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DF end of life hospice trauma. Please advise

159 replies

Totallybannanas · 06/07/2025 20:01

My dad is currently in a hospice receiving care for stage 4 oesophageal cancer. He was admitted two weeks ago, and while there have been slight fluctuations in his condition day to day, overall he has deteriorated rapidly.

He is very frail and thin, though still eating, drinking, and mobile — but with increasing fatigue and weakness. He now has incontinence and wears a pad. They attempted to catheterise him recently, but he was too distressed to tolerate it.

One of the hardest parts is the extreme agitation and confusion. He often seems overwhelmed and doesn't know what to do with himself. He barely sleeps at night, gets up frequently, paces the room, and is visibly anxious and restless. He’s often angry, short-tempered, and frightened — especially of the dying process — and he says things like he wants it to be over.

He’s been very demanding with staff, constantly ringing the bell for medication and complaining about things. He’s receiving lorazepam and oxycodone orally. