Did Hospice rush your loved ones death?

Thanks Flymom for making that point. There needs to be very clear communication at the beginning of a hospice admit. Morphine is givenfor a lot of different symptoms, not just pain. With that being said, hospice uses only their standards of morphine, Ativan, haldol and a few others to "comfort" patients, even though their list of meds is much longer. A patient deserves better treatment than having haldol shot in their mouth when they are asking/begging to leave. No lawyer will help a patient's family. They say after all he was hospice as if this branded him to receive this inhuman treatment. I say hospice needs to be regulated like nursing homes. The administrator told me, you signed the papers now live with it. So please think long and hard about "signing" hospice papers. Allow your loved one to receive care to really help their symptoms and treat them humanely. If it gets to a point of no recovery likely then a hospice talk should happen. Beware of aggressive hospice liaisons who have been doing hospice too long and do not care about the sanctity of life.

Not calling any nurse a killer, but morphine DID cause my mother's death within 4 1/2 hrs.
The family was lead to believe she would be ok with it, we were innocent to what morphine does to a person who is in no pain. My mother had CJD look it up. Why were they not honest with us? It should be throroughly explained to patients family and it seems from this thread it never is. There should be a law requiring this! Yes my mom would eventually be taken by this rare disease, but not when a palliative doctor decides since there is no cure we can just take their life! Not acceptable!

Loveyourelders,
Home care (visiting nurses) are for physical nursing care (dressing changes, blood tests, vitals check, patient teaching, etc.), NOT for custodial care. If your loved one didn't have a skilled nursing need, they would not qualify for home visits.

See Shane, they DO think we're killers!

To those of you who don't want your loved treated by hospice, then DON'T let them be admitted to hospice. You, as the family, can figure out what to do as they are screaming in anxiety or pain or having breathing difficulties but, God forbid, DON'T give them any medicine to let them calm down and be comfortable!!!!!

I'm done, I swear, I'm done with this thread. As a hospice nurse, I've seen families deny the dying person medication that could have helped them. I had one lady scream at the top of her lungs the whole 8 hour shift. Her son refused that she get any medicine because, he said, she became too lethargic. We agreed to lessen the dose but he still refused. He was worried that she wouldn't eat. After days of screaming and not eating anyway, he finally gave in. The woman finally got some rest and slept for half the shift. It's tragic to watch people suffer when they don't have to. But, to those of you who blame hospice for murdering your loved ones, you handle it. I feel sorry for the one who suffers.

Sue and Shane, I agree there should just be home care, no hospice. The nurse immediately admitted him to inpatient. That night he was asking to leave. I was not notified. The next day he was severely drugged. All he wanted was to her out of there. They kept drugging him til he died!

Thanks Shane. I don't think I'm a "killer" either but there are many on this thread that do! They have nothing good to say about hospice except that we (the nurses) killed their family members. Too bad they can't be inside their loved one's head to see that the doses couldn't kill anyone, just relaxing them. It's exactly how I would want to go if I had a terminal illness. Oh well, can't make everyone happy.
I've done the visiting nurse job twice before. Only down side is the darn traffic in my area (southern California). Oh well, I only have 4-1/2 years to go before retirement. :)

Sue, you are not a "killer" nurse because you work at hospice.
I hope you like Home Care. I absolutely loved it and am thinking of going back into HC.
Good luck, sister!

I keep saying I'm going to quit reading this thread (because of comments like that) but...........

On the up side, I'm quitting the Per Diem hospice nurse position I have and have accepted a full time home health visiting nurse job (to help support my mom in memory care). Now I won't be one of the hated "killer nurses" anymore! ;)

Inpatient hospice lead to my father's untimely death. He had congestive heart failure. Hospice lied to us. He was dead in 10 days from their drug protocol. I rue the day I called this hospice! Beware! Love your elders! Ask a lot of questions about what they will and will not do for your loved one!

Thank you. I needed to hear that. God bless

200 mg is generally considered a fatal dose of morphine. You were not even close.

Please be comforted by your good memories and know and understand that you did nothing untoward.

