Discussions that mention morphine

Alzheimer's Disease & Dementia board

I've never written or spoken about this because it remains the most awful thing I've been through, but I will do so here in case it helps out others.

My MIL, 97 years old, no dementia, had a stroke. It took the hospital a couple of days to work out that it was a severe stroke (ie the kind that she would not recover from, which sort of puts her in the ballpark of a disease like dementia). They inserted a feeding tube without consultation, before they worked out how severe it was - had they asked at that stage I can't imagine us saying no.

Despite the stroke, she was compos mentis, knew where she was, wanted to go home, could ask and respond to questions. She had a very heightened response to pain (eg if you kissed her gently on the cheek she screamed). Part of all that I am sure was that they inserted a catheter in a very brutal fashion and she felt as though she was being attacked/violated anytime anyone came near.

Although she was eating before the catheter incident, she completely refused to after - hence the feeding tube. It looked to me as though she had made a decision for herself. As general background, before the stroke, she had limited hearing, movement, and sight, and was in I think a fairly unique situation in that she was being 'cared for' by her 70 year-old daughter with dementia - naturally we were helping a lot but it was a situation that I understand she did not care for. On the other hand she refused any alternative arrangements........ I (and she I'm sure) thought the only reason she was staying around was her sense of duty in looking after her daughter. She often said "I'm 97 ............. I don't know why!!!!!!!!!!.

Two days after the feeding tube was inserted, we were called in for a meeting with a spotty seemingly 17-year-old 'doctor' and a social worker. The gist of the meeting was that we were heartless and cruel to have her on a feeding tube and we needed to make the decision to remove it (and starve her to death). The reasoning behind this was that she was 'unresponsive to pain'. To this day I wonder if they weren't in there jabbing her with needles.

Of course, none of this was my decision, but my DH was in such a state at being presented with this directive to make a decision to remove the feeding tube he was pretty much non-functional. Likewise his other siblings.

I managed to buy some time for her children by establishing that she was completely responsive - if you asked her very gently to roll over, open her eyes or mouth, she responded immediately (I did NOT try poking her to see if she felt pain). I told them that meant they did not need to make the decision right then and there, which hugely relieved them.

In the meantime I did a lot of reading about the situation - you can go out there and find terrible descriptions of evil children denying their parents food, and the patient clutching at the sleeve of passing nurses begging for sustenence........... it is just ghastly.

To boot, MIL was a devout Catholic and I found out that it was totally against that religion to deny food and water in those circumstances........

So, I'm sure she wanted to die, I'm sure she would not have wanted to violate her faith, I'm sure her children would never have gotten over making the decision to remove the feeding tube. It was a truly awful and traumatic and impossible situation.

A few days after that the hospital called to say MIL was dying, and we were all able to be there with her. The nurse that had been so gentle with her, and therefore the only one she had responded to, made a special point of telling me they had given her a dose of morphine (which I know under the circumstances is likely to cause death).

I am rambling here, and no matter how much I ramble I can't begin to describe the awfulness of this situation. I think one lesson out of this is, if there is any chance of ascertaining a person's wishes beforehand, or failing that an agreement between siblings, it will make things much less traumatic when the time comes.
I just read all of these posts from the beginning, and found them incredibly insightful and heartbreaking. I get very, very angry when I think that my pets may be permitted to die with more dignity and grace than my husband. I concur with those who suggested working with a hospice. When my Mom was dying, I had my first hospice experience. One of the things I heard is that hospice doctors have more flexibility in prescribing morphine and other drugs for comfort than other doctors, who can be reluctant to prescribe drugs that will send up flags for the FDA. I don't know if this is true, but the hospice staff were knowledgable and very supportive about end-of-life issues.

I wanted to suggest that you all check with your doctors to make sure that they know about your living wills and instructions. I also suggest that you ask them directly if they have any problems with your wishes. My husband had an Aunt with terminal cancer, with a "do not resuscitate" order. At one point during her long illness, her heart stopped beating and she was resuscitated by the hospital staff and her doctor, who only then told her that he interpreted her directions to mean that she should not be revived only if she was at the end of her life. Since she might have another few months if he revived her, he said it was his mandate to resuscitate her. She complained to him and to the hospital ombudsperson (cranky, sharp old lady!) but couldn't change doctors at that point. In addition to making your wishes known to family members, it's a good idea to have conversations with your doctor about your wishes before the emergency happens. I'd rather know now than later if my doctor's religion, medical beliefs, etc. might affect whether my wishes would be followed.