Hospice

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Sorry you are going through this. Do you mean it is clear that your aunt will not eat or drink on her own again?

Yes she has failed a swallow test and is not permitted liquids or food.

Let me get this straight: she failed a swallow test, so to prevent aspiration they want her to consume nothing by mouth, but it’s OK to starve/dehydrate her to death as long as they pump her full of narcotics.

That’s not “death with dignity.” It’s active killing.

And the idea that a person near the end of life should not get treatment for an infection (which has a palliative effect in addition to being potentially curative) borders on sadistic.

Hospice used to be a good idea when it was in the nature of a social movement. Now it’s a business and a pretty macabre one at that.

Op please please do not listen to this person who clearly does not have medical knowledge of this or how hospice works. It is very normal for people not to eat and drink at the end of life, their body is shutting down and often does not need/want/feel hunger and thirst the way we do.

The relevant post indicated that hydration/nutrition were to be actively denied, not merely skipped by the patient due to lack of interest.

If a person cannot swallow with our asperating, you can not allow the person the choice. And this person has dimentia.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Sorry you are going through this. Do you mean it is clear that your aunt will not eat or drink on her own again?

Yes she has failed a swallow test and is not permitted liquids or food.

Let me get this straight: she failed a swallow test, so to prevent aspiration they want her to consume nothing by mouth, but it’s OK to starve/dehydrate her to death as long as they pump her full of narcotics.

That’s not “death with dignity.” It’s active killing.

And the idea that a person near the end of life should not get treatment for an infection (which has a palliative effect in addition to being potentially curative) borders on sadistic.

Hospice used to be a good idea when it was in the nature of a social movement. Now it’s a business and a pretty macabre one at that.

Op please please do not listen to this person who clearly does not have medical knowledge of this or how hospice works. It is very normal for people not to eat and drink at the end of life, their body is shutting down and often does not need/want/feel hunger and thirst the way we do.

The relevant post indicated that hydration/nutrition were to be actively denied, not merely skipped by the patient due to lack of interest.

Artificial administration of food and water is a specific item in an advanced directive. It is very much something that should indicate in advance that you have no interest in.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Sorry you are going through this. Do you mean it is clear that your aunt will not eat or drink on her own again?

Yes she has failed a swallow test and is not permitted liquids or food.

Let me get this straight: she failed a swallow test, so to prevent aspiration they want her to consume nothing by mouth, but it’s OK to starve/dehydrate her to death as long as they pump her full of narcotics.

That’s not “death with dignity.” It’s active killing.

And the idea that a person near the end of life should not get treatment for an infection (which has a palliative effect in addition to being potentially curative) borders on sadistic.

Hospice used to be a good idea when it was in the nature of a social movement. Now it’s a business and a pretty macabre one at that.

Op please please do not listen to this person who clearly does not have medical knowledge of this or how hospice works. It is very normal for people not to eat and drink at the end of life, their body is shutting down and often does not need/want/feel hunger and thirst the way we do.

The relevant post indicated that hydration/nutrition were to be actively denied, not merely skipped by the patient due to lack of interest.

NP. You obviously haven’t been with a person at this stage of death. This is part of the dying process.

But aside from that, what’s the plan? You force a feeding tube in, and they just wallow in misery since the natural death process will now take longer?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Sorry you are going through this. Do you mean it is clear that your aunt will not eat or drink on her own again?

Yes she has failed a swallow test and is not permitted liquids or food.

Let me get this straight: she failed a swallow test, so to prevent aspiration they want her to consume nothing by mouth, but it’s OK to starve/dehydrate her to death as long as they pump her full of narcotics.

That’s not “death with dignity.” It’s active killing.

And the idea that a person near the end of life should not get treatment for an infection (which has a palliative effect in addition to being potentially curative) borders on sadistic.

Hospice used to be a good idea when it was in the nature of a social movement. Now it’s a business and a pretty macabre one at that.

