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titaniumsalute

(4,742 posts)
Tue Mar 5, 2019, 12:45 PM Mar 2019

Hospice

So I haven't shared on DU but I just lost my dad. I'm not fishing for sympathy posts but rather I wanted to share a positive story. So he was battling late stage liver failure since about the first of December. Between hospital stays, rehab facilities, etc. he was simply declining...muscle mass, cognition due to encephalopathy (elevated ammonia in the blood and brain), interest in living.

We put him into an assisted living facility with Hospice. He only spent about three days in the new AL facility when he began to decline quickly. Hospice stepped in immediately and really was a very pleasant experience. They worked around the clock to make sure dad was comfortable with comfort drugs, anti-anxiety drugs, bedding changes, bed baths, lotions for the dry skin, music therapy, and social counseling of the family. While it was very difficult they truly made it much much better.

Just my experience...but hospice is a God send.

74 replies = new reply since forum marked as read
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Hospice (Original Post) titaniumsalute Mar 2019 OP
So sorry for your loss.... NRaleighLiberal Mar 2019 #1
Thanx for sharing that, ts. Lucid Dreamer Mar 2019 #2
Yes it is. JanetLovesObama Mar 2019 #3
I am sorry for your loss. riverbendviewgal Mar 2019 #4
AGEE 100000000% bluestarone Mar 2019 #5
Me too, as a young adult losing a parent, they were Angels lostnfound Mar 2019 #64
My deepest condolences and as a former hospice nurse, THANKS! flying_wahini Mar 2019 #6
Please read my comment below (comment #40) lunatica Mar 2019 #41
Deepest sympathy malaise Mar 2019 #7
As my dad was dying 12 years ago, hospice care really was an appreciated part of his care The Genealogist Mar 2019 #8
So happy you had a positive experience during a very emotional time..... a kennedy Mar 2019 #9
I was a hospice nurse for almost 4 years, thank you for sharing this Maru Kitteh Mar 2019 #10
Hospice is just as important for the care of the entire family during the lunatica Mar 2019 #42
Oh lunatica, you made me tear up a little there. It was the honor of my life to be there Maru Kitteh Mar 2019 #45
Thank you for your post. titaniumsalute Mar 2019 #73
Hospice attendents are saints on earth. As I've gotten older I've seen it more and more. marble falls Mar 2019 #11
Thank you, Titanium. I'm glad to take the message Hortensis Mar 2019 #12
I have known several people to be in Hospice, and it was wonderful. PoindexterOglethorpe Mar 2019 #13
My mom was in hospice care for the final few weeks of her life. MarianJack Mar 2019 #14
Hospice is wonderful cp Mar 2019 #15
I just lost my dad, too. And you're right about hospice. Reader Rabbit Mar 2019 #16
Hospice nurses and doctors really are a breed apart BritVic Mar 2019 #17
So sorry for your loss and I totally agree about Hospice. lark Mar 2019 #18
Yes. Hospice enabled my husband to die marybourg Mar 2019 #19
Hospice workers are saints... albacore Mar 2019 #20
INDEED hospice is a godsend... RobertDevereaux Mar 2019 #21
Condolences on the loss of your father. gademocrat7 Mar 2019 #22
Hospice has helped me say goodbye to two brothers and my mother.... spanone Mar 2019 #23
Reading all this about hospice makes me wonder, as I've wondered before... LisaM Mar 2019 #24
That's why I practically moved into the hospital whenever lunatica Mar 2019 #44
we had the same experience with my dad Hamlette Mar 2019 #25
As everyone posting, I'll second your experience Duppers Mar 2019 #26
benzos (like xanax) Mosby Mar 2019 #27
Hospice is wonderful. Granny M Mar 2019 #28
My condolences ... my mom died of the same thing bedazzled Mar 2019 #29
Before retirement, I worked with hospice people quite often. Eyeball_Kid Mar 2019 #30
They are all angels hibbing Mar 2019 #31
Hospice is amazing LittleGirl Mar 2019 #32
My Deepest Sympathy, titaniumsalute. Kind of Blue Mar 2019 #33
not a bad thing to be said handmade34 Mar 2019 #34
I had quite the opposite zipplewrath Mar 2019 #35
I am so sorry your experiences were so difficult. pnwmom Mar 2019 #38
I understand zipplewrath Mar 2019 #48
That sounds awful about the morphine. Seeing her go through that must have been painful. pnwmom Mar 2019 #68
Drug induced dysphagia (problem swallowing) Mosby Mar 2019 #43
There are many, many reasons why dying people develop trouble with swallowing. Maru Kitteh Mar 2019 #47
opiates and benzos are being massively overprescribed Mosby Mar 2019 #50
Thank you nini Mar 2019 #53
Morphine helped make your mother more comfortable nini Mar 2019 #55
Oh, I probably will zipplewrath Mar 2019 #69
Unfortunately RobinA Mar 2019 #70
Yes, that's a whole other problem zipplewrath Mar 2019 #71
So sorry! I lost my brother last year, & hospice care was wonderful. displacedtexan Mar 2019 #36
Hospice is wonderful - it really helps people die with dignity mcar Mar 2019 #37
I want to thank you for your work in hospice, lunatica Mar 2019 #46
My Mom Delphinus Mar 2019 #39
I like to say that when hospice workers go to heaven lunatica Mar 2019 #40
Hospice workers are the best! mcar Mar 2019 #60
Kindness is the solution to so many things. lunatica Mar 2019 #61
It is still out there mcar Mar 2019 #62
I cannot agree more. Loryn Mar 2019 #49
My deepest sympathies leftynyc Mar 2019 #51
My experience has Rebl2 Mar 2019 #52
Hospice nurses are geniuses too. planetc Mar 2019 #54
My sincerest condolences to you Ohiogal Mar 2019 #56
All the best to you at this difficult time, titaniumsalute True Dough Mar 2019 #57
Condolences on your loss. Hospice workers are quite amazing. Stinky The Clown Mar 2019 #58
Condolences, titaniumsalute. littlemissmartypants Mar 2019 #59
Same experience nicehuman16 Mar 2019 #63
So sorry for your loss, and I agree with you about hospice! MiniMe Mar 2019 #65
I 100% agree with you about Hospice. And I am terribly sorry that your dad passed. Maraya1969 Mar 2019 #66
I'm so sorry about your father radical noodle Mar 2019 #67
I watched how panicked my Grandma was at the end... pandr32 Mar 2019 #72
Much love and empathy to you, titaniumsalute. calimary Mar 2019 #74

