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Janiel, your question is quite vague. I am assuming that you are curious about Hospice care? When an elder is thought to be in the last stages of dying, often due to an incurable illness, sometime just very aged and infirm, having chosen or unable to eat? Without more information I cannot tell you much other than body systems. We all need food and hydration to continue to live for any length of time. Often with the withdrawal of food alone the body can sustain itself for a month or more. The withdrawal of food and fluids will make the dying process much longer.
As to medications, it would depend on what they were for. For instance, the withdrawal of drugs to lower our cholesterol, a daily aspirin, would make little difference. The withdrawal of insulin in a diabetic might hasten death.
Let us know if your question is more personal and involved, or if you are merely curious about time frames for hospice care.
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worriedinCali Aug 2019
“The withdrawal of food and fluids will make the dying process much longer”. That’s usually not true. You don’t live longer if you stop eating and drinking.
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That’s a broad question because that scenario can happen if you have surgery or you are at the end of life and on hospice.

in the case of hospice at the end of the life.....there comes a point where you don’t need food. Medications except those that keep you comfortable are stopped. If morphine is given, it’s the same dose they give you after surgery. It’s not s lethal dose contrary to popular belief.
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This happened with my Mom... she stopped eating. This went on for about 3 days. It was clear that hospice should be brought in. Her back caused her a lot of pain and the doctors finally admitted there was no longer anything they could do for her.

she had already refused drinks for 2 days before hospice eval. She was sucking on little sponges and swabbing the inside of her mouth.

you need to know that hospice does not starve patients...or refuse them drink. It happens when the body begins to shut completely down. Hospice had nothing to do with it.

The morphine was to control the pain she had in her back. Why live your final days in agony? Would you do that to your dog? Your Mom?

I think you whole question was trying to lead people to believe that hospice does this to cause early termination of their patients, Nothing is further from the truth, and the implication that they do is actually insulting to those of us who endured all those final days/hours with their loved one.
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lealonnie1 Aug 2019
You are right............well said. When I read how hospice 'kills' people it riles me up because I had hospice services in for my dad who I loved dearly, and no, hospice certainly did NOT 'kill' him! What they did was they made his last days on earth bearable instead of filled with pain & agony, for him AND for us. When end of life is imminent, what on earth is the point in 'giving medications'......for what? To prolong their agony so they can live another day or week? Here in Colorado, we have assisted suicide, which I think is awesome, and something I'd use for myself in a HEARTBEAT to save my children the agony of the whole end of life debacle.
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Janiel, am I right in thinking that you have asked a leading question?

I think we can perhaps be more supportive if you would like to share what is worrying you specifically. Are you struggling with decisions about a loved one's end-of-life treatment at the moment, or something like that?
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Jeniel, please fill in your Bio on you Profile page, so that we can all understand your situation, and give us further details, if you want an honest answer to your question, otherwise you are just riling people up on an age old Hospice question that has been asked numerous here on the forum. Also, if you type in "Hospice, end of life care", you will find loads of advice on the subject.

We do know that nearly every one has questions about this issue when faced with placing a Loved one on Hospice and end of life care, I've been there myself a couple of times, so your questions are just as important as the next person, but more details are needed to help you. I hope we can help, God bless!
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It's really all been said here but just to clarify there is a difference between withdrawing food and not forcing food (same with fluids really). A person at the end of life, especially a very ill person will often stop eating on their own and if there is no recovery expectation it seems inhumane to me to force feed them. Likewise if a person is in their last days and you are choosing the humane (IMHO) way of letting them go it seems logical to me to stop forcing medications in them that aren't helping them, especially if they aren't eating or perhaps it's a tremendous effort to swallow, why force them to suffer more (or at all) unless of course it's to ease any pain or discomfort they might be having and that can be administered without having to make them swallow it or deal with stomach issues because they aren't eating with their meds. Offering an adult patient food, drink and even medications and then honoring their wishes about accepting or not seems a respectful thing to to do to me.
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There is no "right" answer to this question. It is antagonistic, imo.
The OP is new here, and may have already left the community, not desirous of an answer, or solutions to a situation.


rhe·tor·i·cal ques·tion

a question asked in order to create a dramatic effect or to make a point rather than to get an answer.