Op please please do not listen to this person who clearly does not have medical knowledge of this or how hospice works. It is very normal for people not to eat and drink at the end of life, their body is shutting down and often does not need/want/feel hunger and thirst the way we do.

The relevant post indicated that hydration/nutrition were to be actively denied, not merely skipped by the patient due to lack of interest.

Artificial administration of food and water is a specific item in an advanced directive. It is very much something that should indicate in advance that you have no interest in.

+1

Very much like being ventilated.

[Anonymous]

Anonymous wrote:My aunt is about to enter hospice care. Without nutrition or liquids what should we expect? Just a few days I assume? She is being treated for an infection but that will stop as well.

IME, 0-14 days.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Sorry you are going through this. Do you mean it is clear that your aunt will not eat or drink on her own again?

Yes she has failed a swallow test and is not permitted liquids or food.

Let me get this straight: she failed a swallow test, so to prevent aspiration they want her to consume nothing by mouth, but it’s OK to starve/dehydrate her to death as long as they pump her full of narcotics.

That’s not “death with dignity.” It’s active killing.

And the idea that a person near the end of life should not get treatment for an infection (which has a palliative effect in addition to being potentially curative) borders on sadistic.

Hospice used to be a good idea when it was in the nature of a social movement. Now it’s a business and a pretty macabre one at that.

Op please please do not listen to this person who clearly does not have medical knowledge of this or how hospice works. It is very normal for people not to eat and drink at the end of life, their body is shutting down and often does not need/want/feel hunger and thirst the way we do.

The relevant post indicated that hydration/nutrition were to be actively denied, not merely skipped by the patient due to lack of interest.

NP. You obviously haven’t been with a person at this stage of death.This is part of the dying process.

But aside from that, what’s the plan? You force a feeding tube in, and they just wallow in misery since the natural death process will now take longer?

There is a grave risk that in making assumptions about and launching personal attacks against a perfect stranger, one will make a fool of themself.

Like you just did.

Without going into detail, unless you are a medical professional involved in end of life care, it is almost inconceivable that you have more experience in that area than I do.

Feeding tubes are not “forced in.” They are inserted via a relatively minor surgical procedure, after due consideration by the patient or the patient’s surrogate of the risks and benefits involved. People being hydrated don’t “wallow in misery” simply because of that. To the contrary, hydration removes at least the misery-inducing element of dehydration.

In any event, the point is not whether a feeding tube is right for any given person but whether hydration should be denied based solely on a swallow test, when the person is going to die of their underlying illness and the longer term risk associated with possible aspiration is irrelevant.

People are not dogs. They deserve compassionate care to the end of their natural life. That care takes different forms in different cases, but “here’s the drugs, now shut up, hurry up and die because your condition disturbs me” is not properly one of them.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Sorry you are going through this. Do you mean it is clear that your aunt will not eat or drink on her own again?

Yes she has failed a swallow test and is not permitted liquids or food.

Let me get this straight: she failed a swallow test, so to prevent aspiration they want her to consume nothing by mouth, but it’s OK to starve/dehydrate her to death as long as they pump her full of narcotics.

That’s not “death with dignity.” It’s active killing.

And the idea that a person near the end of life should not get treatment for an infection (which has a palliative effect in addition to being potentially curative) borders on sadistic.

Hospice used to be a good idea when it was in the nature of a social movement. Now it’s a business and a pretty macabre one at that.

Part of me wants to just say F U because I’ve worked in hospice for the last 7 years and I cared for my grandmother and a best friend at end of life too and you are basically calling me a sadist who tortured my beloved relatives, friends and clients.

But I recognize that you are just deeply ignorant. If you happen to be blessed with a very long life, the day will come when you stop taking nutrition which is a normal aspect of life for humans (and a great many other species) at end of life. And you will learn by your own experience that when your body is ancient and worn out, it doesn’t hurt to not eat or drink.

You might have the common sense now to know that with fasting being a lifestyle craze and a religious practice for centuries, there is voluminous evidence that fasting doesn’t involve pain, but only minor discomfort which quickly passes. That’s in healthy people. In dying people there is no pain, and no hunger pangs resulting from the cessation of consumption of food and water.