NRaleighLiberal

(60,014 posts)
1. So sorry for your loss....
Tue Mar 5, 2019, 12:48 PM
Mar 2019

Hospice was so helpful for our family when we lost my dad, my wife's dad and my wife's mother. It really made all of the difference in such incredibly difficult times.

Lucid Dreamer

(584 posts)
2. Thanx for sharing that, ts.
Tue Mar 5, 2019, 12:49 PM
Mar 2019

I agree with you about the value and comfort of good hospice care. It helps take the pain of grievous losses.

 

JanetLovesObama

(548 posts)
3. Yes it is.
Tue Mar 5, 2019, 12:50 PM
Mar 2019

I have lost quite a few family and friends to cancer and those that went to hospice died very content and comfortable deaths. I definitely want hospice when and if I ever need it.

riverbendviewgal

(4,252 posts)
4. I am sorry for your loss.
Tue Mar 5, 2019, 12:51 PM
Mar 2019

I know the Hospice experience from when my son was in Hospice for a week. He died of a brain tumour. 18 months later my husband was in Hospice for 3 months. He died of non Hodgkin lymphoma.

They were gently cared for. It made it so much less stressful for me and my older son.

We could stay 24/7.

bluestarone

(16,926 posts)
5. AGEE 100000000%
Tue Mar 5, 2019, 12:51 PM
Mar 2019

Exactly the same here with my wifes father three months ago!! Hospice is truly a God send!! They were absolutely THE BEST!! My wife was soo impressed with this group of nurses and one DR. He passed away Jan. 14th, and they were so supportive of my wifes concerns! Can't say enough of this group here! Great post here!

lostnfound

(16,177 posts)
64. Me too, as a young adult losing a parent, they were Angels
Tue Mar 5, 2019, 10:03 PM
Mar 2019

One of the most compassionate groups I’ve were seen

flying_wahini

(6,591 posts)
6. My deepest condolences and as a former hospice nurse, THANKS!
Tue Mar 5, 2019, 12:54 PM
Mar 2019

Most people are not aware that Medicare covers money for all care, equipment and meds during the final stretch. The hard part is that most people wait till too late to enjoy the many benefits that hospice provides.

lunatica

(53,410 posts)
41. Please read my comment below (comment #40)
Tue Mar 5, 2019, 04:15 PM
Mar 2019

I’m so happy to be able to thank a hospice worker in person! And you’re also a DU member! Knowing this just made my day.

The Genealogist

(4,723 posts)
8. As my dad was dying 12 years ago, hospice care really was an appreciated part of his care
Tue Mar 5, 2019, 01:02 PM
Mar 2019

Dad had advanced stage prostate cancer that had metastasized into his bones. LOTS of pain and suffering for him. Hospice care he got was excellent. Glad your dad got exceptional care.

a kennedy

(29,655 posts)
9. So happy you had a positive experience during a very emotional time.....
Tue Mar 5, 2019, 01:14 PM
Mar 2019
My brother who died of melanoma cancer, Dec 23, 1980, was the first hospice patient in a little small town in Wisconsin. First and best, the staff was just amazing for not really having any experience as hospice was just getting started. A very positive experience for our family as well.

