I have posted on here many times and answered questions every now and then. Dad passed away Oct 7th 2013 from Liver Cancer . He was in a hospice facility for 11 days until he died. The day before he was admitted he was in the hospital and was talking,eating and very clear headed but his ammonia levels were high and he had been very combative, not eating and wouldn't take his meds for 4 days at his nursing home. ( He was in for a Psych Evaluation.) The hospice worker talked to me about admitting him instead of returning to the nursing home. I agreed to this and arrangements were made. He was transferred later that day and was alert and in good spirits. The next morning he was unresponsive and stayed that way until he passed. They gave him morphine and ativan around the clock. He never got any water but they did cleanse his mouth and moisten it with swabs. It seemed like he could hear me the first few days because I would shake his shoulder and say "dad". His eyes seemed to be moving under his eyelids and his mouth would move slightly. I did ask about them lowering his dosages so he could wake up a little. The nurse said he was getting a very small dosage already. I just wonder if the drugs made him unresponsive and if less was used he could have ate and drank and lived longer. I know it was time for him to go but I'm kinda puzzled about his going from complete alertness and straight into unresponsiveness so quick. The nurses did a Great job. I myself don't know how they do it. They treated dad like he was their baby. So gentle and compassionate. I was just wondering if anyone else had the feeling that death felt a little rushed once their loved one was placed in Hospice.
"Healthy nurse uses suicide clinic to 'avoid old age.'"
Good grief. The article begins [caveat, by the way, the journalist who wrote this is pretty free with her adjectives and has annoyed me in the past by being plain silly. But let that pass] :
'A leading palliative care nurse with no serious health problems has ended her life at a Swiss suicide clinic because she did not want to end up as a "hobbling old lady."
'Gill Pharaoh, 75, who wrote two books on how to care for the elderly, was not suffering from a terminal disease. She said she had seen enough of old age to know that she was "going over the hill" and wanted to take action to end her life while she was able to do so.'
There are eight more paragraphs like this and frankly it's far too depressing and bonkers to type all of it - if anyone wants to look up the article, you should be able to find it on The Daily Telegraph's website I expect.
A spokesman for Care Not Killing said: deeply troubling case, chilling message etc etc.
While a spokesman for The Society for Old Age Rational Suicide (can't they come up with a snappier title than that? Let's Get Dead or something?) went for the lofty tone with having seen much suffering… rational decision… blah blah blah.
So standard party lines, really; no surprises there.
But what neither the grandly-titled Health Editor nor either spokesman comments on is the, to me anyway, far more alarming question of what kind of palliative care this lady was dishing out on a daily basis that made her feel so strongly that death was preferable. And she wrote books? I hope they're going to die with her.
Thanks for your input. I am talking to rest of family in a couple of weeks to get their input.
So not to be alarmist, but if your mother has that kind of cardiac history, combined with her current symptoms, I would remain extremely suspicious notwithstanding the negative test results.
Not that it necessarily makes any difference in terms of treatment - she's already taking anti-clotting meds, is she? - but it can't do any harm to keep an extra eye open for symptoms. I'm sorry to be a doom merchant. Hope she gradually recovers and things get more stable for her, best of luck to you.
Bad night last night though, I think she is having bad side effects from the gabapentin. She woke up at midnight with nightmares and delusions, then fell this morning (seems ok physically). so I am going to wean her off it. Ugh!
Don't tinker with any medications without at least informing her MD, or not unless you're a trained pharmacologist anyway (which I am definitely not, by the way). It may well be that her overall px does need an urgent review, especially if there has been a change in kidney function or heart function, but this is no job for an amateur - get advice.
You mentioned the surgery for the broken ankle. general anesthesia can adversely affect the elderly and often leads to decline and death. Again not to say it should be avoided if the patient needs it and I stress NEEDs it
Gabapentin's main use is to control seizures but often given for the relief of neuropathic pain. A side effect is often drowiness
A stroke is often preceded by a seizure which could have been missed or confused within the ankle break.
Finally at the end of life drowsiness and sleeping along with less desire to eat or drink are very common.
With hospice you are perfectly free to bring them in and if you don't like them or their services you can have Mom discharged or find another hospice.
For the person who commented about funding for hospice, it is in the interest of the organization to keep the patient alive. Once they die the money stops.
I am thankful every day for our Hospice folks...Wasn't too happy with the first one but finally just decided I might be able to change...called the one I had heard a LOT of good things about and they handled everything immediately....so even the changeover was not a problem...
Doc
An addict??? I never said that.The staff were drug addicts. They were the ones who were forcing her to take drugs putting them in ivs and injections. Forcing her against her will. She told them she could not take sedatives but they forced them on her anyway.Its funny for a woman who was so against drugs dies from too many overdoses.
She signed for a dnr a very long time ago when she was very young.She did not want to linger on if she had something where she needed to be kept alive by a ventilator and she had no hope of recovery. She did not want to be forced to die by use of a dnr. That is definitely not what she wanted.She did not deserve to be killed in this way.
I don't know yet about calling in hospice. I personally don't think she "qualifies", though I have no doubt I could convince the Dr.. We are thinking more of a visiting nurse. My daughter, who is in pre-med and just finished employment at a local nursing home, is starting to come over this week, since I will be laid up with foot surgery. She will be a huge help, especially since she is Mom's favorite!
And lasyly, thank you for clearing up my question about the financial aspect. Yes, if the patient dies so soon, I'm pretty sure they wouldn't get paid after that! Even after reading all 420 comments, it is clear that there are good and bad hospice experiences; it is up to us as caretakers to advocate for our loved ones, to learn about their reactions to medications and communicate with the staff to do what we feel our loved ones would want, and to make their passing peaceful as possible, when the time comes. That being said, seeing MY mother's reaction to such mild drugs, I absolutely know that she would never survive anything stronger.