My 90-year-old mother with end-stage heart failure was put in what I thought was palliative care at home. The home-care agency assured me she would take all heart meds and they would treat any infections. She was lucid. But the agency sent a "hospice" nurse who wanted to give my dear mom morphine right away. She told me if would help her to breath better. She showed me the dose and said it was "small." Days later, following this advice, I gave her one dose (.25mg of liquid morphine from a bottle that said," 100mg per 5ml (20mg/mL). She died a few hours later and I am upset that I gave it to her and wonder if I hastened her death. I have since read what morphine does and I had no idea. I thought it would help her to breath better. Just wondering if this was a powerful dose? Also, Medicare does not pay for "palliative care" so if you request it you will get "hospice care" because that is what Medicare covers.

I had a cousin who passed this week she had cancer 06/13/17 Tuesday morning they said they were taking her to hospice care by 9:30pm that night she passed away Also I had a daughter in-law also with cancer went to hospice 06/15/17 and she passed today @ 2:00 pm 06/16/17. and yes I believe they make them comfortable with morpine the patient gets relaxed because their pain is under control they finally get rest they are sleeping and never wake up they don't want to feel the pain any more.

Ward1234, patients pass on the same time table whether using Hospice or not.

Why it seems like patients pass quickly is because some families wait until the last minute to finally decide to use Hospice.

My Mom was moved to hospice in the final 3 weeks of her life.
I was always worried about losing control over her medical decisions and medications.

About a month before she died her primary care finally admitted to me that he had no idea why my Mom was having so much pain. We had done X-rays, MRI, etc. found nothing to point to acute pain.

Because hospice can administer morphine, Mom was moved to hospice care.

I can speak to the fact that mom was given 2.5 mg every hour to control this pain. Oh geez, what a god-send! Mom did not spend her final weeks in agony.

The decline Mom was going through was obvious for weeks. When the changes became very obvious from one week to the next....I knew the end was coming fast. Of course I was in denial. Even to that last day I was still fooling myself. Nothing prepares us for the loss.

It would be easy to turn my attention to blaming hospice care for her death...it would also be incorrect. But, I understand the need to blame someone, something. I still do not understand what that final decline and end was caused by. I do know that it wasn't hospice...because hospice was even brought in till the very end.

Lenalxca, my heart goes out to you in this difficult time. Your story is much like my own, when simply the pain meds are all you've got, to keep her comfortable, even if that means she may become so sleepy from them, that she is unaware of her surroundings, as you cannot allow her to suffer. Like you, I'm one of six, but thankfully we all live close to one another, and were all actively involved in her care.

I sincerely hope that all your siblings arrive on time, and are able to say their goodbyes to your Mom, and that you get some much needed rest and support yourself! Please know that I will be praying for you and your family, as you say your goodbyes to your loving Mother. She will soon be in a better place, no longer in her pain rattled body, and with God. God bless you and thank you for sharing your story. Stacey B

Hospice is a service we don't want to need, but when we need them, they are invaluable. I think the question should not be if hospice rushed someone's death, rather, did the combination of certain medications hasten the loved one's decline. So here is my situation:
My mother has terminal brain cancer and is in my home on hospice. I happen to be a nurse myself and am familiar with this process. My mom has 6 kids and they've yet to arrive, they will all be here tonight. It's been one week since she was discharged from the hospital. Pain has been an issue, pain management was a struggle in the hospital. She was prescribed oral morphine solution, (OMS) 1 ml (20 mg) every 4 hours, and Ativan 1 mg (0.5 ml) every 5 hours. For the first two days, I followed the medication schedule. By the third day she was lethargic and unresponsive. The hospice nurse said she had begun the transition. She was right, but why so soon? My siblings won't arrive in time. My mother wanted to be with her children, it's all she ever wanted. We live scattered across America. I told them all to get here asap, on day 4. She had to hold on for three days if she was ever going to make it. Day 4 was tense. She hadn't eaten or had any fluids, she wouldn't swallow and it just dripped out and I had to clean out her mouth to prevent her from choking. Her breathing pattern had decreased to around 6 times ( or less,) a min. She was fading, I was crying, rubbing her feet to keep her aware, I've never been religious but in that moment I started praying. I'd been up for two days straight, I was afraid she'd die if I wasn't right there. Stress always keeps me up anyway. That was a long dark night. I didn't give her the morphine or Ativan as scheduled, I backed way off. On day five, as the sun began to rise, she started moving again. The woke up, she nodded in response to my question, " are you thirsty?" She drank water and broth. She came back from the brink. Today is the morning of day 7. All my siblings will be here by tonight, 2 will arrive in a few hours. She is hanging on. I gave her some medicine and she isn't responding well again, I'm seeing the pattern.
My mother will not survive this, I will continue to medicate her as needed, I know she will soon be gone. Do I think the medicine is making her die sooner? Yes, but what is the alternative? I can't have her suffering. She has suffered so much already. I'm relieved that in my particular situation, I have the medicine for her. I'm also glad I knew enough about the medicine to know when not to give it. I'm not going to blame the medicine, the doctor, the hospice or myself when she passes. I blame cancer.
Tonight is the night we will all be together, my mothers final wish will be granted, I hope she holds on just a little while longer.

