I posted about my dad being in a hospice facility and now I want him out. I requested they STOP giving morphine & Ativan, but they said the doctor won't revoke the order! What can I do?

I am very sorry for your loss, monimom.

Oh, so sorry for your loss.

Oh, Monimom - I’m so sorry for your loss. Know you did the best you could for your father and were a good advocate.

I lost my father seven years ago this
July. I can hardly believe it’s been that long as I still think about him nearly every day.

You must be feeling torn up and raw. Especially after your recent fight to see that your father was cared for properly. Know that with time that feeling morphs into something that becomes easier to live with.

Please try to find comfort in the love you and your father shared.

I tend to quote movies - movies were my escape from a rough childhood and still my break from life’s challenges. Anyhoo...

One of my favorites. It’s from the movie Ghost:

"It’s amazing, Molly. The love inside - you take it with you".
~ Sam Wheat, Ghost

Thank you to you all for your replies and advise sadly my dad passed away yesterday afternoon now I am in the process of trying to facilitate his final arrangements.

This must be just awful for you.

I suppose about the best thing you can get done today is make sure your brother has a good To Do list and all the contact numbers. Is he pretty reliable about keeping in touch with you?

I’m so sorry you are going through this pain. I hope it is resolved soon.

I think CM is referring to the end stage COPD. Not the cancer.

https://www.medicalnewstoday.com/articles/314657.php

Monimom, has anyone shown you the lung imaging and talked you through what it shows?

I understand that it might feel to you that everything has happened so fast it can't possibly be just the disease doing this to him, but though I hate to say it - and obviously I don't know about your father himself - actually yes it could.

It makes my heart sink that yet again bad communication on the medics' side is doing this to a family, but that is what it sounds like. Has anyone talked to you helpfully yet?

Monimom-
Im sorry this is still happening. But it does sound like you’ve made some progress by way of getting your dad transferred to a rehab.

In the mean time - kick up a fuss and keep fussing until you speak to the doctor. As well - fuss until you speak to the head administrator at the hospice. Neither the hospice nor the doctor can force treatment by way of the morphine/Ativan if you have the authority as POA to ask for it to be stopped.

You seem to be knowledgeable regarding the tests and procedures- and their results as they apply to your fathers current condition. So, I’ll assume you are sure your father isn’t in pain or distress. If you’re positive that discontinuing these comfort meds is the right choice - then follow your gut. I think sometimes doctors get use to giving orders and don’t respond well when they’re questioned. But as your fathers POA - that’s your responsibility - asking questions, challenging orders that seem wrong to you - looking after your father and ensuring he is getting the appropriate level of care.

However...

Just be a sure as you possibly can be that your taking this in the direction that is what your father would want - not necessarily what you want and hope for - for him, yourself. Know what I mean? Just because your father is not “actively” dying - which is a specific process with specific symptoms- well, that doesn’t mean he’s not in pain or distressed.

Just be sure, okay? I would think the last thing you’d want is for your father to suffer. I can tell from your posts that you love him very much.

Last thing - I’d call the head of the rehab that your father is transferring to on Friday to give them a heads up that your father may arrive medicated. They might have a great deal of concern if he shows up totally out of it. Ask that he be given a couple of days to clear the morphine/Ativan from his system so they - and you - can get an accurate picture as to his current condition and level of needs.

I truely hope you can get this sorted out. Like I said - it’s obvious how
much your father means to you. I loved my dad so much and miss him every day - so I can understand where you’re coming from - wanting to have him with you - both mentally and physically for as long as possible. But sometimes the hard decisions are the best ones. So just be sure, okay?

Monimon, I can't imagine that you have not been sitting at his bedside 24/7 to ensure that he is not being given these drugs.

They are fighting tooth and nail and you are leaving hoping that they comply.

Flights can be changed and most employers understand situations that require additional time off. I think you are looking at trouble not staying to ensure that no meds are given and that he is transferred. You are putting a lot of faith in people that have proven themselves to not care. Yet you give them more time to administer more drugs before you call the ombudsman, at what point do you step in and put a stop to this bs?

I personally can't imagine that he was transferred to a hospice facility without the family agreeing, that's not how it works. POA has the say so if treatment in hospital is discontinued and no more life sustaining treatment is administered. Something is missing.

If you are his legal POA, everyone legally HAS to abide by your wishes. You can direct/manage his healthcare. Hospice must comply with your wishes but, they may discharge him from care also.

Talk with the hospice doctor in regards to the meds you have concerns about. Ask him/her to order a smaller dose or discontinue altogether. However, IF he appears in pain or is agitated, you may want to restart meds at a smaller dose.

I agree, I don't understand this aggressiveness either. From what you post his oxygen levels are good. I am assuming that normally Dad would be able to tell the nurse when he is in pain or is having trouble breathing. You said, I think, the orders are "as needed". To me that is when the patient requests them.

