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goody2shuz · 05-29-2007, 10:23 AM

Hi everybody....some of you may be familiar with my brother's situation from my other thread...he has a rare degenerative disorder called Autonomic Failure and is presently under the care of Hospice in his home. This organization is wonderful and every part of the team that cares for my brother and his family is so wonderful. I just recently returned from staying a week with him and had to return to my own family responsibilities.

Anyway....my question is in regard to the morphine administered. My brother has had pain and his issues lately are that he goes into episodes of apnea that lasts up to 15 minutes with oxygen assisting him....he will appear to be unconscious during these episodes but is able to respond by squeezing my hand, a slight nod or flicker of his eyelids. When he goes into these we push the button to give him more morphine because he does indicate once he comes out of the episode that he is in alot of pain. These episodes can go on for up to a few hours with one gasping breath between and occur every few hours. The morphine has been doubled and he is getting 80mgs/hour and as needed inbetween every 15 minutes. I have noticed that he is much more groggy inbetween his episodes and confused as well. The nurses explained to us that he cannot OD on the morphine and that it will not supress his breathing since they are carefully administering it slowly making adjustments so that his body adjusts to it. I have read that in Hospice the morphine almost progresses the dying process by the way it is administered and am wondering if there is any truth or validity to that. I know that my brother's goal is to be as comfortable as posssible without being too drugged up to interact with his family. But I am beginning to see that he is having a more difficult time doing that.

I just thought that somebody here who is more familiar with Hospice would share their experience with the administration of morphine and exactly what guidelines there are for it to be given to a patient.

Thanks for allowing me to share my concerns.

Love ~ Goody

cher1052 · 05-29-2007, 03:18 PM

Goody, I've responded to some of your other threads. Hospice worked with us in making everything easier for my mom. She died of lung cancer last year. It was so far advanced and the nurses increased her doses of morphin also-to make her more relaxed. What they did for my mom helped her alot-to pass away peacefully. Don't know if this helps you any. take care, Cherie

goody2shuz · 05-31-2007, 05:59 AM

Thanks so much for your response, Cherie. As I reported on my other thread my brother seems to be doing better. He now has an appetite which he has been lacking for the past month or so AND is getting out of bed more. I even hear the difference in his voice when we are talking on the phone.

Just hearing how his past few days have been is such a relief....from what my SIL relays to me he is definitely doing better. I don't know if it is his overall condition OR the relief he is getting with the morphine???

Of course our entire family has been praying for a miracle and perhaps this is the beginning of one.

There is always hope until we have none left to have....right???

Thanks again for your support.

Love ~ Goody

PS ~ I am sorry about the loss of your mom and hope that the pain of not having her here with you lessens as time goes by. It is my belief that love transcends all distance and time and hopefully that thought will comfort you.

cher1052 · 05-31-2007, 07:50 AM

Goody, I'm happy to hear that your brother is doing better. Glad to read he's eating a little more.

Thank you for your comment on my mom-It'll be a year in July-things have been getting better-there have been times when just seeing something when I'm shopping or out can trigger a tear...but that's life. Hope your brother is feeling better SOON! Take care, Cherie

CoyoteBound · 06-02-2007, 10:40 PM

goody,

My Mom was on Hospice the last 10 days she lived and that is the only experience we have had with them. But when we seen that she was not gonna make it because the Doctors had already told us, we went ahead and started preparing her funeral arrangments because it does make it so much easier than having to run do it when they pass away. Let me tell you what the Man told me that worked for the funeral home! He said that if we let Hospice take over that they would put her on Morphine and a Nerve Medicine which they did and he said that she wouldn't last 10 days from the time they took over. But I couldn't just let him tell me that. I had to let the Doctors do what ever they needed to do to make her as comfortable as they could and they did make her comfortable. They did put her on Morphine and she lasted only 10 days from the day they took over. bUt I really feel that they are there to help the patient, not hurt them. I could tell a big difference in the way that my Mom was breathing after they put her on the Morphine. It helped her and that is all that mattered to me was her. They were so good to all of the family also. If we wanted to call them and just ask the Hospice Preacher to come out and talk to us he was there. I think they are great.

I wish your brother a lot of luck! Maybe they can make him comfortable because we don't want to see them struggle do we?

Take care

Jan

ICC · 06-03-2007, 04:09 AM

My husband and I put both of his parents on Hospice at the same time. Father had cancer, mother had diabetic compilcations. They were put on Hospice in Feb. and passed one week apart from each other that May. We could not have asked for better care and more supportive people. They helped to make their passing easier and more comfortable for the parents and all that helped in thier care. We knew what to expect day by day. They were there for all of us. No matter when I called with a question, no matter what time I got an answer immediately. Helped us to feel less alone. Prayers to your brother.

ICC

goody2shuz · 06-06-2007, 11:20 AM

Thank you for your kind responses.

I am wondering what may be occurring....my brother has a rare condition called Autonomic Failure.....it has debilitated him beyond what any doctors have ever seen or experienced and his primary cardiologist is just dumbfounded as to what to do anymore. Because of how it has progressed he placed him on Hopsice so that he could get the care and comfort at home that he needs rather than ending up in an ER everyother day and seeing new doctors who don't know what to do. Anyway....he had progressed to having severe episodes of unconsciousness in which he barely breathes with periods of apnea that will go on for a few hours and quite frequently during the day. The disease has diminished his Atonomic Nervous system in terms of nerve control related to blodd pressure, pulse and has now gone to temperature regulation as well. He has minimal feeling in his extremities moreso on the Left. He is on oxygen and a morphine pump for pain that he experiences in his chest and head whenever an episode occurs and less so inbetween.

Anyway....last week his appetite increased significantly as did his energy. Then he went back to not feeling well with those episodes continuing throughout but less frequently. For the past few days he had NO episodes but his temperature had been having more fluctuations from 96 -103 and he is unable to keep anything down even ice chips. He cannot take his blood pressure meds because of this and he turned his morphine pump off last night feeling that was causing his nausea and remains off of all pain meds....AND he has had no episodes, just feeling worn out.

I don't know what to make of this.....some family members think that perhaps our miracle is coming because he has not been episode free since July 2006. Each day he had at least 3 or 4 episodes which only worstened.

Can anybody make any sense out of all of this???? Last week a friend of my MIL's went to a Shrine and presented my brother there asking for a healing. I am guardedly optimistic that things may be happening because of the drastic change in terms of my brother being episode free as well as off of the morphine. But then we have the temperature and his loss of energy....but that is from not being able to keep anything down and hopefully will subside once he is off the morphine and it is out of his system.....at least that is my guess.

I would appreciate anything anybody could share with me.

Thanks ~ Goody

jahdac821 · 10-29-2007, 08:28 AM

Hi Goody.
I am very interested in your posts - I posted a reply to one thread you had posted about BP.
I'm in Nursing School and have been working in a facility with Alzheimer's residents for over a year now and I have learned a lot about Hospice and their generosity.

Hospice normally accepts people who are terminal or have around 6 months to live ALTHOUGH they do accept other patients who dibilitating diseases such as Cancer, AIDS, tumors, etc.

I hope this helps some.
I know at where I work in our facility, hospice comes there, bathes the residents, keep track of them daily and if we EVER have questions, they always know the answers. They are very generous and kind for what they do.

Hope this helps some. If you need anything else, let me know!

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