The father of a friend of mine was on home hospice for almost a year and a half, after been sent home from a hospital as terminal. My mother-in-law had been not sleeping and asking to die for several months; had been on home hospice for several weeks when she passed. The hospice nurse called her doctor for stronger pain meds, which I had to physically pick up from him, which did make her more comfortable. She did have a peaceful night, talking to her mom and sister (both deceased) and telling me that "tomorrow is Sunday!" I would answer that it was Monday, and she kept insisting. She passed peacefully about dawn. Hospice was a good answer; we had tried a convalescent hospital and she hated it. The visiting nurse was very helpful, taught my sister-in-law how to deal with her care. She had fought lung cancer that went to her liver for about a year, and we couldn't ask her to stay.

Ward1234, "only days for them to die under hospice care"? That statement makes absolutely no sense! My mother was under wonderful hospice care for well over five months, and it was only the last 8 days that she was actively dying, that she was in and out of consciousness, and that was because the different systems of her worn out body were shutting down ie: kidneys, digestive, heart and lungs. And in those five months, my mom was on extremely heavy doses of narcotic medication via IV for her excruciating cancer pain, and she was always coherent and clear-headed, except for those final eight days. Still, she passed peacefully, thankfully to our hospice team.

Do I think there is a rare occasion where hospice might give patients medications to ease their pain and out of this world, perhaps, but never with the intention of actually murdering them.

I think it's unfair to put these sorts of thoughts in people's heads that hospice intentionally kills people. When in fact the opposite is true. They are there to comfort the patient, Comfort the family, and to ease the patient through the dying process. Hospice is an option, an option given to the family to help them, it is never pushed upon people, and people do have the right to refuse their services. You can always choose to go It Alone, take your family member home, and try to see them through to the end without any Aid or assistance from a Hospice care team.  

My family's experience with hospice was wonderful, but it did take a lot of us to fall in line, and to help one another to help our mother through her journey to the end of her life.

I do feel very bad for the people who have had a negative experience with hospice, but I really don't think those experiences should sour others from choosing the hospice route.

Yes! Listening to your story gave me closer. They did the same thing to my brother. Good knows​ it only takes days for them to die under hospice care.

Glad, my sincere condolences. ((Hugs)) We've both been down such a difficult road. My heart goes out to you! Keep in touch my dear.

Glad,
I feel for you and am sending hugs in this difficult time. The pain and suffering are over. May your mom rest in peace.

Awe, thinking of you glad, hug

My mom passed this morning with the support of hospice that was finally able to make her comfortable. Her struggle with Alzheimer's has been beyond challenging. She was kicked out of one facility because of anxiety and agitation that meds would not control. Then hospice recommended the one where she passed. What a wonderful facility, hospice, the caregivers were wonderful. Made the process of dying so much easier for mom and her family.

