Morphine every hour now-is the end near?

Follow
Share

Hi all, well as of today MIL is now getting .5mg morphine every hour. Her oxygen level is in the 70s to low 80s, heart rate is high. I haven't seen her for a week now, my husband doesn't want to take the kids over at this point, so I haven't really been able to ask anyone any questions. So does this mean we are at the end? Will she stay asleep from now until she passes? Obviously communication in this family is....non-existent. I know she can still hear us but nobody called anyone to come say goodbye or have one last conversation with her while she was alert. I'm not sure what to expect now, I guess I just really need to know if she will be alert again? Or will the morphine being given so frequently keep her continually sedated? Anyone know how much longer she might have? I hate the not knowing part. There is much I never got to tell her, I just didn't think it would happen this fast, I thought there would be time for more conversations. The last thing she said to me was a week ago when she asked me to heat up her dinner. I could tell something was different, she thrust the plate at me, didn't say please or thank you, I sensed anger/hostility for the first time. I don't know what happened between that Thursday night and Sunday morning when we got the call that hospice was recommending morphine but I assume she took a turn for the worst.

Find Care & Housing
18

Answers

Show:
I was told that Dad could hear me right up until the end, so I'd say go and tell her all that you want to say, even if she can's respond.
Helpful Answer (11)
Reply to talkey
Report

.5 mg (half of 1 milligram) of Morphine is not much. Are you sure that it isn't 5 mg.? Usual doses are 5 mg., 7.5 mg., 10 mg., 15 mg. In hospice, those doses can be given every hour to keep a patient out of pain and comfortable.

Half of 1 mg. an hour is usually not enough to keep someone asleep and unresponsive.

Oxygen saturation in the 70's and low 80's is extremely low and not sustainable for life. The high heart rate is to compensate for the low oxygen, trying to pump around as much oxygen as quickly as possible.

There is no way to give an exact date or even a guesstimate. I've seen patients hold on 2-3 weeks longer than I thought they would. I've also seen them pass away much sooner than the time they were given.

Hearing is the last sense to leave. If there is anything you want to say, I'd go now and say it. Your husband is right, it's probably not a good time to bring the kids by anymore.

I understand your frustration with the "non-communicative" family. It's not all that strange, however. Families tend to fall apart and turn into "zombies" when death is looming. Since it's your MIL, it really isn't your place to start alerting the entire family to come and say goodbye. Very frustrating. Just do what YOU need to do with and for her.
Helpful Answer (8)
Reply to SueC1957
Report

Worried, it does sound as if she's getting closer to the end. She can't sustain normal breathing with SAT rates in the 70s to low 80s. Is she breathing heavily? Having episodes of apnea, when she just stops breathing before starting again? Staring at the ceiling and not moving her eyes?

I would go to her tomorrow, spend some time comforting her and tell her what you want her to know before she passes. If she does seem angry, it could be that she's afraid.

How is your husband handing this? And her partner?
Helpful Answer (7)
Reply to GardenArtist
Report

I am so sorry for your great loss, Worried. You cared so much. May sweet memories of your MIL bring you and your husband peace.
Helpful Answer (6)
Reply to MountainMoose
Report

Thanks all. I typed wrong, the dosage is 5milligrams of morphine not .5
I forgot to mention that her partner said her pulse doesn’t register on the pulseoxemeter thingy anymore. But he said her oxygen is in the 70s to low 80s and her heart rate I thought he said was in the 50s and 60s but I kind of wasn’t thinking straight by then and the numbers didn’t register in my head. When I asked if that was normal, he and my husband said no, it’s twice as much as that of a healthy person.

MILs partner is not well, he told me that tonight during our brief conversation. He had to call my SIL to come over yesterday for a few hours to give him a break. My husband is hard to read. When MILs partner told him that he is giving her morphine every hour, I saw a sad look on his face as he put his hand over his mouth. He doesn’t talk about this, I have to ask a lot of questions in order to get the information out of him. He is a police officer and he does not show emotion, he is always stoic. So I have a hard time telling how he is handling this, he keeps it all inside but like I said, I saw a small reaction in him tonight. When I try to ask questions, he’s short in his responses and I can tell he doesn’t want to talk about it.

