My grandmother is dying from alzheimer’s and we were told last night that the end is near and that she can’t swallow food anymore. She chokes.
I asked if they were going to start an IV so she wouldn’t starve and was told that she has a DNR. I mentioned that a DNR is against heroic acts to save her life, not for things to sustain what little life she has left.
I’m not sure how to feel about any of this. They are going to let her starve to death but keep her on morphine so she won’t feel any of it. I know the end is near but it sounds so cruel.
And will she really not feel any of it or will it be that she’s just so drugged up that she will be trapped in her mind screaming in pain and frustration?
But if they were to keep her on an IV would that be just as cruel to let her linger?
This concern, at least, you can lay to rest. Morphine doesn’t do that. If anything, your body is screaming at your mind to snap out of it so you can get some work done, and I don’t think that’s an issue with your grandmother.
With my limited knowledge I think that under the circumstances, the best choice has been made.
I am a physician who cares for terminally ill patients.
I would not want an IV if I were in your grandmother’s situation. I’d take the morphine, though.
I’ve given the orders to give morphine (or similar meds) but not give IV fluids. I believe this helps achieve peaceful ends, which are wished for by so many patients.
Of course, this approach depends on clinical judgement, and family wishes, but it is very consistent with proper and merciful care.
I’m sorry about your grandmother. My mom has Alzheimer’s and I would agree with the decision not to feed through an IV and to use morphine. I’ve been given morphine in the hospital. The pain went away, the panic went away…I felt GOOD. I wish we could have gotten it for my dad when he was dying.
For most people, strong opiates reduce hunger to practically zero (hence the “heroin chic” skeletal look) so while I understand your fears, I think they’re unfounded.
It does sound like the most merciful, best decision is being made here.
I’m sorry for your anguish over this, and am sending virtual hugs and good thoughts your way!
My parents made the same decision for my grandmother, who just decided to stop eating when she got near to the end of her life. I think they figured it was a sign that she wanted to go. She died peacefully not too long after that.
Parenteral or IV feedings, IIRC, are incredibly expensive and hard on the liver and kidneys. It wouldn’t bring comfort to your grandmother, but might instead prolong her death and increase her discomfort. It sounds to me like her doctors are doing a good job.
Concur with all the above as far as it being a merciful way to let your grandmother slip away.
My mother was on morphine her last couple of days. This was, largely, to reduce her struggles to breathe - between the lung cancer, and a case of pneumonia she developed, she was fighting to breathe. Oddly, reducing the struggle to breathe made her breathe more easily. I’ve never had lung cancer but when I’ve had a relatively severe asthma flareup, there’s a bit of panic that sets in which probably sets up a chain reaction (panic, work harder to breathe, can’t breathe as well, panic more…).
She was obviously receiving some IV fluids because of the morphine drip but we never felt she was in any discomfort from hunger; then again, even during her last conscious days she was not really eating.
I’m sure the just let her go on her own thing is the best way but the emotional part of me just worries about the pain and suffering of not eating.
I just don’t want her hurting anymore. And I know that shortly she won’t be.
It’s just the random thoughts that rattle around in your head ya’ know? I don’t know what a dying person is thinking or feeling.
It was hard to watch my grandfather pass. Harder when he could just lay in bed and only open his eyes and hear us but not say anything. It was easier to deal with once he couldn’t open his eyes anymore and finally left us a week later.
His muscles would move or he would make groans and sounds like he was in pain but we never really knew if he was or not.
When his eyes were open you could see there were things he wanted to get across. You could read things in his eyes. Like when my grandmother told me not to get too close to him because I had pnemonia and she didn’t want me making him sick. The look he shot her said a thousand words. I giggled my butt off. It was a look of “I can’t believe you just said that”. My grandparents were amazing people and married forever. It was classic.
It’s just the emotional stuff I need to sort out. I can understand the medical people know what they are doing and making the right choices.
QtM was one I was actually hoping would come in and lay things to rest a bit for me.
Thank you all for helping putting my mind a bit more at ease. Hopefully this will be over soon and my grandmother can pass and be in peace.
Deb is a hospice nurse and she often employs morphine (under doctor’s orders) to ease her patients’ passing. The ones who are conscious echo the words of 3acresandatruck, that the morphine really eliminates the pain. Separate sources of pain such as cancer can reduce morphine’s effectiveness, but it is still a great boon to the patient. Mama Zappa’s comments about breathing are also relevant. In some cases, the morphine will suppress breathing in the end stages to allow the patient to pass on more quickly. This is not euthanasia, but a medical procedure to ease the last days or hours.