The proof will be if the OP returns to explain. At that point, I would consider asking what Janiel's real question is??? Giving her the benefit of the doubt, and willing to support her.
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janiel Sep 2019
it was to make a point.
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This question...as written with no other information is not really worth answering.
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janiel Aug 2019
it is a legit question . with one true answer ... death .
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Demand they give me the Ativan that should be administered with it. Ativan should be given to keep the brain relaxed through this whole thiing. The brain/soul needs to relax while the body is going through this.

It really makes a big difference. The "night" hospice nurse, not my gals, told me to administer morphine by crushing it, and gliding it in moms mouth. Did not say one darn thing about the Ativan, and I had to see my mom suffer and her body trying to get through the suffocating effect of this...

Then my Hospice Angel came to our rescue in the AM hours. He said was off at 8 am, but would come by for a few minutes. I told him show me what to do, and how to clear and clean her. I can do it, just show me the right way.

ATIVAN ATIVAN ATIVAN... I don't know the dosage, but it helped mom relax her body, and then it was way more peaceful, and accepting...

End of life.... you want it as peaceful as possible. If it is IV drip, I think that may be even more peaceful... My prayers are with you and your loved ones.

You are here asking a question, you just need to know,.. It is okay. Our bodies are not made to last forever. My FIL who read the bible to my child faced things straight on, and so he did when he got cancer. And he told his only grandchild that. IT IS OKAY.. Make sure they know you love them and they love you.
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My stepmother chose hospice for herself. She refused to eat or drink, refused a feeding tube and IV hydration. She directed me to arrange her hospice care and complete DNR. She could still decide to eat or drink if she felt up to it, which occasionally she did. But she was ready to go. Had had 2 catastrophic strokes that left her bed bound, no use of her hands, diminished vision, and no speech. She didn’t pass away for NINE MONTHS. So hospice is not always an immediate death sentence.

My MIL also chose hospice. She had an incredibly fast growing, aggressive and painful cancer. No treatment could help her. She didn’t want to delay the inevitable while also being miserable going through chemo just to give her a few more weeks. She also could direct when or if she wanted to eat/drink and if she needed pain medication up until a few days before she passed. She eventually was unconscious, but even before that she just didn’t want to eat much, she said it hurt her stomach too much. If she asked for a drink, she got one, but that diminished on her own account as well. For her it was 2 weeks for her to pass. And she was thankful as she knew the end was near she could say her final goodbyes to everyone.

Death comes for us all. At end of life, the body shuts itself down, one system at a time generally starting with digestion. I’d think we’d all like to end our time without pain and misery and the anxious hand-wringing of our loved ones. It’s not about the family and friends not wanting their person to die...they’re going to die at some point. And when death is imminent, send them off with love and peace.
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janiel Sep 2019
absolutely send them off with love and peace . but hospice and "my sisters" just stopped giving mom food and stopped giving her medication to her and started giving her morphine . and i can't say for a fact but it seemed like they were giving it to her more often .(8hrs . 6hrs .. )THEN she fell asleep and didn't wake up . coma i guess ..? it was like 3 days . but they kept giving her morphine for those 3 days . i didn't realize what they were actually doing until it was too late . then within minutes .. seconds .. OH . MY . GOD . i knew . i knew without any doubt . my sisters and hospice killed my mother . i felt sick in my stomach . it was unbearable . i got outside my car and had to vomit . twice . this is not happening . my own sisters and hospice killed mom . unreal . nightmare . what am i going to do? i begged God and mom to forgive me . I BEGGED FOR FORGIVENESS FROM THEM BOTH . i didn't know . i had no idea . not even close . it was unimaginable . but truth is yes, beyond any doubt the three of them had intentionally, purposely and unfortunately legally murdered my mother . how can they sleep at night? how can they live knowing they did this? i wonder .
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My 2 cents worth.. If I become bedridden and have health issues which cannot be reversed, and it's towards the end of the line for me, I may just ask forDoctor assisted help me move to Heaven, (hope that's where I'm going, if not I will just stay around and haunt my family :)

