BREAKING NEWS: Care homes in the UK caught using death penalty drugs, was this to artificially bump the COVID numbers up?
(thedailybeagle.substack.com)
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First of all, you can refuse any medication you wish to refuse in hospice, although COVID patients were not afforded this basic right in hospitals. Second, any and all meds damage the kidneys and liver to some extent. Third, most patients in hospice don't die from medication-induced kidney failure. The normal stages of death are a process of shutting down the body. The extremities are the first to go - feet, hands, legs, arms - you can see the mottling process as the body shuts down support. The next to go are the reproductive and digestive organs, including the intestines, kidneys, liver, pancreas, stomach, etc. This is why patients start refusing food and water, and they start sleeping more. Their bodies stop processing food and water to preserve resources for the heart, lungs, and brain. For non-cancer patients, morphine helps with the pain, anxiety, and shortness of breath with the last stages as the heart, lungs, and finally the brain shut down. For cancer patients, morphine helps to relieve severe and intractable cancer pain. It is administered orally, and the family and the patient are in charge of administration. They can refuse it at any time.
I agree with everything you said and you really have made a great statement concerning the process of death, which I have witnessed several times. I think we were questioning whether morphine could be given in high enough doses to speed up death as opposed to being therapeutic to ease the pain and anxiety during the transition from life to death. But this is really a great comment on the process. My daughter has worked hospice for over 10 years and we have had many good discussions on the process of death and medications used...
My hardest was the death of my beautiful 39 year old sister who died of breast cancer in '92. She looked like the worst concentration camp inmate you could ever imagine...that was hard.
I have seen at least 10 births and I have to say those are usually more joyous occasions. God bless you...have a great day...
Yes, sorry, I meant to address the part about accelerating death and ended up on a tangent. Of course it is possible to overdose and hasten death using morphine, but legitimate practice "should" prevent that. In hospitals or facilities, controlled substances are tightly controlled. The doctor has to order it properly, the pharmacy has to deliver it to the locked cabinet, nurses need to scan it to verify the correct order, administer it, and account for anything they remove from the locked cabinet. Every stage in the process has to verify that the order is correct and the medication/dose/route being given is correct. Nurses are the last line of defense for patient protection from medication errors and they are the ones usually held responsible for them, so they are expected to refuse to administer questionable medication orders. I haven't worked in a facility in several years, so maybe some of that was changed during COVID, and it's also possible that medication dosing guidelines may have been changed amidst the other shenanigans.
Well, my daughter maintains that hospice is much better equipped to deal with dying patients and she is probably right. I just know that there is some leeway on how much morphine a patient gets according to their need. That may be the variable. It is hard to ascertain exactly what the hospitals and nursing homes were doing because the monetary incentives associated with dying with covid seemed to override ethics. I feel like the entire medical system has collapsed to a certain degree...at least any integrity is gone. But hey, that is just me...I told my husband to take me out back and shoot me instead of ever putting me in a nursing home...haha. He is a general contractor and does a lot of work for Pruitt nursing homes in Georgia and to tell you the truth...I wasn't kidding...
My father passed in Nov finally of dementia but also heart disease. He was 85. His death for me was very hard to witness.. but he was dying, and couldn't eat or take fluids at the very end. I allowed him to have some morphine at the very end - he was already mottling and hospice really was kind and helped.
My poor Dad had violent outbursts in his last month. He broke down a door. He pushed a patient out of their bed and destroyed his room. We ultimately had to relent to some psych meds just to keep him contained. I really didn't want him on meds but sometimes you just have to use them. It's all about balance, and using drugs wisely.
It was awful to see him like that...and he too got so thin towards the very end. But I researched the dying process and learned about everything you mentioned above. About a week or so before he died, you couldn't get him to eat or even really take fluids - he'd push it away. I learned that if we forced liquids on him he'd aspirate and suffer more. I guess it's about understanding when someone is "actively dying" vs. not - and that was all new to me. I had to learn about this as it's not something most of us even know about!
I was very grateful for the hospice team - they were incredibly kind and helpful. Thanks for your comment too - it's good for people to know the difference between actively dying and a person who isn't dying.
Thank you. I reserve commenting on the deaths in facilities during COVID, because I've been told there were financial incentives for COVID deaths, and although I hate to think that medical personnel would actively kill someone, I can't say it wasn't done. I found the refusal to allow families to be present and advocate for patients was reprehensible. I was a hospice nurse for several years and found that there are a lot of people who truly believe that hospice nurses are running around killing people with unecessary overdoses of morphine. While I understand that those people may have reasons to believe that, I try to educate people on what in-home hospice care really is.
I don't think it is hospice nurses they think badly of...it is hospital nurses...