At The End.....Are We Doing Enough?

TK67

I would like to hear from others on how your LO approached the end of their journey with this terrible disease?

My mother is 78 and three days ago her hospice nurse admitted her to the hospice inpatient care center.  Mom was choking severely and has not been able to eat or drink without choking for several months now.  Mom was crying and saying that she's tired.  The choking frightens her, of course, and makes her very agitated.  Once she got to the hospice center they put an IV in her for medications (not hydration) and a catheter.  She became agitated again and was fighting the hospice nurses.  They gave her a little Ativan and immediately she got sleepy.  I told mom that I loved her and that if her parents (we called them grandma and grandpa) came for her she should go with them.  Mom nodded she understood and went to sleep.  That was the last time I got to talk to my mother.  

She has been in the hospice care center for three days now with no liquids or food.  They have allowed her to wake up a few times to see if she might be able to eat or drink but each time she fights them and has pulled her IV OUT two times.  Today they started giving her morphine.  When I went to check on her today she was sleeping peacefully.

I suppose this is how things will go until she transitions into active dying.  I'm at a loss as what to do except prepare myself for her to pass.

LicketyGlitz

TK, we had at-home hospice, but the same sort of scenario where she was choking and food/drink were ending up in her lungs. That was the beginning of the end, we too advised to stop food and drink - which we mostly did. We would try a little apple sauce and if it was easy for her and she appeared to enjoy the sensation we would do a little more - at the beginning. But when she hit active dying, just days after beginning to get food in her lungs, we stopped all together. Morphine was a big part of Mom's end of life. She had a fractured hip too, and at times we were not giving her enough pain relief for both the hip and the pain of her body shutting down. She lasted 6 days after hitting active dying. At one point going into what hospice called a "death plateau" where her body stopped moving towards death but didn't move towards more life either. We told her over and over that it was okay to leave but she just didn't.

I wrote a post about our "death plateau" days which may be helpful to you as you and your mom move through to the end. https://www.stumpedtowndementia.com/post/we-re-close

I wish you, your mom, and all those who love her peace in her passing, joy in your memories, and comfort for you all.

ladyzetta

(((Dear TK67)))

I am sorry but prepare yourself its going to be very soon. When Hospice put my DH on  morphine he lasted the one day. He never woke up from his sleep and it was very peaceful. If you can just sit there with her, you will be glad you did. 

I am not sure how long others have been on morphine before passing but my DH was just on from 6am to 6:30pm.  

Hugs to you and your Mom.  

King Boo

TK-

The end started as a very hard process for me, mostly because the timing of 'doing' was over.  So many years, juggling so many stressors, so many decisions and forks in the road.

The time was done for that, and there was only one path to make progress down.  

Having hospice, particularly the benefit of inpatient hospice, gives you the knowledge that experienced hospice staff, who know how to spot the very subtle indicators of discomfort, are there round the clock and can provide morphine as needed, thus preventing your mom from unecessary discomfort.   Those signs can be fleeting - a furrowed brow, a little more muscle tension, etc.  These were missed in our regular LTC bed - on inpatient hospice, spotted quickly.

These final days take patience, and some often hard to come by ability to accept that death is close by.   Some days it dragged, but once active dying began, it goes rather quickly.

Because you are working with hospice, you know this already, but I will mention for the benefit of others that it can be a little frightening if you don't know what to expect.  Our LO's cannot manage their secretions any more, so any mucus in the throat makes things very noisy.  They are not in discomfort.  They begin mouth breathing with effort, this is a reflex that kicks in (Cheyenne Stokes?) - no pain, but it is startling to us.

Once this starts, the countdown has begun.   I wish you peace, bravery and hope that the knowledge that you have done well will sustain you during the coming days.  

TK67

LickityGlitz

Are you The Girl and The Other Girl?  My sister and I have been following your posts on Stumptown!  Thank you for sharing your story and offering your advice!

mommyandme (m&m)

This is so difficult.  Possibly quietly playing some of her favorite music might be comforting.  

When my sis was actively dying from cancer I held her hand continually, talked to her a lot, especially how loved she was and assured her that her children would be ok.  

It was a gift she granted me, to be with her until the end.  I cherish that time so much,  although it was very hard and sad. 

Thoughts of peace for you and yours are being sent your way.  I’m so sorry.