I wasn’t planning on calling anyone to come say goodbye! I just meant that if my husband or his sister or MILs partner were told by hospice that the end is coming, I am a little surprised that she’s now sedated by medication and we didn’t all have any last words with her while she was alert! This is my first time going through this, I knew we would come when she passed and say goodbye but I had just assumed we would also kind of say goodbye while she was still alert. I guess I didn’t understand that it would so sudden-not being alert.

I’m hoping to get over there tomorrow, have to go to my youngest child’s end of year program in the morning and then I’m hoping to go to MILs right after that while the kids are still in school. I know she can still hear us so I will thank her for everything she’s done for us and tell her how much I am going to miss her and that I am sorry for pulling away and not making more of an effort to bring the kids over—the reason for that was because of blatant favoritism they showed to one grandchild and I did what I thought was right at the time. I deeply regret this now. Because of my husbands job, I often had to take the kids there by myself on holidays and birthdays and I hated the favoritism so I protected my kids from it but I think that was a mistake now but of course I am not going to say anything about any of that to MIL! I just want her to know that she was like a second mom to me & I love her and I am going to miss her so much. Life is going to change so much now. She’s the backbone, she is what keeps us together :(
Helpful Answer (5)
Reply to worriedinCali
Report

Depending on the person, 5 milligrams of morphine does not always cause a person to be continually sedated.

Some pulse oximeters have trouble registering or reading irregular, weak or very rapid pulse rates. So I am not surprised that it isn't registering your MIL's pulse. Her O2 saturations are quite low but to be expected. Based on what your husband said I suspect that your MIL's pulse is in the 150--160 range "which is twice as much as that of a healthy person".

I am glad that you are going over to see your MIL and that you are going to tell her all of the things that you mention above. It is too bad that your husband is unable to express more of his emotions, but being a police officer, he has to "turn off" his emotions otherwise he wouldn't be able to do his job. Take your MIL's hand in yours and hold it while you talk to her. Touching someone is a way to show our love for them.

I agree that what you might be interpreting as angry is actually fear or anxiety of what is about to happen.

Unfortunately no one but God knows when He will call one of His children home to Him. All you can do is be there for your MIL and tell her that you love her. May God hold your family in His hands as you go through this experience. God has promised that He will be there to love you, to strengthen you, and to give you what you need to face each and every day. God's Blessings and Peace to you and your family.
Helpful Answer (5)
Reply to DeeAnna
Report

Hi all, my beautiful MIL has passed away, just got the call. Thank you all for your support.
Helpful Answer (5)
Reply to worriedinCali
Report

I can understand if you feel that there was that unfinished conversation you wanted to have today. But I do believe that our loved ones can still feel our love for them through the distance. She was ready to go, even if you were not ready for her to leave. She knew you cared. My condolences.
Helpful Answer (5)
Reply to surprise
Report

Thank you all. Yes she is at peace now and no longer suffering.

