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RE: On death and dying - 8/4/2010 2:44:17 PM

DesFIP

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When my mother was dying, she was not denied liquid. She refused them. Might she have had more time if she had an IV? Possibly. But that was her decision to make.

If an IV with water should be standard, then why not an IV with a sugar solution for energy as well? At what point do you accept that when a patient says to do nothing more, that's exactly what they mean?

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RE: On death and dying - 8/4/2010 2:46:17 PM

ThatDamnedPanda

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quote:

ORIGINAL: lally2

i personally dont see any difference in either of those cases and in a way i find it hard to accept that withdrawing fluids and actively doing nothing is any less proactive than ensuring a patient can comfortably fade out by administering a drug.

its the whole 'actively doing nothing versus actively doing something' - with an end stage patient, no matter what the process, if they are beyond medical help and drugs arent helping, why on earth do we leave them to struggle to the bitter end.

i just think its barbaric to be honest. we dont do it to our animals - in fact we would be accused of being cruel if we did.

I agree. I keep a little insurance policy in a plastic bag in the freezer, just in case that day ever comes for me. 100 milligrams of insurance. I won't say what it is or where I got it, but if the time ever comes that I'm dying of some horrible disease, I don't want to put my fate in the hands of others. I've seen the way people sometimes die when they're in the care of the wrong doctors, and I'm not going out that way.

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RE: On death and dying - 8/4/2010 2:52:37 PM

JstAnotherSub

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quote:

ORIGINAL: DesFIP

When my mother was dying, she was not denied liquid. She refused them. Might she have had more time if she had an IV? Possibly. But that was her decision to make.

If an IV with water should be standard, then why not an IV with a sugar solution for energy as well? At what point do you accept that when a patient says to do nothing more, that's exactly what they mean?

Amen.
I think I would have handled every thing the same way if mom hadn't had a living will, but you never know. The times when I began to feel selfish, and think I wanted her around longer so I could hold a warm hand just a lil bit more, I would remember that carrying out her wishes was what it was about.

< Message edited by JstAnotherSub -- 8/4/2010 2:54:09 PM >

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RE: On death and dying - 8/4/2010 3:08:47 PM

NuevaVida

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My mom and I took care of my Dad through his bone cancer. It was horrendous. He refused hospice and often refused his liquid morphine, despite the pain. He wanted to keep his mind intact.

In his final days, he was in so much pain he coiled up into a ball and was screaming "Make it stop!!!" which will echo throughout my core as long as I live. My mother and I could no longer care for him ourselves - even touching him would make him scream. So we called his doctor to discuss options.

My dad elected to be admitted until hospice was set up, so they could experiment with drug doses to try to alleviate some of that pain. His doctor explained to him and us that he might not come home at this point. We all understood.

Once admitted, I sat with my Dad while his nurse talked to him about morphine doses. He was ready for more morphine. He kept asking her to increase the dose. He asked us to call the family. Everyone came to spend time with him. I was alone with him for awhile, the afternoon before he died. I asked him, "Are you ready to go?" He nodded and said yes, and asked me to take care of my mother. He said he didn't want to die at home because he knew she wouldn't be able to cope with that.

He did not lose his thirst nor was he denied fluids. He could no longer urinate on his own, and his skin had changed color, his breath became awful, and his abdomen became protruded and hard. In short, his organs were shutting down. My brother brought him a milk shake the night before he died. He slurped it down with a smile, and then told the doctor he was ready for his Morphine IV drip. I sat with him while in his "morphine induced coma." At one point he opened his eyes and exclaimed, "It's so peaceful." Then he drifted off. In the morning he was gone.

The doctor explained to us that the morphine relaxed the body so much that the body stopped combating the disease. He was not killed by the morphine. He simply let go at that point. I agree it was the most painless and dignified way for him to die.

Just a year prior, one of my uncles died. He actually requested the morphine drip, stating he knew that would be it for him.

I don't think doctors are out there killing terminal patients. I believe they are providing them a peaceful and painless path to their ultimate and rapidly upcoming death. After witnessing what my Dad went through, I hope someone does the same for me, should I be in such a state. Drug me till I'm gone - that kind of suffering is too much for anyone to bear.

StrangerThan: I am sorry for your losses. I know I was glad for my Dad when he died, as he was no longer in intolerable pain. I hope you can find a way to feel relief for those you lost, that they left this world peacefully.

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RE: On death and dying - 8/4/2010 3:12:21 PM

NuevaVida

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quote:

At what point do you accept that when a patient says to do nothing more, that's exactly what they mean?

Another amen to this.

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RE: On death and dying - 8/4/2010 4:47:25 PM

lally2

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quote:

ORIGINAL: kiwisub12

lally - nothing i have ever seen, or read or been taught said fluids are withheld to hasten death. As a nurse, if the patient wanted something to drink, then a drink is what they got. I have seen however where a doctor won't admit that his patient was dying, and scheduled tests that involved nothing by mouth, but not very often.

I think that nothing by mouth is probably when the patient is unable to swallow, and the nurses are trying to spare them the effort of choking on fluids.

no not to hasten death, but when life support of any kind is considered to be prolonging an otherwise unsustainable life, the patient is unconcious and resuscitation would be offensive. but i have certainly heard of cases where iv's have been removed from the very frail and dying. a discussion was had with relatives and the decision made, but this would have been right towards the end when the patient was unconcious and just lingering on.

i would hate to imagine a person who is compus mentus to be denied fluids, but im not really talking about that stage in the process.

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