When a patient can request terminal hospice care ?

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ptich

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I know that a patient who has terminal lack of breath and rejected a ventillator can be placed under a morphine drip in hospice. Is the same true if a patient without gastrostomy has trouble eating ? Are there other conditions when an ALS patient may request to die with dignity ?
 

saska

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Hi, I'm not sure, but I think what you are referring to is palliative sedation, sometimes referred to as terminal sedation. It is a somewhat controversial procedure used when a person is hours or days away from death, and is experiencing unbearable physical or emotional suffering which can only be alleviated by sedating the person to the point of unconsciousness. The procedure is not meant to hasten death, but inasmuch as fluids and nutrition are often withheld, the person dies typically within a few days. My friend was going to undergo palliative sedation, but then decided not to. About 2 months lapsed from the time hospice was willing to start the procedure to the time he died. Best wishes. Sharon
 

saska

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Hi again. I thought I should supplement my reply by saying that morphine was given to Mike throughout his stay at the hospice facility when he requested it. He was on a constant morphine drip during the last couple weeks of his life, but not a large enough dose to render him unconscious. Sharon
 

ptich

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But what an ALS patient can request in his/her Advanced Healthcare Directive ? Could he require to stop feeding, and be put under a terminal sedation, if certain set of body functions is lost (eg, legs and arms and voice) ?
 

saska

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I don't know. That is something that should be discussed, I think, with the hospice social worker. Also, laws might vary from state to state; again, I don't know. Sharon
 

Al

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The laws differ from state to state and province to province. The local Hospice should be able to advise you on this or even your primary care physician as he may be the one authorizing it depending on the circumstances.
AL.
 
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