My dad had an exacerbation he has COPD and and recently and recently diagnosed lung cancer that that he that he wishes to that he wishes to not seek treatment for, when he was hospitalized with this last exacerbation they checked his co2 levels and found them slightly elevated, although his ph was fine, they decided to use bi pap, a hospitals knee jerk reaction to a person wanting air is to increase o2, but in a copd patient that is never the correct answer, because they cant expel 02 properly it then turns to c02 hence the elevated levels, when they repeated his blood gases, his levels were fine, he was stabilized, he has chest xrays and all was found stable.i was told he woulb be getting discharged to a rehab and was in thr process if choosing 3 facilities when suddenly i was informed he could not go to a rehsb that he had no choice but to go to another step down hospital because he would need to use bipap and rehabs dont do that i later learned this was a lie,they the dr he had gave him a med 3x his normal dose and he had a terrible reaction, very psychotic and breathless they discharged him to kindred hospital, where they then gave hin xanax, he was in a coma like state , i requested fluids during this time, he looked near death, although his 02 levels were 93-98 on 02, the i went to see him his 2nd day of kindred to find him stiil out cold but now with a bipap on with the 02 delivery set to 10l with his sats at 100% his normal 02 level is 2.5, when i requested info on this they removed bipap and put cannula on him, it was then that pulmo dr came in and basically said i needed to contact palliative /hospice, they came reviewed everything and dtermined he was eligible to go to hospice facility, bear in mind howat this point im feeling kindred is NOT a good place, i spoke with hospice intake and inquired about the use of morphine and wss told ig would only be used in severe breathing episodes, but they would utilize his duoneb treatment first, this is NOT what they are doing, i am his POA and i feel i have been railroadedinto this , i have been in touch with the rehab facility he was in for 2 months he just got relessed in mid march, they will have a bed for him friday, and he will be transferred, the hospicefacility hes in has told me he is not actively dying(yet), so he would need to transfer, but during this drug induced state hes inhe isnt eating/ drinkingthis 6ft 187 lb man has a healthy appetite always so this is absolutely the morphine/ativan ..... i have told yhem NO MORE, and what i was told was they will try to avoid administering but if he has difficulty breathing they will adminstef, and i asked ehy they cant use his duoneb instead, she said they do, apparently they claim dr. Will nit allow tge meds to be discontinued, and to use only if they have to, mind you that what i was told initially but that didnt happen. I will add, i came here 1200 miles from my home to surprise my dad almist 2 weeks ago, i was only suppposed to be here 6 days, the middle of the night onyhe day i arrived is when his exacerbatiin occured, i am flying home tomorrow, butmy dad will not be transferred until friday, i have a brother who lives here so my dad will have someone here, i am going to see my dad shortly i am praying they did not give anymore meds but if i find they did i will be contacting ombudsman

Monimom I'm so sorry to read what you're going through. Would it be possible for your brother to meet you there when you visit your dad, and for all three of you (your Dad being present, that is) to ask the attending physician to come and explain?

Take deep breaths and look after yourself. I hope you get better answers today. Please keep in touch.

Who put him in hospice? He did it himself? If so, and you are not POA, there is nothing to be done but respect his wishes,

In hospice, a person is not expected to get up and exercise, walk around, engage in long meaningful conversations or even eat or drink.. that can actually be painful.

I'd much rather have seen my dad serene and calm as opposed to sobbing in pain through his last few weeks on earth.

If you are dad's POA, then this should not have happened. Is someone else a POA also? My mother has 2. I don't look forward to the day these two butt heads.

I am just wondering why you feel correct in ordering medication ceased. Patients are put in hospice for a reason. Would you prefer to possibly see or hear him cry out in pain? Perhaps you are correct but if he is removed what will his care be then? Will it be correct for his diagnosis? Is the condition he is suffering from going to be solved in a different setting without medication he may need. People in hospice are not generally energetic. It is common that they may no longer wish to eat. I hope this situation is resolved but I also hope it is solved with the best interests of the patient as difficult as that may be for you to witness.

It would be good to talk to the doctor. It is possible that the reason your father is not in pain is actually because of the medication. At end of life (particularly with cancer), many people receive heavy medication to control pain and as a result are not completely conscious. Just check.

You call the Doctor. And tell him you are requesting Dad not be given the medications.

Where I live, Hospice can be given at the NH. We don't have "Hospice Houses" as such.

You are your dads POA according to another post and since he can’t make decisions for himself at this time, YOU make the decisions for him. Call the Ombudsman immediately and I would also go to whoever the heck is in charge of the facility!

Do you have POA? If so, they cannot disregard your wishes. Every patient has the right to refuse and if you are POA, it would be the same as your dad refusing.
Call your local Area on Aging and ask to speak to the ombudsman. They are there to look after patient rights.