Nothing is fool proof. All we can hope for is a peaceful exit. I know some poeple who use this extra time to visit with friends and family, and make the best of it. That was wonderful too.
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Janiel posted below in answers to others that he/she knows that death is the ultimate outcome with the withdrawal of food and fluid. Not certain, knowing the answer why he/she decided to ask the question, but stranger things have happened. The question was posted under "hospice" and "palliative care", so perhaps Janiel was simply curious how others feel about withdrawal of food, fluid at end of life, with the administration of morphine. I can only speak for myself. Yes, this is what I would like, and what I have directed my family to do in my behalf, and what I hope would be done for me. Can only speak for myself.
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worriedinCali Aug 2019
The OP gave more info on a different thread days after she posted this. Seems she has a loved one that was on hospice and she questions how things were handled.
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Hospice doesn/t kill.... Hospice is supposed to, as I understand it, to help those and their family deal with the inevitable, death. It is to make this transition easier for both the dying and the family who is left here on Earth. Hospice does not kill. Hospice does not give or take life. It is here for us, to make this hard subject, death, an easier transition...Period.

The people who are on Hospice have already punched their time card. It is going to come with or without Hospice, ,to all of us, here on Earth. These bodies are not going to last forever... Have you seen the End Game? It's long, but good. That sums it up for tonight..Go rent it, You get it. We all get it. Most movies are dramatic.

In the olden days, in some cultures, they would push their ill fated family members out on a boat to live out the remainder of their lives. I guess there are rituals about the ill, death and dying in most civilizations, past and present, and future...

So, if you want more control of your last days, get a living trust, or DNR , or a Will. You do have a choice while you are able to consciously make a choice. And do talk to your doctor, family, lawyer, whoever you are close to. Have it documented. I have a friend who made a living trust and Will. She made copies and sent it to everyone mentioned so there are no unanswered questions. Yes, she is still alive, and she did this about 10 years ago...

You can make a living trust on your own and a Will..Google it. ...
Paralegal, some courts have a help office or room of students who are studying law...Legal library could be a source, Office Depot has forms for purchase for DIY kinda people..
Have witnesses to sign forms, in case you need it.

Best thing is to have an open discussion with your loved ones, and what you want at end of life before you find yourself in this situation. It is hard to face it. It was hard to face your loved ones in their last moments, and you don't want that happening to the ones you are going to leave behind...

And you don't want them to think your death was their fault...Guilt ... What If's.. Not good..
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janiel Aug 2019
they "assist the body to shut down" .. but they don't kill . different wording . same outcome .
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Short responses are better. Sorry everyone for my previous bout of thoughts. It was much too long.
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I have heard that doctor assisted end of life is not easy either... It's not as easy as one might think... I heard that it is a ritual of what pills to take, and when to take them, to assist the body to shut down...

