Morphine in hospice care

An article in Cancer suggests that too little morphine is used in hospice care. As was discussed previously, alleviation of pain and maximizing comfort is paramount in hospice situations. Interestingly, those who were given larger doses of morphine lived longer.

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Jim Grisanzio
I have a lot of experience, unfortunately, dealing with pain, both chronic and acute. I’ve had some surgeries, and I have had my share of morphine, too. It’s amazing stuff. However, I have also experienced pain at levels that even challenged the strength of morphine — it’s a terrifying state that transcends words. And I had these experiences as a young person. So, I don’t understand the faulty logic and immorality of not giving enough morphine in hospice care. I had a family member die of cancer about 20 years ago, writhing in pain because the doctor didn’t want to boost the morphine level too much so as to lead to unconsciousness. My goodness. The patient was 80 and filled with cancer! It’s disheartening to learn that two decades later we have still not figured out the late-stage cancer pain mechanism. This study you point to, though, at least offers some support for more aggressive, more rational pain treatment.
Anonymous
My grandfather is in hospice currently and that is all they do is give him morphine, even when he doesn’t need it. All it is doing is shutting his body down and decreasing his breath rate. They called Saturday to say he would not make it through the night and we went up to stay with him. My mom stayed up there for 24 hours straight to make sure they did not pump him up with morphine when he was not in pain. His kidneys started to function again and his breathing increased. He was alert and oriented and talking. Hospice is not for everyone and neither my family or myself would ever put someone in there again!
susan
My husband died in a hospice. Although I had Medical Power of Attorney, I had to spend nearly one and-a-half hours arguing with a nurse not to snow him out with Lorazipam. (He showed no signs at all of anxiety nor agitation.)
It seemed that all the staff are brainwashed into believing that everyone who is dying is agitated, anguished, tormented, and that all family members are emotional basketcases.
We had no need for the ditzy social workers who wanted to hug us, hold our hands, walk us down the halls. YUCK!!!!
I was a psychtherapist for years, and I have never seen such phony emotional bullshit as I did at this hospice.
The nurse said he was “spiritually distressed” because he wanted his Bible near him.
Where do the hospice people get their screwed-up ideas?
Hospice has created a niche by getting people to believe that everyone who is dying and their family members are wrecks who can’t handle the experience.
As for me – I want to die at home with HOME HEALTH CARE, not hospice!!

Morphine in hospice care

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