Hospice hastening death by medication withdrawal?

[Rosemary_1706]

My 95 year old Mum was transferred from hospital to hospice on last Tuesday. Nice place, beautiful grounds, good food, peaceful setting for greater London.

There was a mess up with the discharge and mum didn't get given her medications with which the hospital discharged her. Hospice nurse asked me to collect the meds from the hospital and take them to hospice and that I did the following morning. On the Thursday morning two of the doctors and their supervising doctor came in and spoke to me. Mum had had severe constipation, infection and has uterine cancer that was not being treated agressively. So I asked what their treatment plan would be - was the constipation loosened up, how the infection was, had cancer spread - that sort of stuff.

It came as a surprise when the head doctor said " we don't know and we don't care. I stopped all her medications and we just treat for pain relief".

I know mum has wanted to die for many months and I accept that she will. I didn't think that hospice meant that all of the meds would be stopped altogether and so soon, not least since I had been asked by hospice to bring the meds from the hospital - a special journey for me. I wasn't told that mum would have her meds withdrawn - meds for high blood pressure, diabetes, antibiotics, antidepressant. Some of these you're warned not to stop all at once for they have withdrawal side effects.

Again, I am accepting that mum has to die sometime but the meds withdrawal seems to be intentionally hastening that death, and that does disturb me. Does it you?

[bowlingbun]

The same happened when my dad went into the hospice, he was comfortable and passed away peacefully a few days later. Ask to see one of the doctors at the hospice to explain.

[Henrietta]

Hi Rosemary
I think it easier to view it the other way round, these medications have been causing your mum all sorts of pain, discomfort and side effects for far too long which your mum herself knew. She is now in safe hands who can see this and help her to find peace at last. They have taken the lead and made it unecessary for you to take such a decision. This time is never easy- sending you hugs.

[jenny lucas]

Rosemary, was that the hospital docs saying that they've withdrawn all non-pain meds, or the hospice docs?

If it's the hospital docs I'm not in the least surprised alas. A friend of mine was taking her mum 'home to die' (cardio and severe diabetes), and she watched the hospital doc discharge her, striking off all the meds on her list.....the implication was clear.

'She'll be dead soon so why bother'.......

However, once she got her mum home (who was very grateful - with wry amusment she said 'I'm glad you got me out of there - I nearly died!') she actually went on to live for a good few months, bedbound and an invalid, and with hospice at home nursing care, but it gave the family a good 'final time' with her, and she eased from life with her daughter and husband there at her side.

[Rosemary_1706]

Good morning. It was the hospice doctor who took mum off the meds. The hospital discharged her with the meds, including the antibiotics for the infection. Without the antibiotics mum's bound to decline. Very fine line here. I would've far preferred to be told before the hospice stopped all meds rather than being told they'd already done it.

[bowlingbun]

Yes, I agree.
When my dad was admitted to the hospice and settled in his bed, they immediately took mum into a room to explain how they would treat dad.
Unfortunately, I wasn't invited in too, which I regret, as I would have been able to support mum and dad much better had I been included.

[Rosemary_1706]

The first doctor we saw on mum's first afternoon there said they would get to know mum over the first few days or a week, and implied they wouldn't be doing anything drastic. Another doctor phoned me the next day with a few questions. We were planning to meet that afternoon after I'd got the meds from the hospital (as requested by the hospice!) but the doctor wasn't there in the afternoon! The day after was when 3 doctors met with me and the senior one said she'd stopped all meds. This is all very unsettling to me. No reason given except that they only treat symptoms.

At no time did the palliative care nurse in hospital tell us that that was going to happen. The hospital consultant had cited 3 months life expectancy and said hospice was for those with life expectancy of 7 to 10 days. That's quite a difference and different to what I've read and friend's experience about being in hospice for a far longer time.

This sounds over dramatic but I didn't think I was sentencing mum to death by requesting the option of hospice care in hospice versus palliative care at home!

[Rosemary_1706]

Here's an update and I don't know what to make of hospice care.

Mum has been in severe pain and has cried out that she wants to urinate but can't. I was just told that the catheter she's had for coming up to a year was removed. Doctors in the hospital have tried removing the catheter, inserted originally due to blocked bowel, but mum has had urinary retention.

I asked one of the nurses if the hospice had access to mum's medical records and she said no! I guess more of the "we don't know and we don't care' syndrome. I could have told them and indeed I have that both times when it was removed before she's had urinary retention. I'm told it was removed because it was blocked. Well mum is a frequent blocker. It's in her charts. I told the nurse that if it is blocked, remove it and replace with unblocked one. Just because a little urine is passed doesn't mean she doesn't have retention. Nurses say they're acting on doctor's orders.

Why doesn't the hospice have access to mum's previous history. It is beyond me!!

[bowlingbun]

My mum was the same, she got infections so they removed the catheter, but then she couldn't wee. Then they put the catheter back in because she too was crying out with pain (she said it was the worst pain she'd ever been in, and she'd once been in hospital with an unoperated broken leg for six weeks!)! I was told her wee was very thick and prone to blocking the catheter. Demand to see the medical director, if they can't sort her out she's going to have to go to hospital again. How terrible for both of you.

[Pet66]

I do feel for you. The words 'dont care' are appalling. They are supposed to care, in every sense of the word.((( Hugs)))