Morphine to ease air hunger?

[Augustmoon]

Hi,
This is my first new thread. My dad, aged 78, has ALS. He was diagnosed last summer. He and my mom live far from me- and my siblings, but we maintain regular communication. Specifically- they are 1200 miles away- in the Florida Keys. Fortunately, I own a home in the same community- but, for me- as the community is an over 55- I rent my home out on a regular winter season basis to meet expenses. I hope to spend more time there- some day. For now- my husband and I work, and have 2 girls in college.

I have been lucky enough to take a few weeks at a time for the past 6 months to visit with my Dad- and, sadly, witness his decline. My siblings have also had opportunity to stay in my house. I'm so glad to have the house, and to share it. I'm wondering- if I offer my home to my brothers and sister at this time- is it appropriate to ask for a small payment- in lieu of my getting money from a rental? Thoughts?

My mom told me today, that the Hospice social worker was paying a visit. I urged my parents to contact hospice because resources are scant in the Florida Keys- and I believe hospice is a resource, as opposed to a death call.

What frightens me however- is that the referring physician- my dad's primary care doc for the last 15 years, has prescribed morphine to help my dad with air hunger. My dad has declined feeding tube and tracheotomy. His Diaphragm is very weak- as his hunched over stance was one of the first symptoms of ALS. He now uses a BiPap at night, and a cough assist machine as exercize every day.

So I'm wondering- is it common, or protocol, to prescribe morphine for breathlessness or air hunger?

 

[Nikki J]

I moved this for better visibility
Yes morphine is used for air hunger but it sounds like he is not using bipap full time? Unless there is something else going on I would have thought it would make sense to optimize bipap first. Hospice though sounds like a good idea support for all

Re the house and payment. Much depends on the family dynamics but I would tread very carefully here. Things to think about- if your siblings did not exist would you be renting it more? Or not because you need it yourself? If you are forgoing rental income specifically because of them how much of a strain is it on your finances? How is your financial situation vs theirs? Are you the rich relative? It is not high season now are you asking for last winter or going forward next year? Much can change in 6 months. Think about how you and your siblings have helped or not each other financially. Don't answer any of this here. Just food for thought

 

[nebrhahe53]

Isnt morphine used only in the end stages, since it also shallows out breathing, requiring more morphine until.....

 

[Atsugi]

Augustmoon, I, too, was leery of using morphine, but a doctor explained how it helps the breathing so we used morphine to help my wife breathe during her final months.

As to your rent question: Money between relatives is a bad thing. My advice is to take the loss.

 

[Augustmoon]

Thanks-all, for your kind and quick responses. I think I'll nix the thoughts of asking for payment from relatives. Definitely, I would never forgive myself if someone didn't visit- or thought badly of me for asking. Time is more precious than money.
And morphine for air hunger- I was under the impression that morphine adds to breathing difficulty, but my research and the answers here, lead me to believe it is the appropriate choice for my dad.

 

[affected]

Morphine is indeed commonly used and it helps a lot.

I agree with Nikki, I would think they would also have him on the bipap during the day, but some PALS resist using it enough too.

Morphine will depress breathing, but usually it is given in lower doses and so what happens is that it isn't enough to depress breathing, but it does relax a little and causing breathing to become a little easier.

 

[lgelb]

Moon,
I so miss the Brandywine. We used to walk along the towpath every week.

Perhaps, for the house, you might place a note in the kitchen asking that whoever is there stock up on nonperishable grocery/household items so the next person doesn't have to rush out.

Agree w/ Nikki, definitely suggest to your dad that he use the BiPAP during the day, w/ a nasal mask (Circadiance was our fave) if he uses a full face mask at night. Morphine reduces demand for air, but the PAP creates the air pressure. If he hasn't been using it except at night, he has no idea how much it can mean during the day.

 

[Augustmoon]

Hi Igelby- I took your advise and started my own thread. Live and learn. The Brandywine tow path is not far from my house. I particularly enjoy kayaking from the Brandywine River Museum to Thompson's Bridge. My dad and I enjoyed kayaking together. Now his red kayak rests in my side yard. He also taught me to sail. Last spring I helped him rig his Flying Scott in the waters of the warm Atlantic, and, unknown to me then, we had our last sail.