Maru Kitteh

(28,340 posts)
10. I was a hospice nurse for almost 4 years, thank you for sharing this
Tue Mar 5, 2019, 01:16 PM
Mar 2019

so that people can have less trepidation about the hospice experience. Nearly all hospice work very hard to make sure they do every single thing they can to help ease the burden of the family while advocating for the wishes and needs of the patient. When I trained new nurses I emphasized to them that you only get one chance to do death right. When other things "go wrong" in medicine they can sometimes be revised, fixed, or at least compensated. You only get one chance to help a person die comfortably and effect positively the lived experience of the family.

Some things most people don't know about hospice:

1.) Hospice doesn't have to be the end. If the patient takes a long-term turn for the better (it happens) they will then "graduate" from hospice and return to whatever level of care and medical intervention they desire.

2.) The patient can go about their normal life as much as they are able and want to while on hospice care; they can even go to work while in hospice care, and I had a couple patients that did exactly that early in their journey.

3.) Hospice has great advantages over regular home care in the amount of skilled nursing care, freedom and resources available to the family and patient at home. The patient doesn't have to be "homebound" and the family has increased access to things like respite care and more. It also ends the torture of having to have the patient make the difficult/impossible journey to come into the MD office just for adjustments in pain and other medications.

lunatica

(53,410 posts)
42. Hospice is just as important for the care of the entire family during the
Tue Mar 5, 2019, 04:27 PM
Mar 2019

need to have it. Please see my post #40 below. Dearest Maru kitteh, thank you from the bottom of my heart. For us it wasn’t just about my mom dying. It was during a terrible financial time in which I had to declare bankruptcy and almost lost our condo, even though I had a job. Times were so bad that I bought my car outright just to make sure I had a place for my mother and me to live if it came to being homeless. I swore that I would never put her away in a home and you, the plural and collective you, stepped in and lifted that unbearable burden right off my shoulders.

I mean every word in my post #40!

Maru Kitteh

(28,340 posts)
45. Oh lunatica, you made me tear up a little there. It was the honor of my life to be there
Tue Mar 5, 2019, 04:45 PM
Mar 2019

for families and patients and help them however we were able. I would return to the field in a heartbeat. It was deeply meaningful and enriching work.

I gained far more from helping to care for families and patients than I could ever give back. for you. You just made my day.

titaniumsalute

(4,742 posts)
73. Thank you for your post.
Wed Mar 6, 2019, 12:53 PM
Mar 2019

I am so impressed I am thinking about volunteering for one of the local Hospice groups.

Sadly my dad was really only in for about 7 days before he died. He went faster than we all thought but it ended on a good note for him...comfortable. If you feel comfortable maybe PM me and tell me some ways I could help as a volunteer?

Hortensis

(58,785 posts)
12. Thank you, Titanium. I'm glad to take the message
Tue Mar 5, 2019, 01:25 PM
Mar 2019

and that they were able to help all of you through this.

Very mundane observation, but with the blessings of the on-line feedback that's revolutionizing choice, including the improvements it's forcing on providers, most people should now be able to find good hospice care.

PoindexterOglethorpe

(25,853 posts)
13. I have known several people to be in Hospice, and it was wonderful.
Tue Mar 5, 2019, 01:36 PM
Mar 2019

It's vastly better than a "Do everything possible, regardless of the cost, the pain, the financial consequences" mindset that is mainstream medicine.

Something else that's not well understood is that people who start Hospice at an appropriate time usually live longer than the "Do all possible" ones. With far better quality of life.

MarianJack

(10,237 posts)
14. My mom was in hospice care for the final few weeks of her life.
Tue Mar 5, 2019, 01:42 PM
Mar 2019

I completely agree that hospice is a godsend.

RESIST!

Reader Rabbit

(2,624 posts)
16. I just lost my dad, too. And you're right about hospice.
Tue Mar 5, 2019, 01:49 PM
Mar 2019

Ours was arranged through Kaiser Permanente, and they couldn't have been more supportive. Dad had a full staff—nurse, doctor, aide, chaplain—all working as a team to make his last weeks as comfortable as possible. I can't say enough good things about the care he received.

BritVic

(262 posts)
17. Hospice nurses and doctors really are a breed apart
Tue Mar 5, 2019, 01:49 PM
Mar 2019

I lost my mother to oesophageal cancer a couple of years ago, she was in our local small 12-bed hospice for just over 7 weeks (she was a fighter !). The staff could not have been more pleasant, she even had a view looking out onto a field with horses. They do invaluable work - I don't know how things work in the US, but our hospice used to receive quite a sizeable chunk of its running costs from the government and raised the rest through charity. Recently a lot of that Govt. funding was chopped (Conservative cuts), so charitable donations have had to bear the brunt of the £2m annual running costs. Support your local hospice !

lark

(23,097 posts)
18. So sorry for your loss and I totally agree about Hospice.
Tue Mar 5, 2019, 01:58 PM
Mar 2019

