How ; in this day and age ,when we euthanize animals with compassion,can we leave an elderly woman in pain and helplessness before death?
I was texted on a Monday that my mother was palliative. I telephoned my brother,who said that mom has a blood clot in her foot and they were going to amputate; a very intelligent 2nd surgeon said; NO.This woman is 82 ; she is living with constant pain, has a blood infection as well as clots.My brother thankfully agreed that she would not want to leave this world piece by piece.
Needless to say I was on my way on a six hour journey to say goodbye to my mother and to be supportive of my brother who had never been exposed to a family members death as I had been.
I arrived to my mother writhing in pain. She was trying to get out of her bed to escape the pain which her body was giving her. I immediately found a nurse and explained that pain management would be a really good thing right about now.
The nurse explained that her pain medications had just come . A perfectly good explanation to me; pain medication was given forthwith. I stayed; wiping mom's brow and talking soothingly, reassuring her that we were all okay and that she had worked so hard in her life and now it was time to rest.
The pain medication was only working for approximately twenty minutes at a time; but she had an order for tranquilizers for every half an hour which the nurses gave her. I stayed until 3:30 a.m. Left to get some sleep after her last shots;feeling that I might have time for approximately 2 hrs sleep.Mom was resting peacefully.
I came back two and a half later to find my mother in complete pain and horrible agitation; all of her clothes were off of her; she had ripped them off because she couldn't stand anything touching her skin. She was screaming and speaking in disjointed sentences. I immediately reassured her that I was there and would go get help. Running down the hall searching for a nurse proved fruitless ; it was shift change. I came back to her room ; tears streaming down my face feeling so helpless. Searching for her call bell proved to be in vain. I searched for any help whatsoever with mom's screams following me down the corridor. Finally finding a PSW (personal service Worker) I implored them to call the nurse that mom was in extreme pain. Five minutes later she came; the PSW and I washed mom and got her into a clean gown and tucked the covers around her . The nurse came and I explained that I should not have to be at mom's side so that I could be sure that she gets her pain meds; I also explained that the pain medications only lasted for 20 min. She said the doctor would be in to see us. My brother came in 5 min. later . I was so thankful that I had gotten there first.I wouldn't have wanted him to see mom the way I found her.
The doctor came to speak with us; I reassured him that even though I was just a PSW that I had seen many people die including my father and my sister and that there was no need for my mother to be in any pain ; that I had explained to my brother what a higher dose of morphine would do ; But, We Wanted MOM OUT Of PAIN!. He reassured us that and infusion would be brought in. Now, of course , we had to wait for the orders to come through again, so mom was in pain for one hour and thirty minutes between doses.
This was horrendous ! She was again trying to crawl out of bed. My brother tried to reassure her but she grew angry with us because she was in so much pain. We tried everything; she refused food or drink; even to the point of me trying just to wet her lips caused anger. Again I searched for the nurse. My brother had to leave he couldn't stand it anymore. I explained, yet again, to another nurse that my mother was in needless pain and if she wanted me to go down on bended knee to plead with her to give her something I gladly would.None of this was said in anger ; I knew that she could only follow doctor's orders.She told me that they would increase her dosage of morphine ; that an infusion was not allowed in a long term care facility, contacting my brother I explained the situation and told him to call here and see if we should not be putting her in a hospital where the morphine infusion could be used.
Meanwhile , back in mom's room trying my best to reassure her that help was coming I waited for the next blessed shot for mom which would give her 20 min. rest.
Another nurse came in and reassured me that her morphine was being increased and that would be given every 2 hrs; then something to calm her would be given every 30 min. She had also charted that it was to be given to mom whether she was awake or asleep. She was like a little puppy waiting to be petted because she had done good;I smiled fighting back tears; telling her thank you so much. In the meantime my mind, my soul was screaming "Why didn't you do as I had asked from the time I walked in this door; Why didn't you all LISTEN TO ME!!!! I have been through this before!! With my palliative patients as well as my father and my sister!! " Anger, such white seething anger was pounding through my body. I bent my head as the blessed shots were given to mom. I stroked her hair and told her she would be alright now; when mom fell into a relaxed sleep I went outside; it was dark,I was alone and I screamed at the moon, my anger and my helplessness and my total and utter hurt vented outwards.