Attacking hospice caregivers is about the lowest of the low for online acting out. Whatever is behind it, I hope you get the help you need.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Sorry you are going through this. Do you mean it is clear that your aunt will not eat or drink on her own again?

Yes she has failed a swallow test and is not permitted liquids or food.

Let me get this straight: she failed a swallow test, so to prevent aspiration they want her to consume nothing by mouth, but it’s OK to starve/dehydrate her to death as long as they pump her full of narcotics.

That’s not “death with dignity.” It’s active killing.

And the idea that a person near the end of life should not get treatment for an infection (which has a palliative effect in addition to being potentially curative) borders on sadistic.

Hospice used to be a good idea when it was in the nature of a social movement. Now it’s a business and a pretty macabre one at that.

Part of me wants to just say F U because I’ve worked in hospice for the last 7 years and I cared for my grandmother and a best friend at end of life too and you are basically calling me a sadist who tortured my beloved relatives, friends and clients.

But I recognize that you are just deeply ignorant. If you happen to be blessed with a very long life, the day will come when you stop taking nutrition which is a normal aspect of life for humans (and a great many other species) at end of life. And you will learn by your own experience that when your body is ancient and worn out, it doesn’t hurt to not eat or drink.

You might have the common sense now to know that with fasting being a lifestyle craze and a religious practice for centuries, there is voluminous evidence that fasting doesn’t involve pain, but only minor discomfort which quickly passes. That’s in healthy people. In dying people there is no pain, and no hunger pangs resulting from the cessation of consumption of food and water.

Attacking hospice caregivers is about the lowest of the low for online acting out. Whatever is behind it, I hope you get the help you need.

There seems to be a reading comprehension problem here. The OP never indicated that the person she cares about decided to stop eating and drinking, lost interest in doing so because of physical and mental deterioration, or slipped into more or less an unconscious state. This is not about “fasting,” and it’s not about the natural process of unhurried death.

OP indicated that the patient in question was set to be deprived of nutrition and hydration she was interested enough in to participate in a (failed) swallow test. That’s something entirely different.

And while the people you’ve cared for may not have seemed to be in pain, I’ve seen enough people gasping for their last breath, burning with fever, and trying to lick their cracked lips to know that your experience is not universal.

You seem incredibly sensitive to the possibility that some of the things you’ve been told or taught were not the best that could have been done. I commend your clear desire to do what’s right, but when having your practices questioned produces such an intense negative reaction it seems awfully defensive.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Sorry you are going through this. Do you mean it is clear that your aunt will not eat or drink on her own again?

Yes she has failed a swallow test and is not permitted liquids or food.

Let me get this straight: she failed a swallow test, so to prevent aspiration they want her to consume nothing by mouth, but it’s OK to starve/dehydrate her to death as long as they pump her full of narcotics.

That’s not “death with dignity.” It’s active killing.

And the idea that a person near the end of life should not get treatment for an infection (which has a palliative effect in addition to being potentially curative) borders on sadistic.

Hospice used to be a good idea when it was in the nature of a social movement. Now it’s a business and a pretty macabre one at that.

Part of me wants to just say F U because I’ve worked in hospice for the last 7 years and I cared for my grandmother and a best friend at end of life too and you are basically calling me a sadist who tortured my beloved relatives, friends and clients.

But I recognize that you are just deeply ignorant. If you happen to be blessed with a very long life, the day will come when you stop taking nutrition which is a normal aspect of life for humans (and a great many other species) at end of life. And you will learn by your own experience that when your body is ancient and worn out, it doesn’t hurt to not eat or drink.

You might have the common sense now to know that with fasting being a lifestyle craze and a religious practice for centuries, there is voluminous evidence that fasting doesn’t involve pain, but only minor discomfort which quickly passes. That’s in healthy people. In dying people there is no pain, and no hunger pangs resulting from the cessation of consumption of food and water.

