Morphine and hospice care
Common Questions and Answers about Morphine and hospice care
avinza
Today she lives at home with 24 hr care. She has a G Tube, colostomy bag and a fistula in her pelvic area. Her condition is terminal. No health care team does not have an estimate of how long she will live. She lives at home with 24 caregivers. When the fistual appeared 3 weeks ago her oncologist advised us to call Hospice. We did, they came, and an RN immediately said she was going to die of septicemia. We were preparing for her death.
My Mom is in end stage COPD and CHF and it has been a battle of "wills" and "won'ts" between my sisters and my mothers care....My Mom is on Hospice care and I believe in there "mission" for "comfort care" but my sisters think that my Mom is/will become a "drug addict" (my Mom can be given Morphine and Ativan if her respirations
get too high... (and my Mom has been having respirations up into the 40's - normal is between 18 to 20....
Relative has terminal skin cancer of the face/head. Under hospice care. Yesterday we could not get a blood pressure reading on left arm or wrist using 2 different monitors. Hospice nurse felt very weak pulse in foot as well. Any suggestions as to what this might be? Blood clot, stroke, no circulation to left side? Also, left arm is tingling and cannot use arm to lift herself from chair.
I have taken care of him (Primary) as well as my husband and now my son for the last 3 years and Hospice a year and a half. He has no use of his legs or hands since the first 6months. He was in a Nursing home but we brought him home In the last few months I have watched his urine change color to amber then bloody looking to normal yellow. He coughs at times. We have suction Machine but nothing else other than oxygen to help him for He has a DNR order ( do not resuscitate.
As far as pain, don't think Morphine is 'it'....there are many options. Home or inpatient hospice services and doctors can prescribe different types and options. One thing that worked for my mom (even during treatment stages) was a portable PCA pump with Dilaudid. This went intravenously three or four times an hour with the option to give a 'breakthrough' or 'relief' dosage when the pain broke through.
t say enough about Hospice and especially the nurses that care for our loved ones in their final days. They are so very compassionate and will be very truthful as the go thru this on a daily basis. The last thing they want to see is for anyone to be in distress and for us Morphine was given along with anxiety meds. How long does your brother have? They would be the ones to ask and help you prepare for what's to occur.
Again, my sincere condolences for such a troubling time.
your son would have had to first be removed from hospice status, the morphine discontinued, etc - in order to even be considered...and that would be with no guarantees of course. It's a pretty tall order...even under the best of circumstances. It sounds as though your son was likely already too sick for that to have happened. I hope that you can find peace in knowing that you did all that you could...
In my case my Dad had congestive heart failure, was put on hospice care, stabilized and came off hospice after 6 months. The next year they found cancer throughout his body, was put back on hospice care.
He so wanted to die at home and we did all we could to care for him. It reached a point that the stress from my Mom's behavior and the extreme fatigue of caring for him wore us out. He agreed to go to a hospice facility for just a few days to give us all a break.
She is on Hospice care and they are prescribed to her but I just worry about her taking too much.... She only weighs in at a whopping 85 pounds....I know that the Comfort Care is a huge thing with Hospice... I just don't want my Mom overdosing herself... as that would be a major sin in the Lords eyes....Any advice on how to gently remind my Mom that less is more for her would be appreciated....
hot stomach, loss of muscle tone, lack of appetite, and lack of energy. She is at home on hospice care, stage IV. She was diagnosed on June 12, 2009. Her home nurse is nice and sweet and tells her she is doing well. Hospice sends morphine and constipation medication. Both of which she does not need and does not use.
If such a person is removed from the ventilator, then his heart and lung will stop functioning and he will not have life any longer. Also such a person cannot just be maintained on oxygen. IV fluids will also be required for energy for body metabolism.
Please discuss with the treating physician. Take care!
She does have our help because she is un steady and weak. Hospice has placed her on morphine at a low dose. She was in pain with hydrocodine.. Her belly is about 2-3 times in size. She still is eating & drinking even though it is very little. Sometimes she does go the bathroom & other times she doesn't when she insists on going the bathroom. Any other signs for me too look for? Her breaths are about 1 to my 3. She is not in a coma at this time. How much longer do I have?
She is suffering from severe myoclonus and seratonin toxicity and hospice wants to take her off Tramadol and replace it with something else. I can find no info at all on withdrawal and tapering protocol in elderly debilitated Alzheimer's patients. My mom can't speak or communicate and I am absolutely horrified at what she may experience. But the Tramadol side effects she is experiencing are life threatening.
My husband is involved with hospice care and it's an amazing group of people (yes, my husband is too). One thing we've learned is that some people want to let go under their own terms. My Dad waited till we were gone till he passed. Some seem to feel more relaxed with family around. I don't know. In your case I think you're right - your mom wanted you to remember the talks you had with her, not the final moment.
She panicked called her local GP,called in Hospice and substituted haldol,morphine and vallium for her heart medictions in one day.My mother was not in pain.This was 5/31/2007 one day before my return.On 5/3 before she knew I was coming the cardiologist said she was fine and continued her medications and to come back in four months.I took her to the hospital and my sisterbehind my back refused to allow her to be medicated same thing on discharge.
My 90 yr old mother died last night in Hospice care. She was in a nursing home for 4 years, where I visited her daily. When we knew the end was near we called in Hospice. When it became evident that she was in the final stages and gasping for breath they administered morphine, orally, then a suppository, then orally again. It all happened so fast but when the last dose was given I was overwhelmed.
My close friend has been told chemo is not working and hospice has been called. She still is going out and trying to remain active but needs someone with her. Her decline was sudden and quick (2 weeks) This normally very docile really sweet person has become extremely argumentative and seems to have lost all control over what she will say. I know she recently starting using a pain patch.
I can tell you that your husband meets the criteria for hospice with the variceal bleeds, hospitalizations, and overall quality of life. It is comfort care. It is passing with peace and dignity. Families I have seen have been very happy with the hospice experience. It also provides support and bereavement for the family.
I watched my sister die of OVCA. She had radiation as a last effort after second surgery then a small bowel obstruction. She left the hospital with a morphine pump to control pain. Hospice got involved and was a great help during this heartbreaking time. They can keep increasing morphine to help control pain or even go to a more potent drug, dilaudid, if needed. In the end we just didn't want her to suffer.
I swore that the morphine was making him hallucinate but the doctors said it was dementia. We took him home and hospice kept upping the dose of the morphine. Finally he got so bad we couldn't take care of him at home. He went to the hospital and finally a nursing facility for 11 days. He died there after his body shutdown. He wouldn't eat or drink anything. He knew all of his family until he died last week.
Morphine is preferred for the treatment of COPD because a doctor can better control its effect on breathing, however, both morphine and methadone work in similar ways -- it is just that methadone suppresses the breathing longer. At end of life, it doesn't matter much which medication you use.
If your husband had an allergy to morphine, then methadone is definitely the proper medication to give.
Death is not often a pleasant experience, especially death from lung cancer.
I am sorry that it has come to this for your sister. The best thing you can do for her is to get her on hospice care. They can come to her home and make sure she is not in pain. There are a lot of pain drugs that don't make you sleepy, like Fentany patches, but she will need to be on morphine or something stronger towards the end.
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