People who want to say their goodbyes, and people who do not want others to know what is happening.... Both were right... And then there are the people who cannot express or don't have a choice...
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AlvaDeer Aug 2019
There are no pills often enough. It is a liquid here. And it is very easy, and honestly often fewer than 15 minutes until you are unconscious. You are given antiemetics prior to the medication. So of course you do have to be able to self administer and be oriented and able to make the decision and able to swallow the medication. People often say their goodbyes and in fact sit with the patient, the family. This is NEVER done in California to someone without the ability to be cognizant of the choice (that is to say those accessing the Right to Die laws), without several doctors, without the agreement that death is imminent within 6 months. This would definitely be my choice. Hospice second choice, with withdrawal of food and fluids. There are many ways "to go" that are painless, as those who don't WANT to go, but take too much fentanyl laced drug know. There are entire families that die painlessly and unknowingly from thinking that lighting a charcoal fire in a barbeque can keep them warm when the gas and electric turn off their heat. Sadly. Then there is nitrous. So there are many ways for those who are into researching such things, and many organizations who will help those seeking a way to make their final exit. I think that most, knowing they HAVE a way, never choose to actually GO this way, and are willing to ride it out with pain relief and help, but feel better knowing there is a way if they need it.
There are so many things worse than death. And anyone who has spent a career in medicine knows this. I think few of us fear death. We fear what comes before it, but often not death itself which often comes as deliverance.
It is a big subject to be certain. And I think that people have very strong feelings on one side or the other. And an absolute right to those feelings and beliefs. Many who belong to a religious faith feel that there is no right to die, and that their God holds such knowledge and power. Like I said, a big subject.
The really important thing, I think, is that our families know our wishes. That we put those wishes in writing. It is sad to me that death, which comes to us all, is such a forbidden subject.
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In our case she was medicated(??) to the point of unconscienceness for two days. Laying flat on her back gargling he saliva. Unable to open her eyes or move. Which is what hospice wanted. Total unresponsive. She had removed the needle in her arm that was to be used for the narcotic. A new one was installed on the back of her shoulder to administer the dope every few hours. She was thirsty and would bite a straw. I used a sponge mouth cleaner to give her water. some times they would suction her mouth etc to reduce the noise.
She was never in any pain but I was told the narcotic was to make her comfortable.
She knew things were going on around her but could not respond. Exactly what hospice wanted.

I am totally pissed about the entire last visit to the hospital and with being encouraged to put her into hospice.

I personally would never go that route, under the same conditions, again.

As for hospice helping me. HAH! I ask for some information planning a funeral and was given a listing of mortuaries. No advise on how to handle that.
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janiel Sep 2019
i completely understand and sympathize with you . they (my sister and hospice) medicated my mother to the point of unconscienceness as well . for 3 days . for her comfort of course . she too couldn't open her eyes . or move for that matter . i wish i knew then what i know now . i'd have put her in my car and drove away . she would be here now . ❤️
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Like so many others.....I am confused. The responsibility of Hospice is to make dying as peaceful as humanely possible. This includes withdrawing life sustaining meds and pain control (usually in the form of morphine). Did they stop giving her her food because of swallowing issues? Or did she just refuse one day because of an ongoing decline in appetite? It's hard to give an insightful answer without knowing the circumstances....especially as to why mom was in Hospice care to begin with. Dementia? Cancer? Heart failure? My MIL has been in hospice now for four months and is doing quite well (considering the circumstances) under their supervision. I realize all this is relative to the individual, but you are claiming that your sisters and hospice committed murder. Is this conjecture on your part because in your grief you're lashing out? My condolences for your loss and I hope you find the peace and answers you are searching for.
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I looked through this thread and don't see any info on your mother.. Why was she in hospice? You have to be near end of life to even qualify to be on hospice? Why was she declared incompetent?

My Dad recently passed in April.. he had advanced stage dementia and an intestinal obstruction that would require extensive surgery and was 88. I was his medical POA.. my sisters blamed me for his death just as you are blaming your sisters....

I dont know your situation but in mine.. my sisters blaming me like that was the most painful and hurtful things I have ever gone through.. I loved my Dad and know I did the best and most loving thing for him.. he did not want to suffer ... I know that based on conversations I had had with him in the past. I miss him terribly.... please think about what you might be putting others through.

