Speeding up my hospice death

[Trainwreck]

It's been awhile since I last posted. The bad, my health is worse. The good, I am now getting hospice care in my home. More bad, my hospice nurse is very religious and against physician assisted suicide.

I'm getting about 12 ounces of Gatorade in per day, and suck on a hard candy occasionally. Stomach won't handle any more than that, and I get frequent bowel obstructions without even eating. I'm 5'4" inches and 78 pounds.

Hospice nurse says weeks, maybe months. But I'm going absolutely crazy because I'm too tired and weak to do anything but lay in bed. Brain is to tired for even mess around on the internet. My mom has to help me get up to go the bathroom, and to take a shower. Hospice thinks we should hire caregivers for when things worsen.

I do not want to be reduced to laying in bed waiting for strangers to change my diapers.

I have liquid morphine and liquid Ativan. If I take it together every night before bed, what are the odds it would kill me? Low, I imagine, but still worth trying? I don't think I could probably take more than 1 Mg Ativan and 10 mg morphine without it getting suspicious.

Any other ideas? I know ceasing to drink would speed things up, but crap, I'm already dieing of hunger and thirst and it's not pleasant. Not sure I can go all out and completely stop.

 

[UpandDownPrincess]

I'm guessing you've already done so, but can't you request another nurse? Even if you don't find one who is terribly helpful, at least he or she would be more in keeping with your values.

How about your MD? Many of them have personal feelings about keeping their patients uncomfortable and might be willing to take a more aggressive stance on your pain. I know that when my sister passed away, vain creature that she was, she hated being bald and clad in a diaper more than anything else about her illness.

Thinking of you.

 

[Jean4]

I'm glad you are back Train.

Talk to your Hospice workers about this. Do you have a DNR in place?

Sending you lots of love and am here if you want to talk.

 

[Trainwreck]

Thank you both! I do have a DNR in place, but the hospice has reiterated over and over how they neither slow death down nor speed it up. I've had 2 nurses besides my regular visit, and they all say the same thing. I'm hoping it's lip service to cover their butts since we are not in a "Death with Dignity" state. They seem very willing to use drugs to keep you comfortable from pain, but I don't think there's much they can do for weakness and utter boredom. The Ativan helps the restlessness some, but my body is stuck in a state of extreme fatigue, yet unable to sleep.

 

[Jean4]

Thank you both! I do have a DNR in place, but the hospice has reiterated over and over how they neither slow death down nor speed it up. I've had 2 nurses besides my regular visit, and they all say the same thing. I'm hoping it's lip service to cover their butts since we are not in a "Death with Dignity" state. They seem very willing to use drugs to keep you comfortable from pain, but I don't think there's much they can do for weakness and utter boredom. The Ativan helps the restlessness some, but my body is stuck in a state of extreme fatigue, yet unable to sleep.

Do they have a religious person? Ask to see him. Tell him you can't take the pain and want things spread up. You may be able to get more info if they will help from them

Are you in the U.S.A.?

 

[UpandDownPrincess]

Thank you both! I do have a DNR in place, but the hospice has reiterated over and over how they neither slow death down nor speed it up. I've had 2 nurses besides my regular visit, and they all say the same thing. I'm hoping it's lip service to cover their butts since we are not in a "Death with Dignity" state. They seem very willing to use drugs to keep you comfortable from pain, but I don't think there's much they can do for weakness and utter boredom. The Ativan helps the restlessness some, but my body is stuck in a state of extreme fatigue, yet unable to sleep.

Oh, that's awful. Some of my meds can send me into a state of sleepy agitation and it's just hell.

It just seems to me that the whole point of hospice to help keep you comfortable, and that you're not.

I'm sorry they're not helping more. Perhaps we need an SS hospice squad...

 

[GoodPersonEffed]

If I were in your position, I would try the method you were considering.

 

[Trainwreck]

If I were in your position, I would try the method you were considering.

Well it certainly won't hurt anything if it fails. I'll just go with 1 mg of liquid lorazepam, 10 mg liquid morphine, and throw in some promethazine (an anti nausea) because that stuff makes me sleep like the dead. And if I wake up tomorrow, I guess I can try again the next night.

Do they have a religious person? Ask to see him. Tell him you can't take the pain and want things spread up. You may be able to get more info if they will help from them

Are you in the U.S.A.?

Yep, USA.

 

[SuicideBoys93]

It's been awhile since I last posted. The bad, my health is worse. The good, I am now getting hospice care in my home. More bad, my hospice nurse is very religious and against physician assisted suicide.

I'm getting about 12 ounces of Gatorade in per day, and suck on a hard candy occasionally. Stomach won't handle any more than that, and I get frequent bowel obstructions without even eating. I'm 5'4" inches and 78 pounds.

