Home Hospice Care

[JustMeInID]

My mother died last year. She had Parkinson's and congestive heart failure. She'd been under the care of hospice at my sister's house. Having been there the last several days before her death, I've got a question. The last 12-18 hours of her life (that time period runs together...not sure how many hours exactly), we were giving her liquid morphine (to regulate her breathing, not for any apparent pain). We gave her nothing to drink, and in the last several hours, we didn't even wet her lips.

Because she would have been terribly dehydrated, and because she was being fed morphine constantly, when she died, had she basically overdosed on the morphine? This has been troubling me since her death.

[MissyMousums]

Originally Posted by JustMeInID

My mother died last year. She had Parkinson's and congestive heart failure. She'd been under the care of hospice at my sister's house. Having been there the last several days before her death, I've got a question. The last 12-18 hours of her life (that time period runs together...not sure how many hours exactly), we were giving her liquid morphine (to regulate her breathing, not for any apparent pain). We gave her nothing to drink, and in the last several hours, we didn't even wet her lips.

Because she would have been terribly dehydrated, and because she was being fed morphine constantly, when she died, had she basically overdosed on the morphine? This has been troubling me since her death.

I was told by the Hospice nurse that being dehydrated made the dying process easier for the patient because the body is breaking down and forcing them to drink can make them uncomfortable. My father showed no interest in fluids in the last couple of days of his life anyway. My father was also taking liquid oxycontin up until the end. We kept him on the prescribed dose and times to give it. The nurses encouraged us to give the oxycontin to make sure he was comfortable. At one point I thought he needed it before he was due to get it and asked one of the aides who was reluctant. I asked, "What? Are we afraid he might OD? He's not going to make it through the night as it is" Mind you I don't normally act like that but people act differently under such circumstances. I was upset because I thought my dad was suffering and did not see how it could hurt since he was near the hour of death.

Don't feel guilty, your mother died peacefully and she had her loved ones around her.

[JustMeInID]

So, basically, the answer is....yes. Even with the explanation, I'm not sure it makes me feel any better. Is it selfish of me to wish I would have surreptiously given her water and had a few more hours to spend with her?

[Spazzie]

My mother died the 15th of this month. We buried her just a week ago today. Mom was an in-home hospice patient and she also had Parkisons. Your post echoed many of my own concerns. For a week mom did not eat or drink and she only had a morpine patch on. We did have some of the liquid quick relief Morphine drops provided in her care package but we didn't use it. I didn't see her as in pain and while her breathing was fast, she didn't look as if she was in distress. Looking back now, I wonder if we should have given her some of the drops to help/slow her breathing? I thought the morphine was for pain and I didn't realize (until after her death) that the bottle indicated for pain and breathing! I felt sorta sick when I read it. I hadn't been aware of it helping with her breathing.

Do you see how we can torture ourselves and doubting our decisions? I loved my mom, as I'm sure you did. I know we did everything we could have done to make sure they didn't suffer. Mom didn't eat or drink anything for her last week, she was almost comalike, but she would open her eyes...but I don't think she saw us. We couldn't force liquids or food on her (she would have choked) and she had requested months ago NO more needles. While I did swab her mouth and keep her lips moist it felt superficial to me.......because my mom was dying! I felt helpless. We felt like we were starving her to death....but we were told over and over we were NOT. This is they dying process and while we grab at straws hoping to find something to do to make everything ok, those options just are not there. Death will happen.

I hope you are able to put your mind where I try too......in the knowledge of knowing you did the best you could to make sure she died peacefully and painfree. What more could we really do for them? Do you think they would want us hurting or feeling the guilt? Death was going to happen and be reassured that you did what you did at the time FOR your mom!

I can relate to the feeling of wanting to be selfish and keep them here a bit longer. My mom's quality of life didn't exist....I think it's more loving to let them go. I know if my mom could she would hug me for being so loving and devoted to her care. I gave her what she had always given me.....love!

((((((((hugs))))))))))

[JustMeInID]

Oh, Spazzie, I'm so sorry to hear of your mother's passing -- and so recently.

I think it was so difficult for me with my mother since she and I hadn't spoken for 15 years before I went to her bedside. My sister said she hadn't been eating hardly at all, maybe a half of a peanut butter sandwich a day, yet just two days before she died, she sat at the table with all of us and ate steak off the grill, potato salad, etc., and drank a glass of milk. The day before that, she had a large salad and a McDonald's hamburger. (I remember reading in the hospice literature that it's not unusual for someone who's dying to suddenly have a taste for something they've always liked.) Then she said she wanted to have the surgery that had been offered to her a couple of years before. Of course, by that time she was dying, and it was much too late. To see that denial in her broke my heart, but not half as much as when the hospice social worker came and spoke out loud the words that she was dying. My mother cried...the tears rolled down her cheeks.

In the early morning of the day before she died, I was the one who got up with her to put her on the potty, and she and I had a wonderful talk. I asked her a lot of questions, and she gave me a lot of answers. But as soon as we were finished, the light went out of her eyes, like she was no longer there. I truly believe she needed to have that talk before she died. And it's so true what I've read: No matter what the circumstances, let people know that you love them before they die.

Thanks for letting me talk.