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Wednesday, March 09, 2011 Z..T., Community Member, asks

Q: If someone is going to be in hospice at home, will hospice give the oral morphine to anyone to administer? Does hospice ask a person who volunteers to be a caregiver if he has a criminal/drug past?

If hospice is supposed to be an advocate for the patient first, shouldn't hospice vet the caregiver before giving him/her morphine to give to the patient? If hospice has no responsibility in making sure the volunteer caregiver is someone who won't abuse the position, how can an elderly, frail patient be protected? I guess I need to know - if hospice doesn't vet the "friend" caregiver, then who protects the patient? Who makes sure the patient is safe? Thank you.
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Answers (5)
Carol Bradley Bursack, Health Guide
8/28/14 7:10am

Hi ZT,

Hospice organizations vary. Some are non-profit and some for-profit. Some are better than others. My experience with our local hospice has been wonderful and I hear the same from others around the country. Still, there are likely some that aren't as careful as others. 

 

If you are worried about a certain volunteer, ask the hospice you are working with how they vet the people who help. If you don't want a certain volunteer to help your loved one, you can likely say so. I would think that most hospice organizations would deny volunteer status to someone with an abuse record, but you can feel free to check.

 

Take care your loved one. You are his or her advocate so you have that right.

Take care of yourself, as well,

Carol

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NC, Community Member
3/ 9/11 9:34pm

Z.T.,

 

I would hire a well-known hospice co. who can comes to the home to set up hospice. This way given the reputation of the hospice, you don't have to worry about the qualification of the caregivers yourself. Normally home health nurse can also  come to the home to give the patient the drugs or pain killer or morphine pad. I think they use the pad or iv morphine. Whoever they send is professional including counselor and social worker... Just like the hospital hospice, everything follows a protocol and the nurses have to ask the doctor's permission for drugs. The family can also have special request such as asking to put back the food iv (sometimes the hospice takes off  the food iv since the patient is dying and does not need food.) The professionals can even show the family members how to take care of the dying person overnight if the professional won't stay overnight.

 

Hope this helps,

NC

 

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Carol Bradley Bursack, Health Guide
3/10/11 8:42am

I agree with Nina - not all hospices are equal. Because of the huge need, there may be some that aren't as good as others. Our hospsice in this area is one I trust totally, but I've heard that some are not as good.

 

Go by your instincts. If you have choices, you may want to try another hospice if you don't feel the volunteer is a safe person. The morphine administration may depend on state law. That's something you could check with your state.

Blessings,

Carol

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anhheyluv1, Community Member
12/20/11 2:04pm

hello,I wanted to add my experience to your question my father-in-law he was sent home with hospice and they did provide him with all different meds including liquid morphine and vomiting meds and all different meds,they call it a comfort pack and he only lasted 1wk and 1/2 and he had COPD for many years and slight dementia and they told us if he seemed the least uncomftable to give him the morphine alot almost as if that was the only thing that would help him,that is like the last resort I didnot know that at first but I do now.I almost wish I would have never gave him that cause he would have been awake more and I would have had more time with him,and then again I understand they didnt want him to suffer.I hope this was useful a bit.

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anhheyluv1, Community Member
12/20/11 2:07pm

I am sorry and they sent our morphine through they mail.but that is a very strong med and it really does knock them out and it does seem to make their passing more peaceful,but  my father-in-law was not a medication type so anything like that was out of the question by him and to see him more less in and out of it it was a shame....

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Carol Bradley Bursack, Health Guide
12/21/11 11:29am

I've never heard of a hospice operating like this, but perhaps you live in an isolated area. The hospice in my community always has a nurse administer morphine or any other drugs. Caregivers don't do that, no do volunteers. I imagine a lot depends on the state where you live and their regulations. In my opinion, qualified people need to administer drugs. If the morphine is the type where the person taking it can press a button and give themselves a dose, that is still regulated by the mechanics of the machine so they can't get too much. Your situation is most unusual.