Hospice nurse says weeks, maybe months. But I'm going absolutely crazy because I'm too tired and weak to do anything but lay in bed. Brain is to tired for even mess around on the internet. My mom has to help me get up to go the bathroom, and to take a shower. Hospice thinks we should hire caregivers for when things worsen.

I do not want to be reduced to laying in bed waiting for strangers to change my diapers.

I have liquid morphine and liquid Ativan. If I take it together every night before bed, what are the odds it would kill me? Low, I imagine, but still worth trying? I don't think I could probably take more than 1 Mg Ativan and 10 mg morphine without it getting suspicious.

Any other ideas? I know ceasing to drink would speed things up, but crap, I'm already dieing of hunger and thirst and it's not pleasant. Not sure I can go all out and completely stop.

This is exactly why assisted suicide should be a birth right anywhere in the world. I'm sorry you're forced to live in pain. I truly hope you find your peace. I'll keep you in my thoughts.

 

[Trainwreck]

Thank you!

 

[Jean4]

Contact them

Compassion & Choices | End-of-Life Resources

Compassion & Choices improves care, expands options and empowers everyone to chart their end-of-life journey.

compassionandchoices.org

 

[fightingsioux]

[I'm somewhat skeptical, for various reasons, about the veracity of this post--a common occurrence on this forum--but I'm going to proceed as if it was real. If my skepticism is unwarranted, then Trainwreck I sincerely apologize.]

You're being manipulated, illegally manipulated--if not being held hostage--no matter what U.S. state you're in. You should never have allowed yourself to get into this predicament, there are many strategies to avoid it, but it is what it is.

ASAP, now or in the morning, call or email this organization:

Death with Dignity National Center
520 SW 6th Avenue, Suite 1220
Portland, OR 97204

Their phone number is: (503) 228-4415.

Their email contact form can be found here: https://www.deathwithdignity.org/email-us/

You need an attorney--IMMEDIATELY--who's experienced in this field, either locally or in your state. They will help you find one. Don't worry about fees.

If you're actually in the situation you describe but still have the mental competence and wherewithal to write your original post, then you can do something about your situation.

 

[TAW122]

I'm sorry to hear about your plights and I agree that assisted suicide should be a right for everyone as no one deserves to suffer endlessly just because of some arbitrary moral values that society has in place. I know that @UpandDownPrincess has suggested the idea of getting another nurse, but what about having someone have POA (Power of Attorney) over your situation like being able to enforce the DNR (e.g. being able to sue on your behalf if the nurses do not honor it or cause more suffering, going against your wishes)? I don't know all the ins and outs of DNR's and the legal side of things so take it with a grain of salt.

 

[Trainwreck]

[I'm somewhat skeptical, for various reasons, about the veracity of this post--a common occurrence on this forum--but I'm going to proceed as if it was real. If my skepticism is unwarranted, then Trainwreck I sincerely apologize.]

You're being manipulated, illegally manipulated--if not being held hostage--no matter what U.S. state you're in. You should never have allowed yourself to get into this predicament, there are many strategies to avoid it, but it is what it is.

ASAP, now or in the morning, call or email this organization:

Death with Dignity National Center
520 SW 6th Avenue, Suite 1220
Portland, OR 97204

Their phone number is: (503) 228-4415.

Their email contact form can be found here: https://www.deathwithdignity.org/email-us/

You need an attorney--IMMEDIATELY--who's experienced in this field, either locally or in your state. They will help you find one. Don't worry about fees.

If you're actually in the situation you describe but still have the mental competence and wherewithal to write your original post, then you can do something about your situation.

I've been around since last fall, when my initial plan was SN. My bad gut foiled that plan. Of course I would have liked to get N, but too risky. I don't live in a Death with Dignity state, so I'm confused how a lawyer can help me?

Could you please explain how I'm being manipulated? I don't see it, but that doesn't mean anything since my brain is hardly on fullpower these days.

I'm not sure what I can say to make you believe me. My mom went to make arrangements for cremation for me today. My dad is in complete denial and won't acknowledge any of this is happening.

Thank you for the organization a you listed, I will give them a read.!

I'm sorry to hear about your plights and I agree that assisted suicide should be a right for everyone as no one deserves to suffer endlessly just because of some arbitrary moral values that society has in place. I know that @UpandDownPrincess has suggested the idea of getting another nurse, but what about having someone have POA (Power of Attorney) over your situation like being able to enforce the DNR (e.g. being able to sue on your behalf if the nurses do not honor it or cause more suffering, going against your wishes)? I don't know all the ins and outs of DNR's and the legal side of things so take it with a grain of salt.

The hospice honors the DNR, they actually set you up with one if you don't already have one in place. In all likelihood, I'll die when hospice isn't here. At that time, my mom will call hospice and they will send someone to confirm death.

My mom is my power of attorney and I completely trust her to make the decisions I want :-)

 

[Hopeindeath!]

I am so sorry you are suffering like this. I just want you to know that I care.

