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.
I'm not sure which route to take and I feel for everyone else in this same situation. It's a difficult decision and experience. Also, shame on the people that verbally abuse someone for their questions in this forum. We're all doing the best we can, this should be a safe environment.
Don't forget, many of our elders will tell us they are fine, that they are in no pain, as they don't want us to worry, yet they are in some type of pain.
Both my parents went through Hospice, medically there wasn't anything more that modern science could do to cure the situation. I was glad both my parents had peaceful deaths, dying in their sleep.
Decades ago, some surgeries required the patient to stay for a week in the hospital. Today those very same surgeries are out-patient, meaning less than 24 hour stay in the hospital.
You might notice a rally with your Mom, the patient will start talking, ask to eat, will be alert.... vast majority of the time this rally only last for a day or two. My Mom and my Dad did the same thing. My Dad was sitting up in his recliner, watching TV, reading the newspaper, trying to eat a bit.... and the next day he was gone :(
One has to remember it is the doctor at the hospital that diagnoses that there isn't anything more medically one can do to help a patient to improve. Thus the doctor will recommend Hospice so that the patient can transition with very little or no pain. Hospice doesn't speed up the passing, just makes it comfortable for the patient.
I know we all tend to go through the what ifs. I did when my Dad passed last month... all the if only I did this or that. In reality, nothing would have changed.
Doctor does state this. He/she has "freedom" as well,since once in Hospice, his/her services are no longer needed, and the patient and/or the patient's family won't see her/him again, unless they are there to witness the passing of the patient.
I know this from personal experience. Since, the doctor that treated my mom, was not at her bedside when she passed, his nurse practitioner was there instead.
I just had a patient on Saturday and Sunday with terminal lung cancer. I knew death would be within a day or two. Her partner had witnessed parents dying in agony without medications and told me her partner WOULD NOT suffer any pain during her death! I was in constant contact with the patient during my 2 eight hour shifts and quickly medicated her when she told me she had pain. Patients also get very restless during the final hours, (maybe they 'sense' death is coming), so I gave her medication for anxiety also. It's common to have excess throat secretions (death rattle), so I gave her meds to dry that up, to make her more comfortable. Her partner had me call the doctor because she was still slightly agitated. I got an order for more anxiety med and an increase in the pain meds, if needed. I could tell that she had only a few hours left, as she was changing her breathing pattern. You might think that the meds did that, but it happens when there are NO meds given too. I've seen a lot of people die in 37 years and that's just how it is. So, to all of you who STILL think we kill our patients, DON'T sign your loved ones up with hospice and YOU manage their pain, anxiety and secretions yourselves. My patients partner will never forget the agonizing deaths of her parents, (Your situation in reverse).
I would add from a non medical person's standpoint that medicine is a very complex field, and that includes the issue of dying. It takes a lot of time and determination to educate oneself.
Hospice also seems to be a scapegoat for a variety of issues, ranging from not accepting the dying process to uncontrolled grief to just plain unwillingness to educate oneself on this aspect of life and the termination of it.
Thanks again for offering a rational and educated opinion.
Wikipedia has an excellent article on the beginnings of hospice care world wide which dates back many centuries.
Hospices world wide are based on the resources available which in many areas are sadly limited. My own husband saw them at work in Malawi where the supply of pain medications and other supplies are sadly limited and many people die in horrible circumstances often from Aids.
We are very fortunate in the USA with the services available from hospice for the dying. Never does a nurse have to say "Sorry you are in such agony but we have used up all the morphine" Nor does she have to work on horrible wounds etc without gloves or dressings or have bedclothes to cover the patients.
When my husband was leaving Malawi he offered the house cleaner his bedding, she just laughed and shook her head and said "I don't have no bed to put it on"
Stop bashing Hospice people and appreciate what is available to you. It is a privilege not a right. Remember Mother Teresa, she gave her life to helping people and many others have devoted their lives to creating the modern movement. Although supported by Medicare and other Insurance, not for profit hospices have to raise a large portion of their funds from volunteer contributions.
The nurses you accuse of being killers are paid far less than their contemporaries in hospital settings so why would a nurse choose to work with the dying if h/she just wanted to kill people. I assure you it is not for the money
If you don't want your parents on Hospice, don't use that option! Instead, try to care for them yourselves, at home, and in pain, or worse, struggling to breathe, and agitated! It is sometimes a very scary thing to do, all on your own! The weeks and months leading up to your parent dying, having the care and professionalism from you Hospice worker's, it's priceless! They know what they are doing far more than any lay person!
In our situation with our Mom, and even though we thought we knew what was happening, our Hospice Nurse recognized signs of our Mom entering into the "active dying phase", that we did not, and I'm so glad we had them there to guide us through that last harrowing week of her life, transferring her to the Hospice Hospital was by far the best thing we ever did! Our Mom was more comfortable, and we were all able to be with her as much as we liked, which was always! But there was not the uncomfortable situation of having her dying in my sisters home, especially since she had several small Grandchildren about, and often. It was my sisters decision, and one we all supported! Thank God for Hospice!
The biggest problem with this thread is the title. People are grieving. They've been through hell, then they see The RUSHED TO DEATH thread. So the nurses are murderers and away we go......
As long as the name of the thread remains the same it will keep erupting with the same old stuff. Like moths to a flame.
Great comments to all the above, BTW......
"Overall, the experience was very peaceful for me and hopefully for my dad too. I have informed my son that hospice is where I want to be when my time to leave this earth nears"
I'm going to mention a book that I've recommended once before here. It's called 'Opening Heaven's Door: What the Dying May Be Trying to Tell Us About Where They're Going', by Patricia Pearson. It's excellent.
Speaking of heaven's door, Bob Dylan won the Nobel prize for literature this week. Remember 'knock-knock-knockin' on heaven's door'? Love that song.