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The Myths and Wonders of Morphine Sulfate for Hospice Patients



The most common example of a hospice myth is about the use of morphine. Some report that it caused their loved one's death because they noted that the person died soon after they received a dose. The reality is, that morphine provides symptom relief and when the person is comfortable, they can let go. A person’s spirit does not have an easy time transitioning when the patient is in pain or is agitated having trouble breathing, or dealing with psychological stress

 

Another purpose of this book Demystifying Hospice: The Secrets to Navigating End-of-Life Care, is to dispel myths like that and help the world understand that medications are always given carefully. It is against the law to over-medicate to facilitate a death. All hospice staff take this responsibility very seriously.

 

There is a well-known phenomenon about comfort and dying. Dying is a very difficult process unless the patient is comfortable.


If you have questions about the use of morphine that resulted in a death soon after, please read on, and consider the variability and scope of this issue and what that person you are thinking about may have experienced. 


From my 20 years as a hospice nurse, I can tell you ways this phenomenon was interpreted, understood, explained, justified, and rationalized by family and/or the hospice staff. Here’s a list of many of the possible things that might have happened, between the time the med was given and the time the patient died. You might think of others.

 

They gave the med                       AND THEN               the patient died!

 

What happened in that              IN BETWEEN           period of time?


Pain was relieved

Breathing was no longer labored

Anxiety was reduced

Agitation went away

The person saw a deceased relative welcome them and they realized they didn’t have to be afraid 

They saw a figure central to their religion welcome them and were not afraid

They recognized that they were forgiven for all their transgressions

Their spirit let go of the need to stay alive for someone else

They took the hand of their deceased spouse, child, parent, lover and left with them.

They did a life review of their happy moments

They did a life review of their sad moments, but saw them as just lessons learned

They realized they didn’t have to be afraid of the medicine

They saw a bright white light that so many others have reported and felt at peace

They recognized that all the family members would be fine and that their dying was not going to be a crisis for them

They recognized that the family members have been fantastic about ensuring the quality of their life during the dying process and when they are gone, the family will not have to do that any longer

 

And accepted their desire and ability to let go ……AND THEY DIED!

 

I hope for many, the list above will help reduce their fears about morphine and if and when asked about it, they will feel comfortable sharing some of those ideas.

 

 

As for the Wonderful uses of morphine, many hospice patients think they have an allergy because in a hospital setting, it was used intravenously for a pain episode and they experienced hallucinations, and nausea and were very loopy. The only true allergy to morphine sulfate is anaphylaxis, which is when the throat tightens up and this can be life-threatening. Giving a med by IV allows the body to absorb much more quickly, than when it is given orally.


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