Mary died early Tuesday morning, before I awoke. It was obvious when I went to check on her that she had just died within an hour or so. This means she spent the last 48 hours of her life fighting for breath, her eyes wide with what I and the daughters interpreted as terror. While we are relieved that she died and is no longer suffering as she has for the past several years, I am incensed that we were unable to get help for her in her last hours. We begged for some morphine to help her through. All she had was some Ativan 1 mg cream and I had to beg to increase the dosage on that when it was clear the 3xday was not doing the job. That did nothing, either. But the doctor (her PA, really) refused to allow the morphine because of her diagnosis of dementia, rather than one of cancer or other obviously painful disease.
A few days before Mary died, the Hospice nurse visited, and when I stated that I was upset that we couldn’t get anything stronger than Ativan to help Mary, the nurse said, “If it bothers you, you should find another line of work.” In other words, it’s ok for the patient to suffer, we just have to not let it bother us. I pointed out to her that the issue here is that Mary was suffering, and that I was bothered because I had spent most of my life working with people who were suffering, but at least I was able to do something that might ameliorate it. Now I seemed to be dealing with people who just assumed that it was ok to watch it happen.
What could a swab or two of morphine have hurt? Since when is it a given that all people with dementia die a painless death? I am not brokenhearted by Mary’s death, but I am about the way she had to die.Related