It was probably decided when Hospice was arranged by your father and/or your mother if she was his Healthcare Power of Attorney. Your parents may have been protecting you from this. You think?

If he specified to NOT withhold food and water, these doctors made a grave decision to do so. I know with my dad, we hydrated even though he was sedated. This was the choice of our family...which includes two brothers that are doctors.
Look, bottom line is, your dad went peacefully...and that is great. But if he specified hydration and did not receive it, these doctors that made that call should be called to the carpet.

No, there was no consent. I KNOW my dad would not have liked the idea. My mom told me that the hospice was putting dad on a drug that was "better" than morphine. I asked for the name and wrote it down.

Then my sis was questioning why dad went downhill so quickly - from eating and walking around to ASLEEP.

And the thing is that water was not WITHHELD technically. He just couldn't ask for any.

But I knew that he was NOT getting water. I just thought (at first) that he was going through a natural part of dying. After a couple of days I looked up the drug and figured it out.

Anyway, if he had died a horrible and painful death, I would probably be upset about THAT.

Hydration should have been intravenous if he could not take it orally. That is a huge mistake on their part and again, they need to be called on this. You should request a copy of his medical records BEFORE making any complaints about this.
Hydration is the responsibility of the doctors/nurses and unless a patient specified otherwise, that includes hanging saline.
Adding water to his treatment would not have caused him pain. He did not have to ask for it...his wishes were specified before he lost consciousness.
Frankly Believer I am shocked at the blatant malpractice that occurred if in fact your father never specified withholding fluids.

MEDC -

From reading on the internet, apparently it is not an uncommon practice. The way they get around the euthanasia issue is they say that terminal sedation is used when nothing else works for the pain. And a possible side effect of the sedation is death.

They could have given fluids but then the patient would live a long time unconscious. I just think it is a way to practice euthanasia. A lot of the articles about TS are from the Netherlands, where euthanasia is routine.

Anyway, I think I will talk to the hospice people. I'm still mulling it over, but am really uncomfortable about it.

This is just horrible Believer. I'd be very upset as well.

I am very sorry, Believer. I am also horrified by TS.

My dad died of emphysema, which is very painful. He did have some terrible pain. He did not want heroic measures taken to save his life, but after we talked to the doctor, he was given however much pain medication as he needed and asked for. He was never rendered unconscious. He went into a coma on Friday evening after eating quite a bit for lunch, and died about 5 a.m. on Saturday. He was given IV fluids until his veins shut down, causing the fluids to leak. He died a peaceful death from an extremely painful disease, but did not require terminal sedation. The night before he went into the coma, he held onto pictures of my grandsons, chuckling about "those cute lil' rascals" for the longest time. It was like he was trying to memorize their little faces. TS prevents moments like these!

I think you should turn your sister loose on those doctors!

I am so sorry to hear this, Believer. I would be very uncomfortable too, and angry besides.

Although I'm not a big fan of lawsuits, and consider them a last resort, I agree with Medc that if your dad died of dehydration without specifying that that was what he wanted (unlikely IMO, most people would probably not choose that), then a clear message needs to be sent. Unfortunately some people only understand the language of money, and to get anything across to them, that is what you have to speak.

I agree with Neak and Lady Clueless. WOW.

Dear [[[[[[[Believer]]]]]]]]

I am so sorry learning of your dad passing away and pray you and your family will find comfort in the memories of happy times.

I can only relate that when Aussies aunt died recently she was given a saline solution and pain relief which though it did cause her to go into a coma in the end she was not starved of water. I dont think its accepted here to do otherwise as far as I know.
Maybe its best to find out everything from the medical records and then consider what action if any is required.

I an sorry for your loss

AW

Geez believer, I am so sorry about this. And sorry that such things can happen in our society.

The hospice centers typically do not provide intravenous fluids...and that is usually spelled out somewhere on the consent form (maybe in fine print, but it should be there somewhere).

If you don't mind my asking, what was the sedative that was used?

I have it written down at work. I don't remember now. But in reading about TS, it seems to have started to be used for intractable pain. But that has changed to pain, or existential pain, or agitation.