Just the fact you are not giving many actual facts about your mom kind of makes me think you are just having a hard time with the death ... which is understandable.. but the accusations you are making to your sisters is horrible.
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janiel Sep 2019
the fact that my 'sisters' and hospice replaced food and water and medication for morphine that placed her into a state of unconscienceness and eventually killed her .. that's horrible .
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I would die, if I was in that bad of health, I would not want to go on.
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janiel Oct 2019
"that bad of health" ?? SHE WASENT! which is exactly my point!
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Hello to my fellow family caregivers and really, anyone who may be trying to learn or decide what to expect about their end of life options, mainly when a terminal illness is diagnosed.
It is not a death sentence, but rather a way to literally ease suffering. The patient always has the option to change their mind if they want, no questions asked.
It's much easier to be prepared for this sad time if the patient and caregivers have some insight.
I have seen several instances, in my own family as well as my clients, when awareness was missing or most often a combination of denial, avoidance, or guilty feelings were hindering people from thinking clearly, and understanding what to know about their situation. It often seemed that needless suffering happened, and may have been prevented for everyone concerned. Every patient has unique and a very personal journey to make until the end of their life.
Hospice is flexible and NOT a thing to fear. It is not a death sentence. Patients are evaluated to determine whether the patient has been diagnosed by a doctor as terminal, with 6 months or less, of life expected. The patient will be re-evaluated every six months, and may even be discharged at that time if they improve. The patient also has every right to discontinue hospice if they want to.
I used to do both adult foster care and private duty (in home) caregiving/hospice care. It's been about 5 years, and my work has been mainly in Michigan, so may be different in other states.
Anyway, Roxinol is a low dose prescription of liquid morphine that is given with an eyedropper, and in my hospice care experience, was used to help patients breathe. This was not intended to treat pain.
In fact, there often were standard "kits", that also contained a low dose prescription of Ativan to help calm restlessness or anxiety. When food and water are refused, the body is likely shutting down and no longer will be needed. Forcing water or food could be dangerous if the patient chokes as a result.
Other items like glycerin swabs or moth sponges to moisten dry lips and mouths. Oxygen These are/were palliative care measures. They were not intended to be used for prolonging or extending the life of patients.
Sadly, many of my patients and their families, including my own, hope for miracles, new medicines or therapies, or even possible remission from the disease(s) or condition they suffer, and so wait till it's way past a more realistic time to ask the patient what they want to do, and reassure them, ask for the doctor to explore hospice, and be more mindful of what hospice care really is for them, in terms of the flexibility of entering as well as leaving hospice care if the patient wishes can offer to both the patient and their family in ways that may so helpful and supportive during this sad time, and after if needed.
I hope my sharing of what could be might help someone who is afraid or unaware to ask questions.
Peace!
Allison
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theoldbaker Sep 2019
I apologize for my assumptions about the selfless devotion I observed first hand and the ways from the confident and experienced nurses, when hospice was not a for profit business. They were my awesome heroines!
The corporations that have been taking advantage of other people's misfortunes should be heavily fined and or charged with negligence and be reviewed frequently by a separate state authority, and, employees from aides who are just riding a clock to nurse 'care managers', who are only willing to do the bare minimum of actual care even if it's just managing to make the paperwork measure up to what their employers require, to be acceptable. Then never even bothering to reach out to hold a patients hand, never mind check their pulse, because that's just 'grunt work' for the aides to do. Empty a bedpan? Ha! They just are not qualified, period.
These FOR profit organizations are no better than the insurance companies who will find any reason they can to avoid spending their shareholders and CEOs money on those who are stressed enough already, to worry about coverage or horrendous co-pays, need to be called out and exposed as the grifters they are. They have no shame. It's just business you know. Grrr….
I worked with a community health department, witnessed amazing home-health nurses and fellow aides, and bathers. The difference is like night and day. I'm shocked, but not all that surprised, because toward the end of my working days, I did see a difference from what I'd taken to be the way hospice was supposed to be, back when it was still an honorable cause, to that of those run by the for profit healthcare industry.
It was not up to my standards because of rules that limited the ways or skills they could or could not apply, I saw this, and agreed, with my clients. I guess I was naïve, and had a fat head, because for me the patient was my boss, and I'd do things like climb a ladder to change a lightbulb, or move furniture to be less obstructive to traffic, or just to vacuum, who would do it if I didn't?!
I was angered and saddened after my favorite (tiny, frail and bony) lady fell and broke her tailbone, so was hospitalized and then was neglected, once for hours, but too often to have happened, if at all, on a toilet seat, because no aides in the aftercare rehab facility had bothered to see why she had rung the bell, or just forgot to. She needed help to transfer to her wheelchair and to bed. They called her names behind her back. She was from Germany and they called her the Nazi lady. What a crew of jerks!
Anyway, to Janiel and others, I had viewed what this topic is about in an idealistic, and biased way. Please be reassured that I learned something today! Allisontheoldbaker
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I would want to die with Hospice help, or Palliative Care, and I've written that.