To understand why my family knowingly took my dad to an inferior hospital just because my sister worked there you would have to understand the family dynamic. My sister sort of took total control of my parents and had a lot of influence over them in the past 15 yrs or so. My parents put her in charge of everything - their wills, trust, healthcare. I live out of state and my brothers are there but not as involved. I think they were afraid it might upset her if they chose a different hospital, and since they had put all their "eggs" in her "basket" so to speak, they couldn't afford to have any kind of dispute or disagreement with her. None of the rest of us agreed with the decision for him to go there, nor could we understand why they took him there. Soon after his diagnosis just before he started taking the experimental drug I tried to pursuade him to go to a local branch of MD Anderson Cancer Center (which is rated #1) just to see what kind of new treatments they may have available, but he said he was satisfied with the doctor he had and would stick with him. So that was that. I later found out that MD Anderson does have a proton targeted treatment regime that kills the cancer cells but not the surrounding tissue. His cancer was inoperable so that might have been a good treatment for him but he wasn't interested in going anywhere else. Hard to explain other than that my sister wears the pants in my family.

Trish,
I'm sorry for your loss. I'm glad that you had a positive hospice experience for your mom.
FYI-No hospice nurse can give meds to a patient if they or their family member refuses it.
Gladimhere,
God bless you and your mom in this difficult time. I'm glad you are having a good hospice experience also. They are there to help the whole family.
2ndbest-I'm sorry your dad had incurable cancer and that you weren't there for his passing. I've worked with many nurses from other countries and have had a hard time getting used to some accents. Please know that just because they aren't native born and are difficult to understand, doesn't mean they aren't fully credentialed. The hospital could loose its operating license if they hired someone without a license. Ask the hospital for proof of her license.
Your father was going to pass and, by signing a DNR (do not resuscitate) form, he knew that. There are many reasons that your father could have "blown up", (kidney failure, etc.). Do you know what IV fluid was infusing? Since you weren't there, you can't say for sure. Maybe it was medication to help with his water retention. You should take this up with the hospital. Ask to review the medical records but you will need someone to interpret the medical jargon.
My question is WHY would your family knowingly take your dad to an inferior hospital just because your sister is a receptionist there? Doesn't make sense.
Also, this is a hospice thread. It doesn't appear that your dad was on hospice. Maybe another area would be better to post your story.

I don't have any experience with hospice as such, but my father was on an experimental drug for his stage 3.5 lung cancer for just a few days and had severe side effects (extreme diarrhea) that left him dehydrated, so was taken to the ER of a state university hospital. After a 6 hr wait in the waiting room, the story I was told is that the nurse, who spoke very little english, administered IV solution to the point that he blew up like a balloon. Since I wasn't there I can't say for sure what happened, but my mother, who is an RN, and the rest of my family were in the room as they witnessed him puffing up like the Michelin Man. I would assume the nurse was checking his urine output, but obviously he was retaining much of the fluid being pumped into him and his kidneys may have shut down. But normally when someone is obviously puffing up you would stop administering the IV solution. But after several hours of this he started gasping for air and was given a sedative (don't know specific drug) and died soon thereafter - about 10 PM that same night. I strongly felt it was malpractice on the part of the nurse (if she was even a qualified nurse). His body was taken to the Office of the Medical Investigator (OMI) which was in the building next door. The reason for his death they came up with after several weeks of "investigating" was "natural causes". I felt this was a sham investigation since this particular hospital has a bad reputation and it is in their best interest to keep deaths like this quiet. This was all complicated by the fact that my sister worked at the hospital (just a receptionist) and my parents didn't want to hurt her feelings by going to a different hospital with a better track record. So most of my family members believe this was malpractice but would never file suit since my sister worked there. When they told me he was in the hospital that day I booked flights for my husband and I to fly out there the following morning, never dreaming he wouldn't even make it that long. I know he didn't have long to live with his cancer diagnosis, but I got the call that he had died late that night and so when we arrived the next morning it was too late to see him alive. I strongly felt like the hospital hastened his death, not willfully but due to incompetence of staff. On a sidenote...my dad had signed a DNR and refused to be intebated, so he didn't want to be kept alive through medical means. Sorry if this is a little off-topic but wanted to share since I too felt like the "care" my father got hastened his death. Hugs to all of you here that have had to deal with this and similar issues.