Carol

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Z..T., Community Member
12/21/11 3:24pm

Thanks everyone for your thoughtful answers.  My dad was alone with his wife and her boyfriend, who is 20 years younger than the wife. The boyfriend was someone with a criminal history, and their affair had been going on for a long time, but my dad did not know. After draining his bank accounts, and forging life insurance policies, etc.,  I believe my dad was then murdered with the morphine that hospice supplied to the wife and boyfriend to administer unsupervised, to my 83 year old dad.  None of my family even knew he was in hospice.  The hospice records reflect that they lied about losing some of the morphine, then lied about finding it again, then the wife said she watered it down, so they gave them 2 prescriptions for morphine on the same day.  My dad was dead the next morning.  The records reflect that of the 90ml total prescribed, 50ml is unaccounted for.

 

This is why I wrote last year. I am still trying to get justice for my dad.

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Carol Bradley Bursack, Health Guide
12/21/11 4:17pm

I hope you get justice. Since your dad's wife was the responsible party, it's possible that hospice supplied the morphine appropropriately. As mentioned, laws vary with states. But the crimial act you looking into is the wife/boyfriend connection. Good luck with your investigation. This is heartbreaking.

Carol

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NC, Community Member
12/22/11 10:39am

ZT,

 

I am sorry it happened that way. The way your Dad died is surely heartbreaking. I think the hospice co. certainly has some legal rules to follow to prevent such abuse. On the other hand, if someone wants to terminate his life, it would require some evidence and proof. This probably needs a court process and it is time consuming and expensive. If you can pursue this easily, it is up to you to do that to get justice. However, if it takes lots of toll on you, you may want to consider moving on. Certainly you won't talk to the wife anymore if this is the case.
This is one reason that I am reluctant to put my FIL under hospice. There is a way to put the patient with severe Alzheimer's under hospice so it offers him comfort care. But this would open the road for abuse if there are some people who want to have this "mercy killing" illegally. Not that I don't like hospice, it is good for terminal patient with pain/cancer. For people with dementia, this is tricky because it is really a slow goodbye.

 

Take care,

NC

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webel, Community Member
2/ 6/12 2:15am

We had no hospice, my 3 sisters took care of our 89 year old mother who was in and out of the hospital with phenomena. She had sever back pain most of her life and severe dementia the last two years of her life. Her back pain allowed her to sleep on her left side only. the last time she was in the hospital the kept her on her back and she was in great pain when she came home. My sisters were so sure of her death that the had the living room looking like a funeral parlor with red velvet drapes sectioning off part of the living room for casket viewing. our mother saw her home in this state. They put her in her bed on her back and the 3 of them administered morphine to her. She was recovering from her bout with phenomena and had been home about one week and went comatose one night and died the next morning. I am sure on an over dose of morphine. My mother had 9 children and this 3 that took care of her got all of her stocks and bonds, savings and checking accounts, My question, is it legal for just any one to give morphine to a patient especially in New Mexico. Or must a trained person ie nurse supposed to give morphine? My condolence to all who has lost a love one in this manner as we do not know how much longer we could have enjoyed our mother.

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D5, Community Member
8/27/14 11:31pm

I read your letter today and I know it's been a few years since your letter was written that i felt a need to write to you. I am sorry for your loss. I hope you have received the justice you were searching for your dad. I also would like to ask you if you have any advise or suggestions you could share. My siblings and I are going thru the same situation. As I was reading your letter I thought for a moment that one of my siblings had written it because it is exactly what is happening in our situation.  My dad recently passed away and we too are trying to get some answers and justice for him. We also believe my dad was murdered with all the medications and the morphine that hospice supplied to his wife. She did not give him water or food while he was taking these meds and when we asked for an autopsy she had him buried in 3 days. I would appreciate any guidance that you can share in helping us.

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Mac, Community Member
5/26/12 5:21pm

