Date
November 16 2015
Written By
Barbara Karnes, RN
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Does Morphine Hasten Death?

Does Morphine Hasten Death?


Comments

Barbara - March 25 2019

Hi Keef, your morphine history is unusual. I doubt many people could be sustained with that amount for that length of time. You said that amount manages your pain, does it affect your mental capabilities? You said it has affected your body in a negative way. The question that comes to my mind is by reducing the physical pain, even though it affected your physical body negatively, have you been able to have some quality in your living that you otherwise would not have had? If the answer is yes, then isn’t that our goal in medicine (to provide the best quality of living). As I write that statement I realize “quality” doesn’t always enter into the equation even though I want it to. Thank you for sharing your unusual situation. My thoughts for you are that you will find joy, peace of mind and fulfillment while living with your physical challenge. Blessings! Barbara

Barbara - March 25 2019

Hi Lisa, The Final Act of Living is a book with the information I give in workshops and in the DVDs. I did the book for the very reason you are asking. We learn in different ways, hearing or seeing to name just two. I am like you I learn more from reading. I hope you find the book helpful. Blessings! Barbara

Keef y - March 25 2019

I have been on morphine every day for 15 years. At one point I was prescribed over 300mgs to be taken evenly twice every day. The pain clinic consultant was appalled at my GP for exceeding the recommended per day dosage set down by the medical body that controls opiates in the UK. The maximum dosage is a maximum of 200mgs per day. Since then I have reduced down to 120mgs per day, the pain is more noticeable.
I was hospitalised in May 2017 for10 days due to chest pains. I was mortified when a doctor (with NO bedside manner) told me I had non -alcoholic liver cirrhosis, fungal infection in my lungs as well as enlarged lymph glands and a couple more hypertensions
So far, since then ( now we are in March 2019 ) there has been no response to any medication. I believe that long term, taking morphine and other ‘toxic’ medication does without doubt does injure my body.

Lisa Covell - March 25 2019

Is there any of your books I could read instead of listening to DVD? I’m hard if hearing and I don’t understand words on TV.

Lisa Shimkus - March 11 2019

I’m so grateful to have found this site. My 96 year old Dad passed away 5 weeks ago after a 9-month battle with advanced prostate cancer. I was with him while my sister (who he lived with was on vacation). He declined so rapidly that I’m feeling as though something I did caused it. From the day I got there he seemed to get progressively worse each day. He went from walking a few steps to complete bed rest within days. He suddenly stopped eating and by the 7th day he was so agitated and uncomfortable that hospice decided we should increase his morphine dosage. Two days later he was gone. My sister made it home hours before he passed. It all happened so fast that we barely had time to comprehend what was happening, we all thought he had months left. I’m grateful that his suffering ended quickly but I still feel responsiblilty because it happened on my watch. I’m very glad I was there to say goodbye but the grief is overwhelming.

Barbara - February 10 2019

Hi Brittany, from your description of your grandmother’s illness her body had entered the dying process. Her body was shutting down, unable to combat the disease that she had lived with for so many years. It sounds like she was given morphine to ease her transition from this world to the next. Not knowing your grandmother’s medical history I cannot say if the morphine was appropriate or not. What I can say is it did not kill her. She was dying whether she had morphine or not and she was dying now, not later. I know that may sound harsh but at the point she was given the morphine her circulation was not able to work in the normal way, plus it was her blood that was not healthy which makes circulation and distribution of the medicine less timely and effective. For your question would she have still been alert if she hadn’t been given the morphine before she died? Dying is not like it is in the movies— we say something important and then take our last breath. In the hours to even days before death a person is generally non responsive (non responsive to their environment). They may be talking, even moving about, but not making sense and movements are aimless. They are not alert as we think of alert. That is how people die and from what you have told me your grandmother died well. Nothing bad or pathological was happening. She died the way people die and she did it well. It is very sad when someone we love dies but from what you have described her death was not bad. It was relatively quick without a great deal of suffering. Having someone we love die is devastating, a loss we have to learn to live with. Let go of how she died, it was not pathological, and savor the time you had with her. We have limited control over the time that we die. Your grandmother died with only you there. That was her gift to you. She choose to have you there to support her as she left. She could have died when you left the room. What trust she had in you. You might write her a letter. Put all of your thoughts and feelings about her and your relationship on paper—the good and the challenging— and then burn the letter and throw the ashes to the wind. My blessings are with you. Barbara

Brittany - February 10 2019

My grandmother had lupus for 20+ yrs. Her platelets and redblood cells got very low and ten blood transfusions and plasmapheris did nothing. They said she had a blood infection and her body was basically killing the red blood cells. In a few weeks she could no longer walk on her own or use her hands. Her final day they gave her morphine and took off her oxygen mask. Before the morphine she was alert and talking to us but after she was completely checked out and then unresponsive. Would she have stayed alert without the morphine? Would she have still be alive? I was the only one in the room with her when she took her last breath and my heart breaks over wether we made the right decision. She passed yesterday morning.

