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.
Your father was doing fairly well within a few days of his death. I think it is a blessing to go so quickly, rather than a long lingering period of the body shutting down. My husband ate scrambled eggs with cheese and salsa the morning he died. He was alert that day. He died while I was reading to him. I was very grateful that when it came, death came quickly.
Again, my condolences. I hope that looking at the medical records will provide the answers you need.
Beers Criteria
Developed by an expert consensus panel, the Beers criteria is a list of potentially inappropriate medications for the elderly. The criteria have been revised several times to remain current. Using the Beers criteria, the 1996 Medical Expenditure Panel Survey found that 20% of 2,455 community-dwelling elderly persons in the United States were using at least one inappropriate drug. The survey data found even higher risks of hospitalization and death from inappropriately prescribed drugs among nursing home patients.
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.
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.
Doc
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...
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.