Ok, mom has brain tumors, we know dementia is at play. She's had 18 (TIA's) and 1 massive stroke. In December 2022 we discovered she had brain tumors again after clearing metastatic lung cancer. It's back, hospice is in! Mom has arterial stasis wounds stage 2, but you'd think she was dying from the sores. She refuses to get up, demands to be waited on hand and foot. The new problem started a few weeks ago. Mom was taking Tylenol as needed for discomfort when the sores (ulcers) were at their worst, she had no pain whatsoever, only discomfort. After a pulled muscle in her back, a nurse quietly mentioned the cancer may have spread (it hasn't) she just pulled a muscle, but they started opioids. Back was better in like a week, but now she's on round the clock opioids and demanding stronger! We are all baffled as she will smile at you and when asked about paid "10! It's a 10! 10 pain, 10 pain!" She screams. Level 10 pain is (crushing a hand, having a baby, being burned alive) not 2 sores on a foot. What gives? Is she addicted to opioids in hospice? Yes, she is in hospice, but I feel like she doesn't know how to process the stimuli. I've explained this to the nurses, as her BP is perfect and her heart rate is excellent! That's not indicative of mind bending pain! Is this behavior? Is it addiction? I mean we went from Tylenol as needed to Vicodin to Morphine (which I put the brakes on) to Norco. She claims the only thing that helps is morphine and Ativan? So something is up. When I told her she would have no more morphine unless she was having air hunger at death (what it was actually prescribed for) she pouted. Then started telling anyone that would listen about how she's being deprived and left to suffer in her lowly state. She has sores, two level 2 arterial sores. Yes they are uncomfortable, not to the bone, nerve tissue, etc. They are sores which are being treated very well. What on earth is going on with her? I'm not depriving her, she has Norco but I'm not drugging her because it's there! Then when she truly needs it, it will not work! She's urinating on herself because she doesn't want to get up and go to the bathroom (5 steps from her) she will not leave this bedroom, bathe or allow bathing, etc. She will be laughing on the phone with my aunt in one breath and dying of this miserable pain the next. I feel like I'm the one losing my mind!
But I agree, she is dying so give her what she thinks she needs.
((((Hugs)))
I am going to make sure my loved ones KNOW for sure that once I'm in hospice care, I'm to get whatever comfort meds I request. Period.
And I'm asking if this is normal with dementia to scream in pain when they can't process the stimuli. I don't want her drugging for the hell of it. I'm not enabling the behavior that I had to live with my entire life because she's dying. I still have to live with myself
Just give her what she wants/needs. Don't try to 'figure her out' esp with dementia. It's impossible and you'll go bonkers trying to decide if she's really hurting or if she's faking.
If the drugs are a part of her Hospice Cocktail, then use them.
My late husband who was under hospice care in our home for the last 22 months of his life, and had had a massive stroke many years earlier, suffered great pain the whole time. Hospice tried morphine, then fentanyl patches and eventually he had a fentanyl pain pump. And he still suffered in pain.
His hospice nurse came to the conclusion that because of the damage done to his brain from the massive stroke and the many seizures he had over the years that his brain was no longer able to process pain medication like a normal brain would. To me that made great sense.
Perhaps that is your moms issue as well as you say she's had several strokes too.
But the bottom line is, please don't let your mom suffer in pain. It doesn't matter what you think at this point really, as long as your mom is comfortable and can die in peace, and hopefully pain free.
Hospice is about quality of life, about being as comfortable and HAPPY as one can be at the end of life.
I am very curious about why you would fear addiction in someone so near death?
I don't understand your wanting to deny your Mom medications at this time, no matter when or why she wants them?
Life gets to a point that being drugged out of your head is actually the best choice, especially with a painful cancer.
If she wants to use hospice to keep her unaware, let her. If it can't happen in your home, place her in a facility that accepts hospice and let them deal with keeping her clean and drugged on her final journey.
I know this isn't easy but, it is her end of life and she should not have to be in pain.
Oh, dementia makes pain receptors wonky, my dad had 14 teeth that had broken off leaving exposed root and never had a moments pain. So you can't judge if the pain is real or imagined, they can't either, let her be comfortable.
I am sorry you are facing losing your mom, it is hard. Hugs, you will do the best thing for her.
option for hospice to be provided in an institution if that’s what she needs. Look into that so that you can keep your sanity, if she’s living at your home or hers.
She has little time left, so stop being the opiod cop and let her have whatever she wants for her pain. From what you describe, she isn’t going to be all perky and happy. If she wants to be drugged out of her mind, who are you to refuse for her? Based on some idea of how she should be? With all that’s going on in her body, there’s no going back to normal.
Very sorry you’re having a hard time with this, but it’s time for you to stop analyzing everything and let go.
Your mother has brain tumors--seems like there's a good chance that her thinking/reasoning/processing abilities would be WAY compromised.
What does the hospice nurse say?
How is addiction an issue here?
Won't she simply be give MORE morphine if there is air hunger and her body has acclimated to it?