Barbara - January 12 2019

Hi Robin, I am so sorry to hear of the experience you had with your father’s last weeks of life. I do not have enough information to comment on your father’s illness, its relationship with morphine, and how it lead to his death. What I can say is when a person is in their 80’s and above, any physical condition and the resulting set backs can lead to death. Non life threatening situations in a 60 or 70 year old can quickly become life threatening and end in death with an 80 or 90 year old. The older the body the less resilience it seems to have in healing. Blessings! Barbara

Robin Doak - January 12 2019

My dad passed away recently from “end stage” dementia while at my home on hospice. Prior to his hospitalization, he was living at an ALF in memory care, eating a regular diet, no oxygen, high energy, walking at moderate cognitive level on November 6. He was 83.

On the afternoon of November 6, he was taken to the ER for a-fib rvr. From that point on, my dad never walked again or stood without assistance, and demonstrated extrapyramidal effects while in the hospital for 2 1/2 weeks. My dad declined so fast at the hands of the doctors as they never addressed the extrapyramidal effects despite my repeated reports of new symptoms; I was dismissed and ignored. His decline forced me to change him from full code to DNR.

On hospice at my home, he improved, sat up edge of bed, wanted to stand, fed himself at times, and talked to me. He had some difficult nights and the hospice nurse convinced me he was in pain and ordered morphine which he was given in very low doses. He was also provided anti-psychotic medications, and developed a severe UTI with antibiotic ordered.

My dad declined which I thought was from the UTI, knowing that can cause severe confusion. He was unable to swallow within days of receiving the morphine, resulting in no food or water. Due to other meds, I didn’t connect the symptoms to morphine.

My dad had been improving, and I actually saw an opportunity for my dad to graduate from hospice. My dad was gone 31 days after entering the hospital, and after 9 days on morphine. He most likely lived longer due to the minimal dosages I gave him, but I never understood how he declined to being bedridden in a week. I’ve always felt I missed something, and now I know! It wasn’t his time, even hospice was surprised how strong willed and physically fit he was despite his a-fib and dementia. If it weren’t for dementia, he’d lived to be 100 I’m sure.

I miss him terribly, and I regret not reading more on morphine and its effects, as I believe he would still be here!

Barbara - January 03 2019

Hi Kim, would you have had more time with your father had you not given him the Morphine and Ativan that hospice had prescribed for him? I don’t know. I don’t have enough medical information to make any kind of assessment. What I can say is your father was on Hospice which tells me his physician believed he had a limited time to live and in prescribing Morphine for air hunger and Ativan for restlessness they were looking to keep him as comfortable as possible during the labor to leave his body. No matter the use of either drug it is not to shorten life but to make it more comfortable—-which is the goal of all hospice workers. “What if I hadn’t given it to him?” He still would have died. Maybe it would have taken him longer (days, weeks) but during that time he would have withdrawn more and more, gone within, slept more. become confused, possibly agitated. We all experience the labor of dying. Some of us can do it more quickly than others. Have you read my booklet Gone From My Sight? It will give you an understanding of the dying process. My guess is you will find your father’s journey in the booklet. You may find some comfort there. My wish for you is to find comfort in the love and relationship you had with your father through out his life. The memory of his last days is a burden you don’t need to carry any longer. Blessings! Barbara

Barbara - January 03 2019

Hi Cynthia, from what I gather you are concerned that your sister died quickly after being given Morphine. You were not told that death was near so it was unexpected. Why was she breathing “very fast”? In the hours to minutes before death the body is in “labor”. Nothing works right. Breathing is generally fast and difficult, often with congestion. Then, as death gets even closer, the breath slows down to often 6 or 8 times a minutes. Just think of a little chick working to get out of it’s shell. We work to get out of our bodies. Did the morphine affect the time of her death? No, I do not believe it did. How do I know for sure? Your sister was given the morphine at 8:00 and at 8:05 her breathing slowed and then stopped at 8:09. A person with a normal functioning body, when given medicine by mouth or rectum, must wait 30 to 45 minutes for the medicine to take effect, to get into the blood stream and begin working. When the body is shutting down the circulation of the blood is slowed down (that is why the hands, feet, arms and legs are bluish colored and cold) and will not get the medicine throughout the body in a timely manner. Even if the morphine was given as an injection it did not have time to make her die. She was working to release from her body, probably all day if not several days, and succeeded at 8:09. I am sorry the nurses did not perceive what was occurring and give you the opportunity to say goodbye. Have you read my booklet Gone From My Sight? I think it will give you an understanding of what occurred as your sister was dying. Two years is a long time to carry this concern with you. I hope you have found some understanding in my response and are now able to put this to rest. Hold on to the good memories with your sister, let go of the rest. From what you have told me nothing bad happened that day, sad, very sad that your sister died but nothing pathological or bad happened. Blessings! Barbara

