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I am my father's healthcare proxy. He is in the later stages of Alzheimer's disease. He has been on ativan for 3 months and now hospice recommends adding a small dose of morphine because they feel he is in some pain. He is handling the .5 mg of ativan very well. I am hesitant about adding the morphine, but I don't want him in pain either. If anyone of you wonderful people on this forum can give me some of your experiences with my dilemma I would appreciate your input. Please do not post horror stories of hospice patients dying from this combination drug therapy. My father's hospice team has been a godsend for providing him with comfort care and the additional equipment provided for him.

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What pain? Pain from what?

Did you feel that your father needed pain relief before hospice suggested it?

They may well be right, and your father would benefit, but don't get bullied over this. If you can't see any justification for the morphine, ask more questions first.
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Ask a pharmacist..but it seems if hospice is involved, all other meds are usually stopped. It does seem to be too much. Is there other pain meds other than morphine that can be used?
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Mthr has had ativan off and on for years for her anxiety and pacing. She went on hospice in Sept and was finally given some real pain relief for her bone on bone knees. She's on a low dose opiod and is so much happier now. I think adding the morphine will probably increase your dad's comfort a ton. And think about it - if it increases his quality of life, it's worth it.
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My dad is under hospice care at home. Every day he takes 0.5mg of Ativan as well as 10mg of morphine. The dosages are adjusted as needed if he’s having a difficult day but that has been unusual. Generally, my father hates taking medication but he calls the morphine “a miracle.” I’m glad to hear that hospice has been a good experience for you. It has been for us as well. Best wishes to you and your father.
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The Ativan is probably being used to help his anxiety which can be a real contributor to problems while the morphine would be specifically for pain. Both can be sedating but not always, ativan for instance doesn't help anxiety simply by knocking him out or "drugging him up" although for some patients that can happen (sounds like he's doing well on it though), it works with body chemistry to calm a person down, take the edge off the anxiety. Morphine can also knock a patient out or drug them out but most body's adapt and with the right dosage if there is real pain that effect doesn't last long. It can also have the opposite effect believe it or not, giving the patient energy and helping to clear their heads, I imagine this has to do with the pain relief and being at the proper dose but I can only speculate on that. These are medications Hospice uses all the time, keeping patients comfortable is their business so if this is their recommendation I would encourage you to let them try it, they can always stop the morphine if it isn't helping and or making other symptoms worse but if the combo helps keep him comfortable I can't see the harm.
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