Attacking hospice caregivers is about the lowest of the low for online acting out. Whatever is behind it, I hope you get the help you need.

There seems to be a reading comprehension problem here. The OP never indicated that the person she cares about decided to stop eating and drinking, lost interest in doing so because of physical and mental deterioration, or slipped into more or less an unconscious state. This is not about “fasting,” and it’s not about the natural process of unhurried death.

OP indicated that the patient in question was set to be deprived of nutrition and hydration she was interested enough in to participate in a (failed) swallow test. That’s something entirely different.

And while the people you’ve cared for may not have seemed to be in pain, I’ve seen enough people gasping for their last breath, burning with fever, and trying to lick their cracked lips to know that your experience is not universal.

You seem incredibly sensitive to the possibility that some of the things you’ve been told or taught were not the best that could have been done. I commend your clear desire to do what’s right, but when having your practices questioned produces such an intense negative reaction it seems awfully defensive.

My mom is dying now. Aren't the gasping and dry mouth par for the course, at least for a cancer death?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Sorry you are going through this. Do you mean it is clear that your aunt will not eat or drink on her own again?

Yes she has failed a swallow test and is not permitted liquids or food.

Let me get this straight: she failed a swallow test, so to prevent aspiration they want her to consume nothing by mouth, but it’s OK to starve/dehydrate her to death as long as they pump her full of narcotics.

That’s not “death with dignity.” It’s active killing.

And the idea that a person near the end of life should not get treatment for an infection (which has a palliative effect in addition to being potentially curative) borders on sadistic.

Hospice used to be a good idea when it was in the nature of a social movement. Now it’s a business and a pretty macabre one at that.

Believe me this is very difficult . The infections (multiple) are not considered curable without surgery which she is not strong enough for. Even beyond the infections she has
a progressive incurable disease and dementia.

I empathize and I understand the difficulty, having been down a similar road. The point about antibiotics is that the bad hospices sometimes withhold them automatically. That is a disservice to the patient. Sometimes even antibiotics that are not going to cure infections can reduce how lousy the infection makes the person feel. That may or may not be the case for your person, but it deserves consideration. Denying even artificial hydration/nutrition in favor of medically induced insensibility is a separate issue. It is one thing for a patient or their surrogate to make a considered decision about this, weighing all the alternatives. It is quite another for a single swallow test to doom a person.

The value of a human life transcends even the individual patient. Too often, the temptation is to put the patient out of “our” misery, not theirs. I’m not suggesting that this is your motive. I do question whether you are getting the best medical and spiritual advice.

Ah, that’s what I thought.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Sorry you are going through this. Do you mean it is clear that your aunt will not eat or drink on her own again?

Yes she has failed a swallow test and is not permitted liquids or food.

Let me get this straight: she failed a swallow test, so to prevent aspiration they want her to consume nothing by mouth, but it’s OK to starve/dehydrate her to death as long as they pump her full of narcotics.

That’s not “death with dignity.” It’s active killing.

And the idea that a person near the end of life should not get treatment for an infection (which has a palliative effect in addition to being potentially curative) borders on sadistic.

Hospice used to be a good idea when it was in the nature of a social movement. Now it’s a business and a pretty macabre one at that.

No, it is allowing natural death.

[Anonymous]

They told me 3-5 days and my mom lasted 5.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Sorry you are going through this. Do you mean it is clear that your aunt will not eat or drink on her own again?

Yes she has failed a swallow test and is not permitted liquids or food.

Let me get this straight: she failed a swallow test, so to prevent aspiration they want her to consume nothing by mouth, but it’s OK to starve/dehydrate her to death as long as they pump her full of narcotics.

That’s not “death with dignity.” It’s active killing.

And the idea that a person near the end of life should not get treatment for an infection (which has a palliative effect in addition to being potentially curative) borders on sadistic.

Hospice used to be a good idea when it was in the nature of a social movement. Now it’s a business and a pretty macabre one at that.

Believe me this is very difficult . The infections (multiple) are not considered curable without surgery which she is not strong enough for. Even beyond the infections she has
a progressive incurable disease and dementia.

