.
Helpful Answer (2)
Reply to DugganB
Report
sunshinelife Aug 23, 2020
Correct. Many patients have told me "the narcotics made me numb, they did not stop the pain". I have seen hip pain respond very well to a simple tea of Thyme & massage with infused chamomile oil. "Nature always heals, given
the opportunity" :)
(0)
Report
See 2 more replies
Ask a Question
Subscribe to
Our Newsletter