I'm all in favor of controlling pain, and I'm happy about the medical advances in that area.

I'm just wondering what other factors enter into the picture. The place where dad died was costing us $8,000. a month. He was only there for a few days. In fact, the hospice nurse called to let me know that my dad was only going to last 2 more days, which proved to be very accurate timing.

I just don't know...........

Dilaudid (Hydromorphone) and Fentanyl are commonly used pain meds that are both quite a bit stronger than morphine, and with fewer adverse reactions.

I'm just wondering if perhaps there was some miscommunication between the family and the hospice. A hospice facility (at least the one's I've seen) will typically provide only oral food and fluids - as long as the patient is able to take oral. My grandmother was in hospice for two weeks before she died and did not receive food or fluids after she became unconscious. As the body starts to "shut down", the GI tract doesn't function as well anymore, either. Even for a conscious patient, sometimes as death becomes more imminent the patient will not want food/water - which is a completely natural part of the dying process but hard to understand from the family's perspective. The hospice we were at (one of the best in our part of the state) does not do IV anything, not even pain meds. Everything is given subcutaneous (through the skin).

I would suggest that you try to get the paperwork that was signed upon admission and see if there is any wording in there regarding hydration and nutrition. (You don't have to let your mom or sis know exactly what you're looking for, but it might make you feel a little better if you find that it is explicitly stated and was perhaps overlooked)

Further, I would think if the hospice was charging $8,000/month, it would be in their best financial interest to keep him alive as long as possible, so intentionally killing him would seem counter-productive...

We used hospice for my father (cancer, hospice at home) and my grandmother (alzheimer's, hospice facility) and they died within 6 days of each other...both were completely free to us and were wonderful services. But, I understand how hard it is, especially when everyone is not on board with the course of treatment. I guess because I'm a nurse, I had some understanding of the hospice process beforehand so I knew what to expect; but most lay-people will not...and will have a harder time asking questions during that time because of all the emotions involved.

I was there when he was admitted to hospice and read all the paperwork. And this hospice DOES allow meds to keep the person comfortable. I did understand that dad was dying, and that some pretty horrible things could happen - fluid buildup in lungs, fracture of his spine from the metastatic CA.

The hospice was WONDERFUL, all the nurses, aids, social workers, chaplains. I don't know what we would have done without them.

And maybe it is because I'm NOT in the medical field, I don't know, maybe it is just part of grieving, but it REALLY bothers me.

I'm going to talk to his nurse on Monday.

That's a good idea (to meet with the nurse). Perhaps they can better explain the choices that were made (or not made) in a way that brings you some comfort. I'm attaching a link that you can read through that explains about hydration and nutrition in the hospice setting (and links to many other hospice issues you may want to read about also):

http://www.hospicefoundation.org/endOfLifeInfo/nutrition_hydration.asp

BTW, I wasn't suggesting that hospices didn't provide pain meds to keep patients comfortable. Our hospice did provide pain medication (sub-q), but did not provide anything IV (no IV meds, no IV fluids). They would, however, have done feeding tubes and fluid through feeding tubes, if we had requested it.

I am very sorry about your dad (I do understand, having just gone through this with my dad a year ago - also metastatic cancer), it's never easy, even under the best of circumstances.

Thanks for the link. It was helpful. In fact it is very helpful just talking about it. I could finally eat today.

Feel free to email me if you need to, or if I can help you find any other resources on this or other related topics.

It does help to talk about it. Many hospices also have support groups (if you are willing to do that sort of thing) for the surviving family members...don't be afraid to take advantage of those resources, they can be VERY helpful in guiding you through the grieving process.

(((((((believer)))))))

Did you get to talk to his nurse?

Yes, Cathy. I guess it WAS in the paperwork that my dad signed. I DID read it, but sure don't remember anything like THAT! And I talked in detail to the hospice people before he was admitted so that I understood their beliefs.

I know that no one is ever happy when the patient dies. I'm still mulling everything over. Thanks for asking.