My aunt had trouble swallowing for her last 2 months, eating very little (1 spoonful) and drinking little.  Her body was shutting down, and the antibiotics were no longer helping with the pneumonia.  She had oxygen, wet swabs for her mouth, on her side and turned, etc., but for her last 5 days she was unresponsive.  I did some energy clearing, talked to her, and she actually closed her mouth and smiled!  Hearing is last to go.  I reassured her it was ok to go.  So, no food, water, or meds.  Her energy body was totally absent from the waist down, just cold. 

It was still another day before she showed signs of pain:  fast heart rate, fast breathing, grimacing. When she did that, they gave her a shot of morphine, and I gave permission to give her more if she seemed to need it.  I was there for her last 10 hours, and glad she got the care she needed.

I am sorry for your loss, and the confusion around what was actually done.
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Death is Okay. And after reading some responses, I guess, I just need to know death is okay. The quicker, the less pain, as we see them going through, is better. I want quick for me. For anyone I know, No body needs to suffer. I guess that all depends on the state of being and mind. I had a few of my immediate family members pass and close relatives and friends. It is hard no matter how or where they passed. Hospital, home, hospice, not hospice, cancer, ALZ... All we know is we care for our loved ones, and it is hard... Doesn't get easier...
Try to find a place in your heart where YOU do not feel guilt for this outcome. And you can forgive anyone including yourself. We are here for a short time, and I am learning, a bit late, to try to enjoy some of this time with my loved ones while I am here...
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janiel Sep 2019
thanks
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Janiel... It may seem like they did something bad... They did not. Your mom was probably ready to go, and they just gave her body something so speed up the process. I personally did this to my mom. The oncall hospice nurse told me how to crush the pills and smear the inside of her mouth with it, every hour on the hour.She unfortunately forgot to tell me about the other pill that goes along with it to calm her brain, and ease her physical feelings. I had to do the by myself, that nurse did not stay with me. The caretakers at the house were too tired to deal with us... It was not fun or enjoyable, and I can probably assure you, your family did not have fun doing this. You may not think you had time to say your goodbyes, but do not give or feel guilt about it. Talk to Mom now, know she loves you, know she is still looking after you. You have another guardian angel. All you need to do is talk to her :) My heart goes out to you...
Just know DEATH IS OK. Suffering longer than need be is not ok...
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Withholding food starves us. Morphine kills the pain of being starved, (but morphine also causes death directly, in higher doses) esp in elderly.
I hope this hasn't happened to anyone in ur family.
(I didn't see any details listed after the question, so I don't know specifically why you're asking). Recently my mother died from this same 'treatment'. If it has happened to your family also, I truly can sympathize. You may contact me anytime.
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rovana Oct 2019
Not if your organs cannot process the food. At that point it will do no good to mourish.
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Janiel, if your organs are shutting down, then not giving food and water is a good thing - it could not be processed by the failing organs and would cause pain and problems.  What is good is to use a wet cloth to dampen lips, inside mouth, etc. As for the doses of morphine - I'm trying to understand why you would refuse to give painkillers to someone in pain. (Also can ease breathing.)
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i'm not trying to lead people to believe anything . I BELIEVE IT . to you there is nothing further from the truth . to me it IS the truth . i'm not implicating . i'm actually saying . and yes i too "endured all those final hours/days with my loved one"
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