Barbara - January 03 2019

Dear Tilly, This poor gentleman! My concern is that he has dementia and mental health issues so why is the medical team working with him not bypassing his medical wishes and giving him the appropriate care he needs. Does he have a designated medical spokes person (here in the US is called a Medical Durable Power of Attorney). You are right if he continues on this path of limited medical attention he will become septic and die. Your challenge is to give him the best possible care within the limits everyone has put on you. My thoughts and blessings are with both of you. Barbara

Kim - January 03 2019

My dad passed away in February from congestive heart failure. He was on hospice care in my home. I’ve been going over and over his last days of life and thinking that I may have caused his death by giving him morphine and Ativan. I administered all of his medication. It was almost like as soon as we called in hospice and started the morphine and Ativan he began dying. He stopped communicating after 2-3 days on hospice care and died 2 days after. I was told the morphine was for “air hunger” and the Ativan was for agitation. What if I hadn’t given it to him? Would I have had more time with him? I am heartbroken still and it’s 11 months later.

cynthia shipley - January 03 2019

My sister battled Lupus for most of her adult life. She died two years ago. Something keeps nagging me since then. On the day she died, I arrived at the nursing home (in a hospital) at 9:30 AM she was breathing very fast. She wasn’t breathing that way when I went home the evening before at 10:30 PM. She was not responsive and hadn’t been for days. She was on Ativan and Morphine. Her husband is a respiratory therapist. It was strange that he was there as he never came until 8:00 PM, stayed 15 minutes and left every day. I asked why she was breathing so fast and he offered no answer. I thought morphine was supposed to slow a person’s breathing. She continued to breath at a fast rate of speed until 8 PM. At that time they gave her more morphine and at 8:05 PM her breathing slowed to normal. She stopped breathing a 8:09 PM. The nurses gave me very little information whenever I talked to them, although I was her health care provider. I asked that they let me know when she was near death. I wanted to be with her as much as I could. I babysat my two grandchildren and tried to split my time between my sister and my grandchildren. I had to beg her husband to visit her. That was when she was still lucid. She agreed to change her health care provider to me. I found out later that he had been having an affair. He knew all the nurses. They never told me anything as to how close she might be to death. I can’t understand why she was breathing so fast. Can you shed any light on this?

Tilly - January 03 2019

Ive been currently looking after a patient for 7 yrs with dementia, and sicotic mental health, he recently got an auto immune disorder, his body is full of sores which are infected as the dressings are green, i am a carer and have been for 30yrs, hes in a lot of pain so is now on oramorph every 4 hrs, the wounds and the smell is erendous but won’t give him any antibiotics after finding 2 bugs from his sores, he refuses for anyone to go near him to change i know he isnt gonna come out from this as i know he will end up with sepsis which will kill him, its heartbreaking seeing him like this

Barbara - November 28 2018

Oh Laura, I am so sorry you had such a stressful time with your mother’s passing. It is so difficult to watch someone die, particularly when you don’t know what to do. From what you have told me you did a wonderful job of caring for and being with your mom during her dying days. What you have described, although scary to watch, is how people die. Your mom actually did a good job of getting out of her body. Just think of a little chick working to get out of it’s shell, that is what your mom was doing, working to get out of her body. And it takes work—some more than others. It sounds like all the medicines she was receiving allowed her to relax and make the work of releasing a bit easier. Laura, know that despite appearances your mother could hear you and knew you were with her, supporting her during her final act of living. My blessings are with you, your family, and your blessed new baby. Barbara

Sad Daughter - November 28 2018

Hello. My mom had stage 4 metastatic breast cancer that was all over. Her bones, lungs, lymph nodes, breast, and liver. She was amazing and lived all on her own in the 8 days before she passed, with a weekly visit from hospice and daily visits from me and my newborn. It was so hard. She suddenly couldn’t breathe well and went to the hospital, and just seemed to go into a coma. It was so strange. She was in and out of it. She woke up having stomach pain (the liver tumor) and they told her it was time to go home to hospice. When we moved her she wasn’t even coherent. She got to her final home and it was 7 days until she passed. She only woke once and was very agitated and uncomfortable, she was very very VERY thin and her bottom had a bone pressing on the bed so she needed to be moved. I kept moving her but no position helped. Finally I crushed up her xanax bc she had taken that so long and hadn’t had it, and used a syringe to put it in her mouth. She calmed down and fell back asleep and never came to again after that. She was also on morphine through all this, a full syringe every hour. She seemed like she was in a coma, she was also getting Ativan after that every 2 hours. It was sooo much medicine for her tiny 85lb body, plus she hadn’t eaten in like 5 days. Her eyes were open. She just seemed gone. I sat by her the whole 7 days while my husband and his family cared for our newborn son and daughter (we were all in the same house.) but, I could never tell after that last dose of her Xanax if she could hear me. I hated that she had woken so uncomfortable and that was her and my last memory. I had moved her 15 times and was crying telling her I didn’t know what to do to help anymore, bc she was never comfortable. And then she went back into her “coma” state with her eyes open for like 4 days and passed. How can she have heard me with all the pain and anxiety medicine? Was she in pain since her body maybe couldn’t even process the meds she was receiving?