I just lost my dad last Sunday, May 20, 2012. My sister came out to California when she  was told that our dad was in the hospital and had fallen. She came out from Oklahoma when I told her we should discuss my dads financial arrangements. At the time he was 89. She came out, moved in with him, was not working, her husband was not working, their son was living with them, not working. And after 6 months they went through everything in my dads garage and had his house sold. All without me knowing about it. 12 hours before she took my dad to live with her in Oklahoma, where her and her husband owned a home, my dad called me and said he wanted to talk to my as his house and been sold and he was moving out there with them. When she moved him out there she told me there were nurses coming to the home and taking care of him. It got to where he couldn't walk or stand. I asked my sister how the nurses were taking care of him and she said there was nothing they could do for him medically he has COPD. She never told me he was in hospice. In fact after my dad died I called the Hospice they said I was not on the list for them to be authorized to answer any of my questions. It wasn't until I talked to my dad on the phone who said he was in the hospital and my sister corrected him and said "No, your in hospice" that I found out. I found out through questioning her he was put on morphine a few months ago, and had been in Hospice since Dec. 21, 2011. She called me on a Friday before he died and said he went unconscious. They stopped giving him his insulin two days before, and meds and he was not fed I.V. and told my sister (according to her) to give him morphine once every two hours now. He looked like a skeleton. When he died that following Sunday she called me to say he had passed away. I always thought since morphine is a drug no one but a nurse could administer it. How do I know if my dad was not overdosed? I called to find out where he was taken and if an autopsy were to be done, because my sister said she did not know. I was told by the medical examiners office that if you are in hospice you do not have to have one and you are taken directly to the funeral home. Called the funeral home and the director got upset with me because I was asking all these questions. I told them I will fax a power of Attorney over to them because I have every right to know and to do nothing without my consent. The director told me he was to be cremated that night, Tuesday. They recieved my POA but said the cremation had already taken place. Pretty quick I thought. Sounds like someone got tired and could have suffocated my dad with a pillow for all I know. And maybe the funeral directors are in it with the hospice. But alot of things were witheld from me and am still in the process of finding things out. If it wasn't for greed or evilness none of this would happen. If there was nothing to hide then I would get straight answers.

 

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Carol Bradley Bursack, Health Guide
5/27/12 8:16am

I'm so sorry. This is a terrible story about greed and control. With my parents, who were both on hospice, all pain meds were given by a nurse and carefully controlled. I would assume that the hospice only gave an approved amount of morphine to the family for administration, but there's no way for them to prevent abuse of the morphine by a family member. All hospices aren't the same, so some may give morphine to families to administer if state law doesn't prohibit it, by many others would not.

Since you had POA, the family should have put you on the list to get information. Obviously they wanted to hide things from you. I wouldn't blame the funeral home. They likely followed directions from the family before they received your POA. You'll always wonder about this sad end. You may want to take advantage of grief counseling to help you cope. My heartfelt condolences. You've suffered a great deal.

Carol

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Concerned, Community Member
12/23/12 3:20am

Hospice NEEDS NATIONAL Standards established and administered . I recently witnessed my wifes sister basically being murdered under the cloak of hospice.

She was only in her early 60s , but had cancer for less than a year. She was clear minded and NOT complaining of pain. 

But her husband was allowed to administer the morphine patches and liquid morphine.  

My wife and I became suspect because of her physical and mental conditions. They were very good , then suddenly over a 3 day period she went

commatose. She was so strong she did not die for almost two weeks of no food and constant doses of morphine.

Her cancer had not attacked any major organs and her vital signs were normal.

But her alertness and health just dwindled away from what seemed like over doses of morphine. When she was wide awake at the end of any dosing period. She would not be complaining of pain at all. But her husnand would insist that  it was time for her meds ???? What the hell , I asked myself. In the last three months we noticed a new woman visiting quite offen that seemed close - to

friendly with my wifes sisters husband.

I beleive that my intuition is correct in that without regulations on who can give these life ending drugs , that a person/pateint unknowinhly gives up thier right to live. And even worse, Can and does open the door for a family member with

motive the ability to legally murder that person.

Again, Hospice programs need National standards and regulation. And only a nurse or doctor should have the possetion and right to administer the drugs.. NEVER NEVER a family member.

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Carol Bradley Bursack, Health Guide
12/24/12 10:46am

Where I live, no one can go on hospice without a doctor determining that he or she is terminal and will die within six months. A doctor is always part of the team, with a nurse on hand, at least by phone, at all times. I've never heard of a situation like yours, but it goes to local regulations. Most hospice organizations are wonderful, but like anything else, there are some that aren't very good. I generally prefer the not-for-profits (though I'm not saying a for-profit can't be good). You may want to look into your state regulations and see what's going on.

Take care,

Carol

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By Z..T., Community Member— Last Modified: 08/28/14, First Published: 03/09/11