I don't know what we would have done without Hospice when dad was dying, really think mom could have hurt or even killed herself trying to take care of him. Dad had black lesions covering his legs and spine and couldn't walk, but was so determined not to die he wouldn't let himself sleep nd insisted on them helping him up to his walker, holding him on it and walking him around the house. Mom and my aunt were getting really sick from 24x7 care with no real rest and my aunt came down with pneumonia. I called in Hospice for a family intervention and OMG life improved so much when mom finally agreed and let me bring in hospice to help them. We loved hospice so much we asked for donations to them in lieu of flowers for both mom and dad's funerals.

marybourg

(12,631 posts)
19. Yes. Hospice enabled my husband to die
Tue Mar 5, 2019, 01:59 PM
Mar 2019

at home, pain free, instead of in the hospital hooked up to machines, the way my dad went.

albacore

(2,398 posts)
20. Hospice workers are saints...
Tue Mar 5, 2019, 02:02 PM
Mar 2019

Spouse lost three people, and they were all comforted and cared for by hospice folks in Longview, WA. Death with dignity.
The people and facilities are the finest.

RobertDevereaux

(1,857 posts)
21. INDEED hospice is a godsend...
Tue Mar 5, 2019, 02:15 PM
Mar 2019

Many hospice organizations also offer grief support groups of various kinds, usually meeting monthly and either free or very inexpensive.

That service too is invaluable!

gademocrat7

(10,656 posts)
22. Condolences on the loss of your father.
Tue Mar 5, 2019, 02:18 PM
Mar 2019

Hospice is an incredible organization. Their compassionate care is like no other.

LisaM

(27,806 posts)
24. Reading all this about hospice makes me wonder, as I've wondered before...
Tue Mar 5, 2019, 02:23 PM
Mar 2019

why regular care in hospitals can't be at least stepped up to mimic this model more. I haven't spent much time in hospitals, but the last few times I've been with someone there (and these are people with decent or really good insurance), the emphasis was on entering data and so forth than the medical staff actually paying one-on-one attention to the patients. My sister-in-law was in with appendicitis, and in the maybe three days I visited her, I never saw the same nurse come around twice, they kept changing her room, and it was like starting all over every time someone looked at her charts. It seems to me that more direct care would be a lot more cost beneficial and also more rewarding to both the patient and the medical professionals.

lunatica

(53,410 posts)
44. That's why I practically moved into the hospital whenever
Tue Mar 5, 2019, 04:42 PM
Mar 2019

My mother was there. I would take sick days or vacation days and just go to he hospital and spend hours there every day. The nurses are overworked and under appreciated. They simply don’t have enough time to spend with each patient. I can’t tell you how many times nurses told me how glad they were to have me there, and how lucky my mom was to have me take care of every need she had. Just her physical needs because she wasn’t very ambulatory or she would slide down on the bed, or it took her a long time to go through a meal I took care of.

And every time she was in the hospital or in a rehabilitation center her roommates got the ace treatment from me too. I was practically an expert at it and the doctors and nurses knew it and appreciated it. So did her roommates.

Hamlette

(15,411 posts)
25. we had the same experience with my dad
Tue Mar 5, 2019, 02:31 PM
Mar 2019

it was awful and they were wonderful. What a great organization and a needed service. Sorry for you loss. I usually don't reply to these posts about the loss of a loved one but I should more often. Each one of these posts brings back memories which help me put the world into perspective. Thank you.

Duppers

(28,120 posts)
26. As everyone posting, I'll second your experience
Tue Mar 5, 2019, 02:32 PM
Mar 2019

With hospice. I lost my 93yo mother just 2mos. ago and although I wasn't there, my brother kept me updated daily and reported how remarkable the care was that she received from U. of Tennessee Hospice Care staff.

Thank you for letting everyone know about your dad's care.

Granny M

(1,395 posts)
28. Hospice is wonderful.
Tue Mar 5, 2019, 02:43 PM
Mar 2019

They have helped our family several times over the years. So sorry for your loss. It is never easy. Peace to you and yours.

bedazzled

(1,761 posts)
29. My condolences ... my mom died of the same thing
Tue Mar 5, 2019, 02:44 PM
Mar 2019

March 15 two years ago. The disorder is hard to live with, but once she decided to decline treatment, the end was rapid and, dare I say it, welcome. Hospice workers are angels on earth

Eyeball_Kid

(7,431 posts)
30. Before retirement, I worked with hospice people quite often.
Tue Mar 5, 2019, 02:53 PM
Mar 2019

I haven't come across a more dedicated, optimistic, and compassionate group of workers. They truly do make a difference.

hibbing

(10,098 posts)
31. They are all angels
Tue Mar 5, 2019, 02:58 PM
Mar 2019

My father was only in hospice a few days, but it was a comfort knowing that he was being cared for so wonderfully.

