How long does a doctor or other health professional usually wait to give morphine if the patient is not eating or drinking?
When someone is not eating or drinking, this is usually a sign that their body is shutting down. If the potential is there that someone is nearing death, I will make sure that they have pain medications ordered so that they will be comfortable. If a person is able to swallow safely, oral medications like Vicodin can be given. However, as time progresses, morphine is one of the best medications for a terminal discomfort. Not only can it help pain, but it can ease breathing, help lessen anxiety, and promote comfort. Not only that, but it comes in many formulations so that we can tailor it to individual patients needs.
The key is not to start it too late, as then the pain can get hard to control. At my facility, we start it as soon as pain or shortness of breath becomes an issue. We initially use very small doses, usually only a couple of milligrams at a time. This usually works quickly, without causing too many side effects.
I have many years of experience with taking care of dying patients. Unless you give someone an overdose, morphine does not hasten death as many people believe. I have seen people on morphine for years who are able to live comfortably. Please discuss any concerns you have about morphine use with the healthcare professionals that are taking care of your loved one. I am sure they will address your concerns.
It depends on the illness and the manner in which the doctor is treating it. My mother was was put on morphine when I signed her up under Hospice. She was in the end stages, and I think that is when it is truly considered. Most patient's pain is managed by Vicodin, but eventually this does not do the job well.
One thing to remember is that morphine will hasten the process of the illness and death.
This issue is something the doctor would go over with you in detail. There are pros and cons to it, but ultimately when they get to this stage, it is heartbreakting to watch them suffer.
My Father's estate was embezzled by a paid home health provider, one that I hired. Dad lived in CA at the time and I was in AZ. This paid care giver became engaged to marry dad, brought in her own attorney, had Dad revoke his POA, his medical care directive, and sign his personal property over to her and her adult children, who were on unemployment at the time. I learned that legal documents prepared on behalf of the Senior are not worth the paper they are written on. They can be revoked with the stroke of a pen, unless you have been deemed incompetent BY THE STATE. Dad had a family trust that was established 10 years prior and it was revoked with one stroke of the pen. The care giver told Dad that I wouldn’t allow him to write checks, and that he was signing for a new checking account.
That incident cost Dad over one million dollars and me over $250,000 in legal fees, in addition to 3 years of my business income. It has left Dad penniless, me financially bankrupt, and both emotionally and physically drained. Someone needs to wake up. What is the value of a revocable trust if an elder can sign it away with the persuasion of a home care provider? This is been a costly lesson for me and for Dad. One from which we can not recover.
By the way, this home care provider administered morphine, without consulting me, and at the direction of Hospice, since she was "in the home". I was told by hospice that i was interfering with Dad’s care, even though I was his trustee, and his POA and medical care director at the time. I was the one who HIRED Hospice. Dad was poisoned by morphine, and when he began to projectile vomit blood, he was given 24-48 hours to live. This care giver then emailed her new POA to Dad's attorney who in turn called me and APS. I was ordered by the state to file for a guardianship.
Hospice social workers and nurses need to have more PRACTICAL experience before deciding to administer a drug that can kill a senior without the family or POA's approval. Dad is still alive and doing well, but I do not trust Hospice providers.
This care giver was not bondable, but cost me 3 years in court, objecting to my guardianship, stating that I had hired her to murder Dad, but to make him suffer before dying.. Where is the justice in the legal system, and where is the protection for our Seniors? I am disappointed in an elder care system that promotes fraud, disregards trusts, and in a Hospice service that promotes marriage between a Senior that is obviously unable to protect himself and a paid care giver 30 years his junior. I have lost all faith in the elder care system. I think it's time for these young social workers to get some experience before instigating corruption to the very people they were hired to assist.
Hospice helped my mother through her final days. They managed her pain medication with grace and care.
I was with my mother most every day and sometimes in the wee hours of the morning. When I wasn't with her, my sister or brother was. We were beside our mother's bed. We talked to the doctor often. We talked to staff. (DAILY). We talked to nurses. (DAILY). We talked to our mother. (DAILY). Communication was on-going. We worked as a team on our mother's behalf. Bottom line. We wanted the best for our mother. We didn't want her to be alone. We didn't want her to suffer any more.
