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Good morning Has anyone experienced terminal agitation / restlessness with a loved one in end stage? I think my Mom may be dealing with this complication right now
I've never seen this kind of behavior before, it's almost scary. My mom is pretty immobile and in her bed most of the day just these past two days. It's now 7:23am, and since 3am she's been pulling all her clothes off, pulling on anything she can get her hands on, trying to get out of the hospital bed, calling out for her sisters, her parents (who are both gone), my dad (who is gone), and me. She calls out, please please please, and, oh my god oh my god. And, come and get me, come in here, okay okay okay. I go in and check on her, she's "fine," just keeps calling out. I've been back and forth in there with meds, putting her Depends back on, putting her jammie shirt back on, she absolutely will not keep her jammie bottoms on, and putting on a new bed pad. And I'm 4'11", so it's a little difficult! I cannot BELIEVE she is still awake after the meds I've given her .She's like a bionic woman! She hasn't eaten or drank anything, other than a few sips of water or juice, the past 4 days, and when Hospice doctor came to see her on Thursday she said there were crackles in her lungs, she thinks possibly aspiration, or progression of her pulmonary fibrosis.
I'm going to call our Hospice nurse in a couple of hours, as I just really don't know what to do right now.
Oh, Terry, what an awful night.
Did hospice give you some additional tools besides just morphine to address this? Meds. vary by patient, diagnosis and need; but we had a standing order for as needed Ativan for those times when Dad could not settle.
Being on hospice does not preclude comfort measure consults with a MD. We saw a geriatric psychiatrist many times for medication adjustment for anxiety.
Are you aware that there are inpatient hospice options if symptoms cannot be well addressed at home? It's usually for the final week or days. . .but if Mom's distress and symptoms cannot be addressed well at home, this is an option.
24 hr. hospice specific nurses; often, the medications they have are a little more designed to address symptoms more quickly (because they are under direct assessment of a hospice RN and direction of a hospice Medical Director. )
So, for example, when Dad's secretions go to be too much, they could administer a larger amount of medication to address this subcutaneously, where as at the nursing home it was a smaller dosage administered orally. A 25 foot move to the hospice wing down the hallway greatly impacted what was available to us in care.
I have had a hard time reconciling the decision to allow Hospice to remove him from our home, but in retrospect I realize that he was in the final stage of the disease and there really wasn't any other choice that could have been made. This is a difficult time for you and I am so sorry that you have to see this and live this. Let your Mom know how much she is loved and have the strength to let her go...it is her time.
Many blessings to you,