Hospice

[pnwmom]

68. That sounds awful about the morphine. Seeing her go through that must have been painful.

Last edited Wed Mar 6, 2019, 05:43 AM - Edit history (3)

But you have a misconception about hospice. Although someone may enter hospice who already has a feeding tube, hospice care doesn't include the insertion of a tube, which requires the use of anesthesia and which a confused patient might try to rip out. Once your parents chose hospice, they were choosing a natural death. Inserting a tube to feed someone who has lost the swallowing reflex, and is actively dying, can increase and prolong discomfort.

You're probably right that the hospital's rush to get your mother out may have been at the root of the problems. No one was prepared for what was to come.

https://www.hospicesect.org/hospice-and-palliative-care/feeding-hydration-and-hospice-care

Can someone have a feeding tube under hospice care?

Hospice doesn’t include the placement of feeding tubes, or any other steps taken to prolong life at this stage of care. However, patients who already have a feeding tube in place may benefit from hospice services. We will never ask anyone to remove a feeding tube in order to be eligible for assistance.

Sometimes, very close to the end of life, patients may choose to have feeding tubes removed. This decision can also be made on their behalf by loved ones or medical professionals, as artificial feeding and hydration may no longer be playing a helpful role or may become harmful or painful.

https://americanhospice.org/caregiving/artificial-nutrition-and-hydration-at-the-end-of-life-beneficial-or-harmful/

A nasogastric tube can cause choking and extreme discomfort at placement and afterwards. At the time of insertion, it can be misplaced in the trachea and cause pneumonia. The tube can cause erosions and abrasions, even perforations (holes) in the nasal passages, esophagus and stomach, and can cause acute and chronic bleeding. Aspiration pneumonia is a risk whenever an NG tube is in place. If a person is confused, he/she may need restraints to keep him/her from pulling the tube out. This can cause a whole host of problems, including psychic distress and increased agitation and anxiety, skin breakdown due to immobility, pneumonia due to immobility, and injury from restraints, to name a few.

A gastrostomy tube requires anesthesia during placement and has risks associated with the use of anesthesia. There is also a risk of infection of the abdominal wall and peritonitis (life threatening infection of the abdominal cavity). Gastrointestinal bleeding, blockage of the bowel or perforation of the bowel may occur. Diarrhea from the feeding formula is fairly common. Aspiration pneumonia is also common. If the person requires restraints to keep from pulling the tube out, the same complications listed above can occur.