Date
October 30 2017
Written By
Barbara Karnes
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Some Think Hospice Kills

Some Think Hospice Kills

Comments

kenneth d marlatt - November 02 2017

I don’t think we could have done this without hospice. although my wife was under their care for over 5 months and my wife slowly lost her grip on life. she had bone cancer and was in extreme pain, although she never complained. hospice was always there for her, giving her loving care. during her struggle with life, she had to have large doses of morphine to control the pain. the nurse said at that stage you were really not overdosing her with drugs as her pain was beyond help and that her body functions were shutting down. I truly believe hospice were like angels sent from heaven preparing my wife for her final journey. my wife was allowed to die at home surrounded by her family. this was only made possible by hospice.

Michael Duffy - November 02 2017

Hi Barbara,
Thanks for the blog post on Hospice Kills. I believe as you stated the reasons for this very common misconception are multifaceted. I feel one of the primary reasons is the ignorance of the medical community specifically the community physicians. We have physicians in the community that believe “Hospice Kills”.
Education is needed across the board and my service is not interested in taking the lead. I have been advocating for outreach education on the full-time basis with our community physicians. No one wants to spend the money. It is so frustrating. Thanks for listening.
Mike

Cathy - November 02 2017

Carole- were you aware of the goals and outcomes of Hospice care for end of life situations? Allowing your loved one to pass on without pain or discomfot, and WITH comfot and dignity are two important premises. Fearfulness, anxiety, agitation & restlessness are all characteristics of end of life behaviors. Was that how you invisioned your loved one passing and moving on? Death is a process which moves through stages. Could it be possible that the Ativan was the means to peacefulness at the end of life for your Mom as opposed to ending her life?

Barbara Karnes - November 02 2017

Hi Donna, thank you for your comments on our blog. You mentioned two people who were admitted to Hospice and died shortly after morphine was given for pain management. I do not have enough medical information to comment on the two individual situations. I will make some general statements.
Hospice is thought of as taking care of people who are dying. Because of that they get referrals of patients when they are actively dying. Families of those patients are generally not aware of how close their loved one is to actually dying. The person dies within days and it is thought to be hospice’s fault.
People are very aware of the opiod problem this country is facing. What most people don’t know is how narcotics are used in end of life care. People think about overdosing because that is where our mind is in relationship to society challenges. It is actually very hard to overdose a person who has a lot of pain. It is the healthy body with no pain that generally dies of an overdose.
When a person is days to hours from death the body is not processing medications normally. Their circulation is slowed which affects the ability of a narcotic to get through the system. The narcotic is not doing its job let alone being enough to kill someone.
It is our lack of understanding, our lack of adequate education in end of life comfort management that leads to families believing morphine killed their loved one.
If hospice is at fault I think it is because there has been a lack of family education.
Blessings! Barbara

Frank Seidel - November 02 2017

Barbara: Thank you for your comments. It is something that will have to be repeated many times more because many people have trouble accepting that death is certain we just don’t know when and how. In my law practice of estate planning so many times my client would say, “if I die” and I would have to gently correct saying, “it’s not if, it’s when”. That correction was necessary to guide their thinking to practical planning as opposed to being unrealistic while under the delusion that death was mere speculation.

Donna - November 01 2017

Hi Barbara,

I would really be interested in reading a blog post you would write on pain management while in hospice. I recently had two male friends in hospice with pain. One a Parkinson’s patient who got a brain bleed from a fall and one from liver cancer, spreading throughout his body. The first died within a week of hospice placement and the second the next day after hospice treatment. Both were given Morphine for their pain. The subject of eventual overdose and amount of dosage was discussed by the women grieving…..

Thank you,

Donna

Sandra G Prater - November 01 2017

I’ve read your blogs since my husband passed away in June, 2017, and appreciate your explaining the dying process and Hospice’s part in comforting the patient as they go through the process. My Dad was cared for by Hospice 5 years ago and I witnessed the role that Hospice played in his final weeks and days. As the weeks went by and Hospice explained his condition, we realized his death was eminent and prepared ourselves for the finality of his life. Then as we watched him gradually and calmly succumb, we knew he was not in pain and it comforted our anxiety. My husband was also cared for by Hospice this year and although there were many feelings to endure in his last months, I felt confident Hospice would help my family through the process. I realized that letting him face his death painlessly after a long period of declining health and pitiful symptoms was the Humane approach to take rather than extending his certain end with unnatural means. Just as you say, Hospice certainly doesn’t kill people but rather allows them to peacefully and comfortably meet a timely and certain appointment.

Barbara Karnes - November 01 2017

Hi Carole, I am sorry to hear you did not have the opportunity to talk with your mother before she died. There are always so many things we wish we would have said after an opportunity is gone. May I suggest that you write her a letter. Write is now even though she is gone. Put in the letter all the things you wanted to say but did not get the chance. After you have written the letter, burn it and toss the ashes to the wind. See your message flying to her. Know some part of her will know the contents of your heart.
Blessings! Barbara

Barbara Karnes - November 01 2017

Hi Pam, thank you for your comment on my blog. I just want to reassure you that giving a doctor prescribed narcotic dosage does not hasten death. It reduces physical pain and can ease labored breathing. There are so many misconceptions about narcotics, and administering an overdose is one of them.
You might want to scroll through some of my other blog posts where I talk about morphine and its use at end of life. One thing to know is if you give a dose of morphine or pain medicine and a few minutes later the person dies it was not the drug. If death is that close the circulation is almost non existent and the drug has not had time to get into the system let alone do anything.
Blessings! Barbara

Barbara Karnes - November 01 2017

Hi Marilyn, I would love for you to use and share my blog posts—any of them, that is why I write them. I appreciate you giving me credit. Certainly put them on your sites.
Thanks for asking. Barbara

Barbara Karnes - November 01 2017

Good Morning William, I read your response to my blog post on “Hospice Kills”. I disagree with your comment that there are “campaigns" promoting dying as “horrific—with under managed symptoms and financial ruin” in order to advocate for physician assisted dying. In fact fewer people than expected have selected the very comprehensive, extensive process of being accepted into the program. Also the drugs are very expensive making actually getting them difficult. I am aware of numbers of hospices that have worked with people who have gotten the approval. The patient and their families need not be alone. Our work is not to judge people in their end of life decisions but to offer support, guidance and comfort.
Blessings! Barbara

Constance Malaambo, RN (retired ED) - November 01 2017

I teach a five hour class on completing “your” Advance Directive in CA. at CSULB. I reference the The Final Act of Living throughout the class; spending time on hospice. It definitely is misunderstood. And thanks to sister (retired RN hospice), I keep a variety of pamphlets on hand.

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