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My mum was eating and drinking on arrival at hospice but was having difficulty swallowing at times. She suffered from swallowing issues for years but I think it had been made worse after being in hospital months and ended up in malnutrition and dyhration. After her stay, she was painfully thin.


So they suggested hospice. I never saw her being fed in hospice. She was wide awake, suffered no dementia or anything else.


I was told to leave the room to move her, and came back in to find her out of it for next day and half. woke up and because she had not had food and water during that time, could no longer swallow, stopped her food and drink so I had to watch her starve to death until she started dying.


I know swallowing issues can be near dying but she had that problem a while. I feel death was bought on by giving her morphine to stop her eating and drinking.


She never refused food and drink until they stopped it.


I have alot of good things to say about hospice, most of staff caring.


But feel her death was bought on quicker


Anyone else had similar experience?

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Swallowing issues are very common with advanced dementia/Alzheimer's and other health issues for elders. Hospice is called in when such issues are present because they can keep the elder comfortable during the entire end of life journey. My mother died last month under hospice care, with advanced dementia, and wasn't eating much, refusing her medications, and may herself have had a swallowing issue towards the end too, as some of her meds had to be ground up & put into applesauce.

You titled this question, "Swallowing & Malnutrition"...........did you consider having a feeding tube/PEG tube inserted so your mom would have been able to get nutrition that way, since swallowing wasn't possible? For me, I would never have opted for such a life-extending measure b/c mom had advanced dementia & other disease processes at play (and a DNR also). So extending her life artificially did not seem to me like a wise idea; what for? So she could continue suffering and having terrible delusions with dementia? No way.

It's tough to lose a parent, no matter what the circumstances are, and you have my deepest condolences over your loss.
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TChamp Mar 2022
You did the right thing. Keeping somebody artificially alive like a vegetable is inhumane and cruel.
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You haven't completed a profile so we don't know how long your mom has been struggling with dysphagia or whether your question is about something imminent or you are just gathering information and planning for the future. AgingCare has several articles that you may find helpful to you

https://www.agingcare.com/topics/257/swallowing/articles

or you might try typing dysphagia into the site search (beside your avatar).

My mom lived on pureed foods and thickened fluids for several years at the end of her life but she was always willing and mostly able to eat when carefully fed, for her it was not inability to eat but rather aspiration pneumonia that caused her death.
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My father couldn't swallow and we were given the option of a feeding tube or hospice. My dad had said he never wanted any invasive action, including a feeding tube. It was a hard decision as he died two days after going into hospice, but I know I honored his wishes.
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Someone who got o the point of being able to swallow, is close to dying . The only alternative is tube-feeding, but that is better done in a nursing home or hospice.
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My mum had swallowing issues for years but may have been made worse from malnutrition /dyhration after being ill in hospital.
She did not refuse food and water in hospice but they stopped her food and water, she was still trying to eat/drink.
We had to watch her starve until she started dying which was awful to watch.
Was told there was nothing they could do to help her swallowing.
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MJ1929 Mar 2022
You could have fed her if you felt she was capable of it, but the hospice folks don't tend to do things that can cause someone to choke to death or develop aspiration pneumonia.

Morphine doesn't "make" someone not eat or drink. Its effects only last a couple of hours (a hospice dose) and serves to make someone more comfortable during the dying process. My mother was on morphine for at least a week before she died, and she was drinking her protein shakes up until the day before she died.
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These can be two different problems.
A person may not be able to swallow thinner fluids and foods. This might be resolved by thickening liquids and pureeing foods.
A person, because of disease progression, may not be able to swallow at all. This happens with dementia and at end of life.
At end of life the body no longer process food for energy and does not need it. Digesting would take energy away from other more "important" functions like keeping the heart beating and the lungs working. Eventually all those process stop.
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Not being able to swallow is the first thing that happens when the body is shutting down. Giving food, at this point, does more harm than good.

If Hospital personnel suggested Hospice then it was thought Mom was dying. That no more could be done for her. If Mom had lost the ability to swallow forcing food and drink may have caused her to aspirate food and that causes Pnemonia.
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Some people with advanced Parkinsons or other neurological disorders (e.g., ALS) have progressive swallowing problems and can get to the point where they can't swallow at all. However, their body isn't necessarily shutting down and they aren't in the last stages before death. The decision then has to be made as to whether the person wants a feeding tube. If so, and there aren't other complications, a person can live comfortably for some time with a feeding tube. Eating or drinking can be very dangerous when people get to this point; I believe the leading cause of death for people with Parkinson's is aspiration pneumonia. Do you have any idea what might have caused your mother's progressive swallowing difficulties?
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I see you changed your post entirely Roses, from what it said originally. My question to you is, why did you not fire hospice if you felt as though they were 'killing' your mother or doing something to 'hasten' her death????

My mother was given morphine (small doses on a regular basis) AND Ativan during the last week of her end-of-life journey, and if that morphine 'ended her life' faster, GOOD. I'm glad. You know why? Because she was dying of heart failure, not of a morphine overdose or b/c hospice said it was time FOR her to die. But b/c her heart was giving out after beating for 95 years. Had my mother been asking for food and drink during this time, I would have INSISTED she get it. She did, in fact, eat a bit and drink some water for the first few days, and nobody said NO YOU CAN'T DO THAT JOANN! I sat with her the entire last week of her life and watched everything that went on! It wasn't the 'morphine' that stopped her from eating/drinking, it was the death process itself that did it! I witnessed this with my father too, same thing, same process, not hospice induced, but entirely disease induced. Had I felt that hospice was doing an injustice to EITHER of my parents, I'd have fired them on the spot. And I also realized something: that hospice STOPS getting paid an exorbitant amount of money from Medicare once the patient dies, so they have NO impetus to hasten their patient's demise. Not to mention, they'd have been put out of business long long ago were they doing such deeds since 'euthanasia' is against the law here.

I know how hard it is to watch a loved one die. I did it twice, and thank God, there are no more parents I have to watch go thru that gruesome process. In both cases, I wanted to blame somebody. I wanted to lash out and I had plenty of anger inside of me, too. I really did. But there was nobody TO blame. What I was thankful for with both of my parents was that their end of life journey was FAST. They didn't linger for weeks or months struggling with rattled breathing or suffering in pain to where I had to keep asking hospice for more & more comfort meds. The speed factor was a huge blessing in BOTH cases for ALL of us. To watch a loved one go thru that process for even longer would have taken an even bigger toll on me, as it would have for you too. When life on earth is over, it's time to HAVE it over and for them to move onto the next phase of their eternal lives. That's my take on things, anyway.
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If hospice was in a Hospital setting, maybe not surprising. Many hospitals may want the patient to pass on so they can have an available room.

I'm sorry about your mom
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Giving a senior with "swallowing issues" food, and even water, is the quickest way on earth to KILL them.
Food that is given to someone with swallow issues can be taken into the airways, thence to the lungs. There it causes a particular type of pnemonia called Aspiration Pneumonia. Because there would likely not be antibiotic treatment that would mean a painful death with a lot of breathing distress.
Hospice is end of life care.
Hospice is there to promote a peaceful end that is pain free and as free of distress as death can be.
Discuss this with your hospice people. They are your resource.
As I said, if you want it QUICK (if full of distress) then feed someone with no swallow reflex.
I am sorry. All of this is not easy I know. But discuss things with Hospice. Even after death they will be open to discussing with you things that are still keeping you up at night.
I am so sorry for your loss. I hope you will remember the love, the good times. Do know that your Hospice will also direct you to grief counseling if you wish to avail yourself. Best of luck.
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