No, death was not rushed! Not in the least. Mom has been on hospice since October, now she is finally reaching the end. Morphine was started over the weekend, because towards the end of the Alzheimer's journey my mom was exhibiting severe anxiety and agitation. Biting, hitting, scratching, you name it she did it. It was a part of her journey as it is with some. Now at least, the anxiety and anger are gone, she is comfortable and will leave this earth soon. Hospice has been a wonderful support, and helped the family in ways that are very difficult to express. Hospice has been a very positive experience. Soon mom will be gone.

Toxins and morphine just make me want to scream!!!!!!!!!!!!!!!!!!!!!! They are the two most common words that we all are continue to share.

This is such a difficult subject. It is hard not to second guess every decision you made after a loved one dies. I have been doing this for a year since my mother passed. During the eight months preceding her death she spent at least one week a month in the hospital being treated for UTIs and pneumonia. She had moved to a memory care unit at an assisted living facility near my home nine months prior to her death. She had a very weak heart and other issues. . Two severe heart attacks and having seven stents over last few years had taken their toll. At her last hospitilization hospice was suggested. The hospital doctor and her primary physician had both already told us that it had to be God keeping her alive. There was no scientific reason. There were women at her memory care that had been on hospice for three and four years so that gave us hope. We spoke to their families and felt reassurance that we were not sentencing her to death. We met with hospice and the memory care staff. The plans were that she would continue receiving physical therapy for walking and strength, her regular medicine regimen and that the facility nurses, hospice nurses and doctors would treat all illnesses such as UTIs, pneumonia and other illnesses unrelated to her heart at the facility. The purpose was to keep her life as normal as possible. Any change of environment can negatively affect people with dementia We were aware that they would not perform heroic lifesaving measures if she had a heart attack. She left the hospital on Monday and we signed her up for hospice that day. Monday night she was in great form, laughing, talking. She had met a new friend and I was greatly encouraged. Tuesday morning she wasn't as chipper but that wasn't unusual. She was never a morning person. During the course of the day Tuesday something happened. I received a call that she had suffered a mental breakdown- she was normally docile but was screaming help me, help me. Hospice had been there to evaluate her that morning and was called to come back. I got there before them and that was the first time I felt that she did not recognize me. She could normally carry on conversations intelligently. Her dementia caused her to forget that people had been there but in the moment and in her own environment she was usually ok. My greatest fear is that we didn't tell her hospice was coming and that when they came to evaluate her on Tuesday something within her clicked and she literally gave up. The hospice nurse said that haldol, antivan and morphine were available to keep her comfortable. I declined all three that night and the nurse was not at all pushy about it. She explained that they were for her comfort but that is was our decision. I stayed the night and by Wednesday she was not very responsive. She had not had the drugs so we couldn't blame this change on that. When the hospice nurse got there she told me her eyes were fixed and that was a sign her body was shutting down. For the next three weeks we could not get her to eat or drink no matter how hard we tried.  I realize now that not eating or drinking is another way the body prepares you for death. But as far as hospice killing her....I don't feel that way at all. Their presence was a comfort. They did suggest Ativan and morphine but did not insist it be given. I had already told them no haldol. Although antivan and morphine were prescribed for every four hours they allowed me to decide when to give. I did not want to drug her and only requested the Ativan or morphine when she seemed to be agitated or in pain which was usually no more than once or twice each 24 hour period. Would I enlist hospice care again? Yes. They were so gentle and respectful of my mother- carefully bathing her, talking in a soothing manner, explaining process of death to us, helping her have a peaceful passing, etc. Do I think they hastened her death? No. It would be easy to say they contributed just so I would have somebody to blame. But the mere fact their services are usually contracted when someone is near death suggests the family is already aware that death is close. Do I have any regrets? Yes, everyday I wish I had listened to more stories, hugged a little longer but I will always have the knowledge that all decisions seemed to be the right ones at the time. That's all that we can hope for. That we did the best we could.

Heartbroken, so sorry for you lost. Please note the amount of morphine given is no different than the amount given to surgery patients right after an operation.

Your husband was on his own time table for passing with or without Hospice.

Now what the nurse said was inexcusable, so very heartless.  I hope you filed a complaint the facility.