I empathize and I understand the difficulty, having been down a similar road. The point about antibiotics is that the bad hospices sometimes withhold them automatically. That is a disservice to the patient. Sometimes even antibiotics that are not going to cure infections can reduce how lousy the infection makes the person feel. That may or may not be the case for your person, but it deserves consideration. Denying even artificial hydration/nutrition in favor of medically induced insensibility is a separate issue. It is one thing for a patient or their surrogate to make a considered decision about this, weighing all the alternatives. It is quite another for a single swallow test to doom a person.

The value of a human life transcends even the individual patient. Too often, the temptation is to put the patient out of “our” misery, not theirs. I’m not suggesting that this is your motive. I do question whether you are getting the best medical and spiritual advice.

Ah, that’s what I thought.

Exactly. Someone has a "pro-life" ax to grind. And the quotes are because this person in all likelihood favors quantity, not quality, of life, and believes it should only be God's will when someone dies. This person probably sees absolutely no inconsistency between their belief in a kind, loving God and their belief that people should not be allowed to choose how and when they want to die, no matter the terrible suffering they're experiencing. This person also probably has selective beliefs about modern medicine and God's will -- i.e., it's God's will to administer antibiotics, never to withhold them. It's God's will to administer morphine to alleviate pain, but God forbid it should be enough to end pain and suffering altogether.

I'm so over your "spiritual" BS. Go preach somewhere else.

[Anonymous]

There's IV nutrition (TPN) and water. Can live on that a very long time if otherwise healthy. My guess is the infection or other issues will cause death soon. Maybe week or 2 if she isn't responsive? I'm not doc though.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Sorry you are going through this. Do you mean it is clear that your aunt will not eat or drink on her own again?

Yes she has failed a swallow test and is not permitted liquids or food.

Let me get this straight: she failed a swallow test, so to prevent aspiration they want her to consume nothing by mouth, but it’s OK to starve/dehydrate her to death as long as they pump her full of narcotics.

That’s not “death with dignity.” It’s active killing.

And the idea that a person near the end of life should not get treatment for an infection (which has a palliative effect in addition to being potentially curative) borders on sadistic.

Hospice used to be a good idea when it was in the nature of a social movement. Now it’s a business and a pretty macabre one at that.

Believe me this is very difficult . The infections (multiple) are not considered curable without surgery which she is not strong enough for. Even beyond the infections she has
a progressive incurable disease and dementia.

I empathize and I understand the difficulty, having been down a similar road. The point about antibiotics is that the bad hospices sometimes withhold them automatically. That is a disservice to the patient. Sometimes even antibiotics that are not going to cure infections can reduce how lousy the infection makes the person feel. That may or may not be the case for your person, but it deserves consideration. Denying even artificial hydration/nutrition in favor of medically induced insensibility is a separate issue. It is one thing for a patient or their surrogate to make a considered decision about this, weighing all the alternatives. It is quite another for a single swallow test to doom a person.

The value of a human life transcends even the individual patient. Too often, the temptation is to put the patient out of “our” misery, not theirs. I’m not suggesting that this is your motive. I do question whether you are getting the best medical and spiritual advice.

Ah, that’s what I thought.

Exactly. Someone has a "pro-life" ax to grind. And the quotes are because this person in all likelihood favors quantity, not quality, of life, and believes it should only be God's will when someone dies. This person probably sees absolutely no inconsistency between their belief in a kind, loving God and their belief that people should not be allowed to choose how and when they want to die, no matter the terrible suffering they're experiencing. This person also probably has selective beliefs about modern medicine and God's will -- i.e., it's God's will to administer antibiotics, never to withhold them. It's God's will to administer morphine to alleviate pain, but God forbid it should be enough to end pain and suffering altogether.

I'm so over your "spiritual" BS. Go preach somewhere else.

There's laws that prohibit assisted death. And nurses are trained on max morphine levels. This isn't optional, like choose own adventure.