Peace

Kind of Blue

(8,709 posts)
33. My Deepest Sympathy, titaniumsalute.
Tue Mar 5, 2019, 03:00 PM
Mar 2019

You said it all about hospice staff. And they'll continue to reach out to you for many months to come or as long as you wish.
Take care of yourself

handmade34

(22,756 posts)
34. not a bad thing to be said
Tue Mar 5, 2019, 03:08 PM
Mar 2019

about Hospice... the positive for me was the respect and the ability to be in the moment with, 20 years ago, my husband and last year, with my father during their last few hours and minutes...

zipplewrath

(16,646 posts)
35. I had quite the opposite
Tue Mar 5, 2019, 03:11 PM
Mar 2019

I've always suspected we were the exception to the rule, because generally they come so highly regarded. And our two situations were kinda out of the norm so I think everyone was outside of their area of expertise.

Dad. He was in a "memory unit" for a couple of years, but his health started to take such a bad turn that he was put into a facility that advertised itself as a "hospice facility". He had excellent insurance and so could afford quite the high level of care provided. But he was expected to last at most 3 months and he hung on for 9. They started to talk about having to move him to another facility for long term care. Okay, we started the research, and then out of the blue, Mother is talking about terminating feeding. Kinda caught us off guard. We all lived out of town so there were phone calls first, but Mom's hearing was kinda bad. So visits were next. She couldn't seem to explain how this had come about so quickly. One brother was a designated "health care advocate". So he tried to talk to the facility and got quite frustrated. Every question was answered by starting with "Well, your mother had decided...". We knew that, we just wondered WHY? What had she been told? It's not that we disagreed per se, it's just that it came about so quickly and she couldn't seem to tell us why.

It took a couple of weeks, but finally someone made a case associated with the inability of Dad to swallow anymore and they'd have to put him on a feeding tube. Okay, I get it. It was strange though for my seriously catholic parents to choose this, but it is permissible, although most of us thought she would have discussed it with the family pastor. She had not. But whatever, once explained most of us didn't really disagree. There was this feeling though that they had backed into this explanation. That it took two weeks to think it up. But we mostly just "blamed mom" for not understanding what she had agreed to.

3 years later, Mom is in the hospital again for serious heart problems. She's too ill for any surgery and her heart is slowly failing. Maybe a month at the most. So we take her to her home and had prearranged for Hospice to come in. It was a tough day because she was becoming less than coherent and there was alot of moving around to do and various care arrangements to be made. The Hospice nurse showed up and immediately started barking orders. Two of us were there and she was dealing with the Health Delegate by telephone. She wasn't keen on answering any questions and kept starting every exchange with, "you have to understand, your mother is dying". Yeah, we know, that's why WE called YOU. She insisted on administering morphine despite mom not complaining of any pain. She did say the blood pressure cuff hurt, but the nurse INSISTED that it be taken. Mom's bed wasn't good enough and we HAD to get a hospital bed TODAY. We're all trying to cooperate but we're from out of town and everything takes a bit longer. And again, every exchange started with, "you know your mother is dying".

She died that night. In hindsight I should have figured out just how close she was. And maybe that's what the nurse was trying to communicate. The home healthcare aid that we had, took off her socks to change her and her feet were blue. Later her fingers turned blue. It's why she wasn't all that coherent. Her heart was failing so fast that none of her body, including her brain, was getting enough oxygen/blood. Having Hospice there was pointless. But I would have expected the nurse to see the signs, or at least check for them. Instead she took blood pressure but never looked at her feet. She force morphine on her for no apparent reason. And she caused a tremendous amount of upheavel in a family that was watching their mother die. We didn't need the bed. We didn't need the morphine. We needed to be told we had hours, maybe a day, not just told "your mother is dying".

Fortunately, I don't think mom or dad were cognizant enough to be aware of what was happening.

pnwmom

(108,977 posts)
38. I am so sorry your experiences were so difficult.
Tue Mar 5, 2019, 03:52 PM
Mar 2019

I hope you don't feel too bad about the morphine, though. It can help a dying person, who isn't getting enough oxygen, feel less anxious.

And not putting a feeding tube in for your father is pretty normal, even for a Catholic facility. The Catholic church doesn't require extraordinary means to keep someone alive, and feeding tubes are in that category. Losing the swallowing reflex is a sign that someone is actively dying, and they will be more comfortable without a tube or food. Also, taking her blood pressure was a way of telling the nurse how far along she was. I remember when my mother was dying hearing how low her blood pressure was getting.

It sounds like the main problem with hospice for your family wasn't necessarily the care for your parents, but the problems with communicating with the adult children. I know how stressful and upsetting it is to lose a parent. I am sorry the situation was so hard for all of you.

zipplewrath

(16,646 posts)
48. I understand
Tue Mar 5, 2019, 05:08 PM
Mar 2019
I hope you don't feel too bad about the morphine, though. It can help a dying person, who isn't getting enough oxygen, feel less anxious.


