When should we become concerned about how long my uncle is sleeping after taking Ativan?

Thanks for the help everyone. Uncle finally woke up after sleeping for 24 hrs. We gave him morphine (to reduce pain while moving him), then cleaned and changed him. The only issue is that he HATES being on his right side. We put him back on his left side for now. If he's that close to the end, what does it matter? I didn't see any signs of redness or bruising.

Still waiting for a call from a hospice nurse. We're actually going to call and cancel it, they've wasted enough of our day. We didn't know that the Ativan would/could knock someone out for that long.

He said he had a good sleep and would like to sleep like that again. I asked if he prefers to be asleep or awake and he said, "awake," but he sleeps a lot anyway. We're not sure when or if he should have the Ativan again. Should it be given if he starts groaning? Since family is finally coming to visit, we're thinking of only giving him a quarter tablet instead of the whole 0.5 mg.

Hospice is failing you here in not giving you a real inservice on what to expect. You are free to change him while he sleeps; he may sleep through the change, awaken briefly and go back to sleep. If morphine is being given and is needed there must be pain issues? Hospice is end of life care. To my mind sleep is the preferred state to prevent pain. If the patient is sleeping and is having no breathing difficulties the morphine may not be needed.
But what you need now is basically a hospice nurse. Please write down all your questions and have them ready. If you cannot reach someone at this hospice care then that is of great concern.

KateH2, I've read many stories here on the forum from people who have cared for someone right to the end and the unfortunate reality is that everyone is essentially flying solo and having to figure it out as they go, often with devastating emotional effects. No amount of reading or visits from hospice can take the place of having experienced staff available 24/7, can your cousin afford to hire extra shifts of workers or to move him to a hospice facility?

We called hospice and we've been waiting for hours for them to call us as to when a nurse will be coming out. They could not answer over the phone as to what we should do in reference to waking him up. We're supposed to give morphine before changing him, but if his sleeping is a concern, then do we still give morphine?

Very frustrating.

Your other posts indicate that your uncle is at the end of life. Hospice should have provided the family with a booklet called “gone before my sight”. It will give valuable insight on what you can expect during the final stage. If he’s on the minim dosage of .5mg he’s not sleeping because he’s heavily medicated. The Ativan and morphine are what’s keeping him comfortable and pain free. And that’s what you want. Because the alternative is pain & suffering. You do need to change him and reposition him as Cwillie said. And I agree with the others, you should be calling hospice with all of your concerns. But above all, you both need to know what to expect during this time and that booklet from hospice is a great tool.

You posted on another thread that his time is short - weeks and days (hours?) rather than months and years. 0.5 mg of Ativan is such a small dose it's practically non existent, and the alternative is horrible agitation. I think it is time for you both to read the booklet on what to expect at end of life, IMO going gently into that good night is the preferred option.

Every person is different. I too vote for you to call the nurse line with your concerns.
Regardless yes, change him and reposition him. Allowing him to stay in the same position for long periods of time predisposes him to pressure ulcers. Allowing him to stay in a soiled diaper (God I hate that word when using it on adults) is not good for his skin and will cause breakdown.

Another vote for calling the nurse line. Your hospice provider should be able to give you support and answer questions like this around the clock.

Ativan can have different effects on different people. My dd took one and immediately slept for 4 hours. My son had the same dose, same time and no real impact.

You need to talk to the Hospice people about it.