 

[Deleted member 1496]

Hi Trainwreck,

Hugs. I'm not familiar with hospice protocol, but here are some ideas:

Ask for a different nurse, if you can, one who is not against physician assisted suicide. My medical group is also anti-suicide, but there is one doctor willing to give referrals to a doctor outside of my medical group who is not anti-suicide.

Sometimes fluid & nutrition when you're in hospice is not recommended because if you don't feel like eating or drinking, adding fluids & nutrition causes more pain. But since you're hungry and thirsty, ask your nurse whether they can do IV fluids and/or TPN. From what I understand, TPN (Total Parenteral Nutrition) is like feeding tubes, but it bypasses your gastric system, so your stomach & bowel obstruction problems. However, it may require a PICC line and that may cause more complications, so they might not recommend it. Cost-wise, TPN is about $2K/day, so you might need to know whether insurance covers it.

Also, I've heard of some hospice folks who will look the other way when you do your own cocktail or OD. Hence, asking for a non-pro-life nurse. And maybe make a separate post in this forum with morphine in the subject line and how much you need to OD on it overnight.



For others, correct me if I'm wrong because I would like to know, but I think Trainwreck has it right for his/her state. So far, the way I've found the legal processes to work is:

DNR: limited to not performing measures to extend life (e.g., CPR), comfort care, whether you are transported to a hospital or stay at home. there's nothing in it by itself that covers assisted suicide.

Death with Dignity (assisted suicide): it is a state law that allows for this when you can prove mental competence: California, Colorado, District of Columbia, Hawaii, Maine, Montana (maybe), New Jersey, Oregon, Vermont, and Washington only. In other states, I think legally, the medical team has no options.

Power of Attorney: it's also limited by state law. In a state without the Death with Dignity Law, POA/AHCD allows for starting & stopping of life support, but nothing for death/dying support, except to decide whether you are transported to a hospital. There are some post-death decisions, (e.g., cremation or burial) that they can decide too.

 

[Trainwreck]

Well, my 1 mg Ativan, 10mg morphine, and a dash of phenergan did not work. Didn't figure it would, but due to the phenergan, I slept the whole day (even a small amount does that to me).

Tiredofcoping, IVs and TPN are not usually used in hospice care. If you come Into the program with a picc line or port, they won't pull them, but they won't put them in because it's essentially a life saving measure. The will give antibiotics for something that is not the reason you're in hospice (ie. a urinary tract infection), but otherwise, they just attempt to make you comfortable.

i don't want to rock the boat too much with my hospice, because I'm really quite lucky they took me on. I'm younger than their average patient, my conditions are more chronic than terminal, but due to loosing a large percentage of body weight due to malabsorption, I just barely met their requirements. Now that I'm getting regular bowel obstructions with just Gatorade, I'm really glad to have them (no more spending time in the hospital). I don't wish to pursue aggressive treatment, which is all that's left for me (painful, costly, requires traveling to another state, has less than a 50% chance of working, and in all likely hood, a doctor would not want to operate on me in such a depleted state), so hospice is my best option right now. I might just have to quit drinking. They wont question it, since I keep getting these obstructions, but it's kind of scary and will quickly push me into being fully dependent on a caregiver. I can only hope it doesn't go beyond 2 weeks, and that they'll do a good job keeping me medicated.

 

[FITALL]

i don't want to rock the boat too much with my hospice, because I'm really quite lucky they took me on. I'm younger than their average patient, my conditions are more chronic than terminal, but due to loosing a large percentage of body weight due to malabsorption, I just barely met their requirements. Now that I'm getting regular bowel obstructions with just Gatorade, I'm really glad to have them (no more spending time in the hospital). I can only hope it doesn't go beyond 2 weeks, and that they'll do a good job keeping me medicated.

Sorry for everything you are going through. My mother died of cancer about a year and a half ago. We engaged hospice about a month before she passed and they had just approved round the clock care the day she died. They were absolutely amazing in terms of ensuring my mother's pain was under control and keeping her comfortable. I don't know if they will approach your situation differently (chronic vs terminal) but hopefully they won't. That should mean their only concern is keeping you comfortable. If nothing else, they should keep you medicated and comfortable. I wish you the best.

 

[Deleted member 1496]

Yeah, I totally get not wanting to rock the boat. It's like biting the hand that feeds you.

BTW, for the thirstiness and being able to drink, are you already taking strong constipation meds? Check out https://www.hospicepatients.org/hospic28.html (tl;dr morphine -> constipation -> bowel obstruction -> vomiting).

 

[Trainwreck]

I was, but took me off them because they thought it was too much (senna and colace). Since I'm not taking much morphine yet, it's not yet constipating me. My obstructions are caused by an artery squeezing on the upper part of my intestine. Sometimes liquids slide through okay, sometimes they back up. Thanks for the info though!