I'm sure it can, but in this case it did not. It only amplified the feelings she was already having, and they literally had to physically force it into her mouth. She bit the nurses hand. It was some sort of capsule that had fluid in it that had to be "broken" into her mouth for her to ingest. Her final hours were pretty awful because of the slow failure of the mental functions. Forcing her to change beds, and inducing unnecessary pain, as well as administering medications that only made things worse just exacerbated things.

I can understand if they just weren't able to detect how far along she was, but the whole affair gave the appearance of "boilerplate" care without regard to the individual.

Also, taking her blood pressure was a way of telling the nurse how far along she was.


I'm dubious. She told us nothing after taking it and it had been taken not two hours earlier by the transport nurse. We objected and she explained it was "required for insurance reasons".

And not putting a feeding tube in for your father is pretty normal, even for a Catholic facility.


You're absolutely correct. However, I know my parents, especially my father, which is why I was surprised she didn't consult the Parish Priest with which she had a twenty year relationship.

It sounds like the main problem with hospice for your family wasn't necessarily the care for your parents, but the problems with communicating with the adult children.


You could be right, but I am dubious. There was the constant suggestion that we didn't understand and that we were somehow trying to "hang on" too long or something. And as I said, in the case of my father, there were the definite overtones of coming up with an explanation weeks after the decision was made. They should have easily been able to repeat their discussion with my mother so that we could understand what she had been told. They had no problems doing that when they didn't like the decisions she was making.

Like I say, I suspect our situation both times was pretty much out of the norm for them. None of us were probably "experts" at handling the situation. With dad, if they had suspect how long he would last, they probably never would have admitted him in the first place. And with mom, if the Hospice nurse had been called to the hospital first, a quick discussion with the doctors might have clued her more into exactly how far along she was. The hospital was in a hell fire hurry to get her out, and that may be the root cause of the whole affair.

pnwmom

(108,977 posts)
68. That sounds awful about the morphine. Seeing her go through that must have been painful.
Wed Mar 6, 2019, 04:13 AM
Mar 2019

Last edited Wed Mar 6, 2019, 05:43 AM - Edit history (3)

But you have a misconception about hospice. Although someone may enter hospice who already has a feeding tube, hospice care doesn't include the insertion of a tube, which requires the use of anesthesia and which a confused patient might try to rip out. Once your parents chose hospice, they were choosing a natural death. Inserting a tube to feed someone who has lost the swallowing reflex, and is actively dying, can increase and prolong discomfort.

You're probably right that the hospital's rush to get your mother out may have been at the root of the problems. No one was prepared for what was to come.

https://www.hospicesect.org/hospice-and-palliative-care/feeding-hydration-and-hospice-care

Can someone have a feeding tube under hospice care?

Hospice doesn’t include the placement of feeding tubes, or any other steps taken to prolong life at this stage of care. However, patients who already have a feeding tube in place may benefit from hospice services. We will never ask anyone to remove a feeding tube in order to be eligible for assistance.

Sometimes, very close to the end of life, patients may choose to have feeding tubes removed. This decision can also be made on their behalf by loved ones or medical professionals, as artificial feeding and hydration may no longer be playing a helpful role or may become harmful or painful.

https://americanhospice.org/caregiving/artificial-nutrition-and-hydration-at-the-end-of-life-beneficial-or-harmful/

A nasogastric tube can cause choking and extreme discomfort at placement and afterwards. At the time of insertion, it can be misplaced in the trachea and cause pneumonia. The tube can cause erosions and abrasions, even perforations (holes) in the nasal passages, esophagus and stomach, and can cause acute and chronic bleeding. Aspiration pneumonia is a risk whenever an NG tube is in place. If a person is confused, he/she may need restraints to keep him/her from pulling the tube out. This can cause a whole host of problems, including psychic distress and increased agitation and anxiety, skin breakdown due to immobility, pneumonia due to immobility, and injury from restraints, to name a few.

A gastrostomy tube requires anesthesia during placement and has risks associated with the use of anesthesia. There is also a risk of infection of the abdominal wall and peritonitis (life threatening infection of the abdominal cavity). Gastrointestinal bleeding, blockage of the bowel or perforation of the bowel may occur. Diarrhea from the feeding formula is fairly common. Aspiration pneumonia is also common. If the person requires restraints to keep from pulling the tube out, the same complications listed above can occur.

Mosby

(16,306 posts)
43. Drug induced dysphagia (problem swallowing)
Tue Mar 5, 2019, 04:37 PM
Mar 2019

Is caused by combining morphine derivatives with benzos.

Maru Kitteh

(28,340 posts)
47. There are many, many reasons why dying people develop trouble with swallowing.
Tue Mar 5, 2019, 04:58 PM
Mar 2019

It would be a tragic mistake to leave the dying suffering in pain and panic because of an incomplete clinical picture and/or misconceptions about the medications that can ease their suffering.

nini

(16,672 posts)
53. Thank you
Tue Mar 5, 2019, 06:00 PM
Mar 2019

As death gets close, the body is shutting down and doesn't need food or water anymore. Which is why hospice doesn't do IVs.. the body cannot handle the fluid anymore.

