How do I stop feeling guilty about suggesting to put Mom in hospice?

Noproblem67 asked...

My mom has been bed ridden for a while now. She is in ex stream pain, and has taken pain meds for years, she is a large woman, and my dad has struggled for so long to care for her, and cant lift her anymore, though, he does have some equipment, its not enough. She also has congestive heart failure, and is on oxygen full time, she is diabetic, and really should be on dialysis,but cant. She hasnt seen a doctor for months. I suggested hospice to my father, and he wasnt sure, but they decided to do it, and it was good, but they came in and gave her so much medications that she wasnt even able to talk. All she did was sleep. The backed off on as much, so she could at least communicate with them, but seams to be going down hill Fast since she has been on it. My sister and father has said that they are upset, cause she was doing ok, but he just needed help, and now I feel its my fault... She isnt eating, and not drinking and has urinated but 300 units in 24 hrs. (she has a catheter now.) She isnt even asking for her pain meds any more... I am in Arizona, and they are in Oregon, and I felt that they could help~as I wasnt able to be there to help :O( It breaks my heart to think that my wanting to help her and my father, has now lead to her death. How can I ever make them understand that I just wanted to help? I know time is getting near, and in 2 days is my fathers birthday~ I couldnt bear to have her pass away then..My Heart is aching...My father loves her so much, as do I but I cant help but feel Intense guilt... :O(

Expert Answer

Audrey Wuerl, RN, BSN, PHN, is education coordinator for Hospice of San Joaquin in California. She is also a geriatric trainer for the End-of-Life Nursing Education Consortium (ELNEC), which promotes education in geriatric nursing and end-of-life care.

This is a situation in which communication with the Case Manager would be helpful. Call the hospice treating your mother and speak to the Case Manager or the Social Worker. Express your concerns; and you'll, also be able to get current, first-hand information on what is really happening in her disease process. Sometimes, as the patient declines, the family members are so overwhelmed they cannot process all that is happening.

The normal end-of-life process would include more sleeping as the body is exhausted from fighting the disease. While her medications may be making her less interactive, they can be helping control her pain. In your mother's case, she has many things going on (or co-morbidities) that she has to cope with. And, your father has been her caregiver for so long that giving up "control" to others may be difficult (and cause guilt). Please realize that the body is very wise in that it knows when food and fluids are too much to digest"”so it is normal and natural to eat less. Being unable to swallow is also a normal physiologic change as death draws near.

Remember that hospice is supportive care"”for mom and for all of your family. Our job is to keep your mom's pain and symptoms controlled so she can have a peaceful life closure, in her own home, with family present.