I’m sharing this in case it helps someone else who finds their way here looking for the answers and information I sought. Her final days were peaceful, although her partner did say that for 2 days before she passed she complained of feeling terrible. (Which was to be expected). In hindsight, there were clues that her time here was coming to an end. Either I was in denial or just didn’t understand what I was being told. I know now, that the phone call we got on Sunday saying that hubby needed to call the nurse, hear things for himself and then call his siblings, was sign number #1. At the time, and not yet knowing that (I assume) she had rapidly declined since I last saw her 3 days earlier), I thought she was just losing her breath/having SOB more frequently and hospice was simply stepping in and asking us to stop letting her suffer. I thought they were just wanting us to give low semi-regular doses to control her breathing because for weeks. She would experience SOB and take lorezepham if it her levels didn’t rise up fast enough. To me, that was suffering so I thought the morphine just meant her breathing would be controlled now and she wouldn’t lose her breath anymore. I have also figured out that she was in a bad state last Saturday when we stopped by to drop off cake from a family party. My husband was supposed to run in, and as usual make sure she didn’t need anything and tell her he loved her and to call if she needed anything. He was inside for 15-20 minutes and I now know he was trying to talk her into taking morphine. The next morning is when he spoke to the nurse and seeing as how he told me yesterday that he knew she was close to passing, I can reasonably assume that the nurse told him MIL had days left. On Thursday night when we stopped by, I thought it was odd that my husband wanted us to stay in the car. His excuse was the closed front curtain, if it was closed during the day it meant the home aide was bathing her & we shouldn’t come in. But no one was there and it was around 7:30 at night. He went inside and MILs partner came out to the car to talk to me. He said he was giving her morphine every hour now and that he wasn’t doing well himself. I got hung up on the hourly morphine because I didn’t know what it meant. I asked him if the nurse said anything about how much time she might have left and he said no, the nurse isn’t going to tell us anything anymore. He also said, and this was clue #2, that he is out of the picture now. That it’s all up to her kids now. This was his way of saying that she was at the end and she can no longer make decisions for herself. But I was too caught up on the hourly morphine to hear what he was saying at the time. Yesterday at the house, I heard him telling someone on the phone that the had nurse said she wouldn’t make it through the weekend, yet later on he told me he tried to tell everyone that the end was here but nobody listens, everyone thinks he’s the boy that cries wolf. I don’t really believe that but it’s possible he told my BIL and SIL and they didn’t accept it. I have asked question and after question and he never said anything about how much time she might have left. My BIL seemed to be in denial. But as far as her symptoms go, over the last 3 weeks she hardly ate and suffered from increased shortness of breath. She didn’t experience dysphagia until Thursday. She had also stopped eating by the. Also on Thursday she could hardly speak. Not sure what time of day it was but Her partner reports that when he went to give her a dose of morphine, she said “ok I’m going to go to sleep now”. And that’s what she did. She was sleeping when we stopped by after 7pm and I don’t think she ever awoke after that. Her breathing was labored that night and she had noisy breathing when her partner woke to use the restroom around 5am but he also said she passed at 4am so I don’t know exactly when she passed.

So I will probably always question why things were handled this way. I know her partner didn’t want everyone there when she passed but I thought we would all know when we where down to the last day or hours with her. My little nephew also had the same expectation I had, he thought we were all going to come in and say goodbye to her. Sadly that didn’t happen. I’m at peace knowing that I can visit her at the cemetery anytime I want and have a private conversation with her. I know she knew that we all loved her. The last few times I was a lone with her, I felt a sense of calmness and love. When I left, I had feelings of love and peacefulness. The last time I saw her alive, I sensed tension or anger in her and I know now that she was probably experiencing fear and agitation. She knew what was coming.

Again thank you all so much. You are all strangers but your advice, support and encouragement has helped me get through this difficult time.
Helpful Answer (5)
Reply to worriedinCali
Report

Worried, thanks for the update. I am so sorry for your loss, and for the emotional turmoil that existed b/c of her partner's staunch position. But she's past the discomfort stage now, and I suspect from his recent responses that he'll privately consider his own reluctance to accept the situation and handle it in a different way.

I'm sure your MIL knew of your loving feelings towards her. Although I haven't read anything on this issue, I've suspected for some time that in the end stage of life, not only has hearing become more acute (as I've been told by nurses), but that insight does as well. I'm sure she sensed your love as well as that of your husband.

Perhaps she was thinking of that yesterday, decided it was time, and just let go.

I do hope your family is able to find peace and know that your mother-in-law also has been relieved of her challenges.
Helpful Answer (4)
Reply to GardenArtist
Report

See All Answers