I'm sure you know that though.

nini

(16,672 posts)
55. Morphine helped make your mother more comfortable
Tue Mar 5, 2019, 06:07 PM
Mar 2019

It helps with stressful breathing and helps keep a patient calm.

The bed is for those caring for her so they can raise the bed etc..

The feeding tube is not necessary at the end. The body cannot process the food/fluids anymore. It makes it harder on them to have them. The Catholic church does not believe letting a person die naturally is wrong.

It's too bad you had a crappy nurse for your mom and it sounds like your dad got bilked for insurance.

Hospice is a wonderful thing and if a family doesn't understand the hows and why it becomes a battle. The fact no one walked you through it is the problem, not what they wanted to do.

Sorry for your losses.

On edit: pnwmom said it better than I did. I didn't see her post until after I finished this. Please don't be afraid of hospice again though I hope you don't have to deal with that again ever.. if not a long long time.

zipplewrath

(16,646 posts)
69. Oh, I probably will
Wed Mar 6, 2019, 08:59 AM
Mar 2019

I've got alot of older siblings, several of them aren't married and I may end up being responsible for them. But I won't avoid Hospice. Quite the opposite, at this point I kinda know what discussions to have with them at the outset so these things don't happen again. Too many good experiences on too many peoples part to not work with them.

RobinA

(9,888 posts)
70. Unfortunately
Wed Mar 6, 2019, 09:10 AM
Mar 2019

For a variety of reasons I have developed very little trust in anyone in the medical field. And I say that as someone who was raised by a physician and a nurse. 1) There are a lot of reasons other than clinical efficacy why decisions are made, 2) There is no communication between various "providers," and 3) medical providers are only as good as their ability to utilize what they have been taught. Hospice is no different. Anyone with a loved one under medical care for anything even somewhat serious should research and keep an eagle eye on what is going on until they KNOW they can trust the professionals involved. And even then it pays to keep on top of what's going on.

zipplewrath

(16,646 posts)
71. Yes, that's a whole other problem
Wed Mar 6, 2019, 09:22 AM
Mar 2019

I never intended this to be a Hospice bashing subthread. And we probably shouldn't diverge off into the off topic discussions of the need to be an "active user" of medical care. But you are right, 50% of what happened to my family were associated with our lack of preparedness to engage with Hospice. That lack can quickly be interpreted as uncaring or incapability to deal with the situation and many professionals reaction will be to immediately "take over".

And it is no different with almost any medical care. One needs to assert to the medical industry at all levels that they engage with you and explain (not justify) what they are advocating doing. It is equally important to engage with them on what they may NOT be doing. Things do get overlooked, especially in the fragmented care system that is our healthcare industry we have create. There is far too much "boilerplate" care going on. They'll call it "following the protocol", but when pushed, it is often determined that the protocol isn't intended to be quite that strict or unadaptable to the individual patient and what's really going on is they're just "turning the crank".

displacedtexan

(15,696 posts)
36. So sorry! I lost my brother last year, & hospice care was wonderful.
Tue Mar 5, 2019, 03:22 PM
Mar 2019

The hospice nurses stayed at the house with us around the clock until my brother passed away peacefully. Then they helped with the details you don't even think about, like contacting the coroner & funeral home. They even taught me how to dispose of his medications properly. They didn't just help my brother; they helped our entire family.

Stay well in the coming days, and know that we're all here for you.

mcar

(42,307 posts)
37. Hospice is wonderful - it really helps people die with dignity
Tue Mar 5, 2019, 03:31 PM
Mar 2019

I worked for a national hospice (I'm in PR) for 6 years and loved it. The medical professionals and volunteers are so caring and compassionate.

I'm sorry for your loss but glad your dad made the journey in comfort.

lunatica

(53,410 posts)
46. I want to thank you for your work in hospice,
Tue Mar 5, 2019, 04:49 PM
Mar 2019

Please read what I think of you in my comment #40!

I mean every word of it!

Delphinus

(11,830 posts)
39. My Mom
Tue Mar 5, 2019, 03:58 PM
Mar 2019

had hospice too - and I have been extolling their virtues ever since. I knew it was a good choice, but seeing it in action really solidified things for me.

Condolences on your father's death - and thank you for sharing your experience.

lunatica

(53,410 posts)
40. I like to say that when hospice workers go to heaven
Tue Mar 5, 2019, 04:08 PM
Mar 2019

they take the fast lane and are waved through, without question, by St Peter.

My mother, and all of us were in the hands of angels in her last months.

I’m an atheist so all of this is just an expression of gratitude and appreciation in words and concepts everyone can understand.

mcar

(42,307 posts)
60. Hospice workers are the best!
Tue Mar 5, 2019, 08:55 PM
Mar 2019

And The volunteers are simply amazing.

