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Hospice care
Question from Beverly Stanley on 12/9/2012:

I believe that my father's death was hastened in this last days in a nursing home last year. It has haunted me because I can't get all of the truth about it. My father had dementia, prostate cancer, and congestive heart failure. His dementia caused him to be violent, so he was drugged; even so, he had injured aides, even at age 89 years. He awoke one day and passed out in his room. A nurse determined he was dying, called his doctor, and he told her to start him on morphine and other drugs. These made him incapable of swallowing. He had signed a living will under my sister's guidance (not the Catholic one I provided), who was his power-of-attorney. This one said no extreme measures would be initiated, but that included intravenous. He was given tylenol for a high fever. I was called and went to see him. He was restless and I offered him a water-soaked sponge, which, even in his heavily drugged state, he sucked on frantically. I questioned the diagnosis and not providing fluids, since he couldn't swallow, it was said. I asked to speak to the doctor, but he refused to speak to me. My sister (his former caregiver) became extremely angry and said that giving him intravenous would only prolong his life and giving him fluids would only cause him to drown, which I could not believe. He would die within 3 days this way, she said. My answer was that anyone in his condition, fever and all, who had fluids withheld would die in 3 days and that dehydration would be the actual cause of death, not his heart as the nurse said. With no physician exam, how could they diagnose him and then just let him thirst? It caused a lot of bitter words from her and then my brother. It was the Friday before Christmas. I had accepted that my father would die; I just didn't want his death hastened by artificial means: drugs to make him ineligible for an IV (couldn't swallow) and no fluids resulting in dehydration. Because of the holiday, there was nothing I could do. Dad lived 4 days; he died on Christmas evening. Cause of death was listed as dementia and congestive heart failure. I believe he had pneumonia and he would have died soon, but it was dehydration that caused his death. I talked to the nurses and they said this is how it's done with hospice care: a nurse determines the patient is dying, a "comfort pack" of drugs is given, no IVs are administered, and the patient dies in a few days or less. The nursing home personnel get very upset if the family finds a way to have IVs administered (no living will) and resent that the patient lives for several days instead. The American Medical Association has determined that intravenous is considering extreme in the dying. I believe this is another form of euthanasia and needs to be brought to light. My sister bought the lie and would not budge from her position as his guardian. I felt so helpless and have prayed that God will forgive me for not doing more. Maybe I can help someone else. There must be others like me. Can you help me find a way to help?

Answer by Judie Brown on 12/10/2012:

Dear Beverly

Your experience and the pain you have been feeling is not singular to you alone. There are many people who feel helpless because of the actions of other family members when a loved one is near death and is in a hospice that has a philosophy that is not supportive of life. The acute heartache you are feeling may continue because in your heart you know what was right and that what happened in reality was not right. I would agree with you that not enough was done to ascertain your father's exact condition.

Further, as you know hydration is not going to cure or treat a disease but it will and does keep a patient comfortable.

I suggest to you that you first review the Nursing Home and Hospice Checklist that we published. This is the sort of information that everyone needs to have before a crisis occurs as it did in your life with your father.

I believe you can use your own experience to guide others away from care facilities that are not supportive of life. If logic and common sense had been used in your father's case he probably would have died on Christmas Eve anyway but not from being starved to death. And that is the tragedy of it all.

You are in my prayers.

Judie Brown


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