It was not until Hospice came in.... that my mother was FINALLY without pain. Other patients would say, "I wonder when that baby is going to stop crying."
The administering of morphine brought her comfort. It did not kill her, but eased her into her next passage, i.e., death.
Vigilance and being 'on top' of all that goes on is extremely important.
Elder care is available for guidance, but the big job is the full responsibility of the family member (s).
I'm sorry you had such difficulty. It's unfortunate you had distance between the two of you and too bad you could not have been physically present to the extent you could have fired the caregiver and hired somebody else.
Obviously, very complicated. I hope you let things go and heal. Go forward with your own life as it's all you've got. Good luck.
When my mother-in-law became bedridden, that was the day she stopped eating. Two days later, she could no longer swallow teaspoons of liquid and her toleration for the pain she was in also ended the same day. The hospice nurse (who was in my house every day)and doctor, along with the primary care doctor and myself, decided it was time to put her on morphine. Before then, she had been on methadone for many months and for the most part, was relatively pain free, as far as we could tell. However, once she became bedridden and completely stopped eating, it was clear that the end was very close. Her ability to mask her pain was no longer there and it was obvious that the methadone was not going to be of any use any longer. She immediately responded to the morphine and for the next 6 days, mostly in a deep sleep, she was as comfortable as we could possibly make her. I think it was more the amount of pain and the degree of discomfort that she was in than the fact that she had stopped eating that was the catalyst for putting her on the morphine. I hope this answers your question. Prayers and thoughts are with you.
I just need to get off these meds
I acted as caregiver for my mom who had been entered into hospice care when I took over her care,and for a sister in law a few years later. Both were under the care of hospice and both were given morphine. A dear friend of mine was also under the care of hospice and provided morphine for pain. All are now deceased. What I learned from my experiences with hospice is that they are an organization who's focus is on providing comfort to those who are terminally ill, So that when a patient is assigned to them for services,if they do not protest any of the nurses, doctors or aids recommendations, then everything will go smoothly along the lines that hospice plots for the patient, and that is ultimately the administration of morphine,and/or other drugs and the death of the patient. You will not have problems with hospice unless you run awry of their reommended services, that is go against giving drugs and you will get an argument, and more than that if you push it.
If the patient has family and other individuals that are clearly commited to the care of their loved one, hospice does not take such a strong stance against family if they disagree with any recommended hospice practices. If the patient is of the mind that they aren't ready to meet their maker, and don't want to take drugs, they may be met with some resistance, but no one is forced to accept their services, and if their protestations are strong enough they will be heard and released from Hospice services. I was told that one can go in and out of hospice care as often as neccessary, Beiing signed up for hospice care is not a death sentence, everyone that goes in for care does not die. And if you think you'd like to try some other type of treatment you are certainly free to do so.
I met a lady who had throat cancer and gone through chemo and all of the rest of the tortures that cancer patients must endure, to go into remission and then contract cancer elsewhere in her body. She was eventually sent to hospice care and given the morphine, which she said only had her sleep all day for days at a time, and that she had to get off of the drugs becuae they were killing her. So she did, that was three years ago, and she is still with us. I believe that how you feel about your ailment has a lot to do with its effect on you. So make up your mind to get off the meds if thats what you want to do. Acupuncture works real well for pain.
Mt brother had been sick for about 3 weeks and in the hospital. They said he would most likely not live thru the night but he did, the dr encouraged me to call in hospice. We had them for a day ro two in hte hospital, but he wanted to return to the nursing home where he lived, so hospice signed him off their service. He got sicker the second day back at the nursing home and hospice was called back in. They immediately gave him morphine and some pain med that started with an L. They were giving it pretty quick, seemed like maybe each 2 hours. I left as it got later in the evening (oh how I wish I had stayed longer) andhe was dead before 7 AM. I do believe he was given too much morphine along with the L pain med. I had no idea he was gonna go that quick or I would not have agreed and I would have stayed with him longer, not allow him to die alone with no family there. I had great thoughts of Hospice before, now I am not so sure I would want them for another family member.
Until I saw first hand how Hospice works with Morphine I never would have believed it was legal.