True story: my job was to write stories for local media about hospice workers and volunteers in those specific areas (the hospice I worked for had programs throughout the country).

One time, I interviewed a hospice volunteer in TX who was a Vietnam veteran. He told me about one of his favorite patients - a Vietnamese man whom he visited in the man's home. The man was a North Vietnamese immigrant who had fought for N Vietnam during the war! IOW, they fought against each other.

I asked the volunteer how he was able to do that. He said they just sat down and talked it out. He visited the man weekly until his death. Just thinking about it brings tears to my eyes.

Loryn

(943 posts)
49. I cannot agree more.
Tue Mar 5, 2019, 05:27 PM
Mar 2019

I lost my mom unexpectedly January 29th. My dad had dementia, and had been diagnosed with colon/liver cancer in November. When I told him of her death, he totally gave up. Hospice supported us every step of the way until he followed her the 21st of last month.

They are truly angels in human form.





planetc

(7,808 posts)
54. Hospice nurses are geniuses too.
Tue Mar 5, 2019, 06:01 PM
Mar 2019

My sister was, although always precise and civil, difficult to deal with. She was difficult for me to deal with, so I know what a challenge the nurses had, and how well they handled the semi-impossible task of persuading her to finally give up. She was 69, and died of our inability to treat cancer effectively and without bankrupting the patient. She had declined treatment after breast cancer metastasized. With the last months of her life, she finished work with the last two of her ESL and citizenship students, and they became citizens that fall. But I digress: the other volunteers at our local hospice were also superb, and the acapella singers who visited her room gave her the last real pleasure she had on this earth.

Ohiogal

(31,989 posts)
56. My sincerest condolences to you
Tue Mar 5, 2019, 06:13 PM
Mar 2019

What an absolutely beautiful post. Thank you so much for sharing your experience with us.

True Dough

(17,303 posts)
57. All the best to you at this difficult time, titaniumsalute
Tue Mar 5, 2019, 06:28 PM
Mar 2019

My mom's hospice experience turned me into a hospice volunteer. They provide such an amazing service. It's a privilege to be able to spend time with people in their last days and hours.

Stinky The Clown

(67,798 posts)
58. Condolences on your loss. Hospice workers are quite amazing.
Tue Mar 5, 2019, 07:10 PM
Mar 2019

Between parents and inlaws, I have quite a bit of experience with hospice. If humans can fairly be described as angels, Hospice workers at near the head of the line.

nicehuman16

(7 posts)
63. Same experience
Tue Mar 5, 2019, 09:48 PM
Mar 2019

I am very sorry for your loss. My sister in law passed away in hospice care in November. They made a bad situation more comfortable for her and our family. It was a dignified and comfortable passing and they were wonderful.

MiniMe

(21,714 posts)
65. So sorry for your loss, and I agree with you about hospice!
Tue Mar 5, 2019, 10:27 PM
Mar 2019

Had Hospice for my mom when I lost her in 2013 and they were great. I was able to keep mom home until a few days before she passed because that was what she wanted. I couldn't have handled things without Hospice.

radical noodle

(8,000 posts)
67. I'm so sorry about your father
Tue Mar 5, 2019, 11:49 PM
Mar 2019

My mother had already passed away when my father was suspected to be suffering from colon cancer. He refused testing or treatment and I got him into hospice as soon as I could. The first few weeks of hospice care actually showed a slight improvement because his pain was being better managed. Indeed, hospice was incredible and I don't know how we would have been able to keep him home until the end without them.

pandr32

(11,581 posts)
72. I watched how panicked my Grandma was at the end...
Wed Mar 6, 2019, 12:04 PM
Mar 2019

...and heard her feeble cries that the hospital staff seemed to be too busy to answer. She was in a terrible state of distress and I thought to myself how wrong it was.

While I am sorry for the loss of your Dad, I am relieved and encouraged with the positive experience with Hospice you shared with us. This is how it should be.

Thank you so much, and may your grief be assuaged with your memories of his treatment and comfort during his last days.


calimary

(81,238 posts)
74. Much love and empathy to you, titaniumsalute.
Wed Mar 6, 2019, 01:22 PM
Mar 2019

I watched both my parents, and my dear mother-in-law go down slow, hard, and agonizing. It was hard on everyone in the family, especially watching them fade and struggle and know we couldn’t do much more than that, none of us being medical specialists.

Those folks who provide elder care and hospice really are angels in the flesh. And they do indeed wind up helping the whole family, not just the ailing or dying member. I’m glad that such help is there, in this day and age. I’m extra glad it was available to you and your family.

Shit - these transitions are never easy or painless. And I guess most of us will face some version of it near the end. Sometimes that’s all one can pray for: safe passage.

Just know you’re surrounded by love, affection, sympathy, and support here, too, for sure.

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