Barbara - October 24 2018

Hi Sylvia, If your husband is not in physical pain but having difficulty breathing a small amount of morphine may, operative word may, make breathing easier. The Ativan can help with the agitation. What you described tells me he is in the “labor” of dying. I think he is doing what his body is supposed to be doing as he approaches death. Have you read my booklet “Gone From My Sight”? It will describe the signs of approaching death that are normal and natural. Agitation and seeing people that aren’t there is part of what happens in the weeks before death from disease. If I can be of further help use my personal email barbara@bkooks.com. Sylvia, this is a challenging time. Think of the little chick trying to get out of it’s shell. It is hard work and that is what your husband is doing now—working to get out of his body. My thoughts and blessings are with you. Barbara

Sylvia - October 24 2018

My husband is dying of liver chrossis non alcoholic
He was alert but with a lot of agitation and seeing people who were not there
The hospice team said to start him
On mprphine and Ativan
I did for the last couple days but now he is in a state where he doesn’t eat or drink or take his other meds
He had never complained of pain but my question why give drugs if not in pain
He wheezes a lot so they said the morphine will help
So confused

Barbara - October 11 2018

My Dear Jessica, I am so sorry for the loss of your great love. So young, it is hard for us to wrap our mind around such a loss. It seems the morphine gave him the comfort to release from his body. Our body, when it is dying, is like a little chick working to free itself from the shell it has lived in for awhile. It is hard work. Morphine helps us relax with the physical pain eased and we can get out of our shell (when we are ready). I don’t know if you have read Gone From My Sight, my booklet on how people die, but it may be helpful. Also My Friend, I Care, my grief booklet, will be helpful in understanding your grief. You might want to write a letter to your best friend and put everything that is in your heart in the letter. No one needs to see the letter or hear the tears. Then burn the letter and throw the ashes to the wind. Know in your heart your friend will know the letter. My blessings are with you. Barbara

Jessica Brister - October 11 2018

I’m so glad I came across this.For 17 weeks I have been reliving the final days of my best friend and someone I loved with my heart and soul.He was 39 years old and passed from pancreatic cancer in five weeks.Every time he groaned out I couldn’t take it.The nurse told me to let her know and she would help with his discomfort.All these weeks I felt responsible for his death.Maybe I should have let him wake up.Was he trying to talk to me?Did he know what was going on?Questions I have had.I have got to let this go it has been making me sick.The article has shown me that those meds just kept him comfortable to something that was already upon us.I hope this article helps others and we will see over time if it truly helps me. Death is just so final and nobody should have to feel responsible for it.

Ang irons - October 04 2018

Hi my husband died of bladder cancer inJuly and was given morphine towards the end. In a syringe drive, but up until the last breath he was with us He never went into the sleep that we where told to expect. This was because he fought to be with us till the end and up to ten mins before he died he was still asking for thing and death came so quick. He was not in pain thank you to the care of a fantastic hospice

Barbara - September 23 2018

Hi Kim, it is so hard when death comes to someone we love. Being on Hospice and morphine probably did not shorten your mother’s life. My guess is the lung cancer just progressed in those 3 years to the point her body could no longer function. In many cases a small amount of morphine will make breathing easier but eventually nothing will stop the progression of the cancer. My blessings are with you in your grief. Barbara

Kim L. - September 23 2018

My mom had lung cancer for almost 3 years and she was doing pretty good but then she started coughing more and one night she was coughing so bad where she was almost choking so the next day she wanted me to call her doctor to get hospice to come out that same day, I wanted to call my sister to take her to the doctor’s (we don’t have a car) I didn’t want to call hospice because what happened with my dad and plus what I heard about hospice. But she keep on telling me to call so I did it was on the sixteenth and on the thirty first of the same month my mom was gone they gave her morphine and Ativan they show how to do it and I was against it at first especially the morphine but they told me morphine will help her breath better it will open up her lungs. Now my mom is gone and I’m so lost without her.

Linda y Annlot - August 21 2018

This site answered my question of did my administering oral morphine cause my husband’s death. I did the right thing and he died peacefully after weeks of pain.

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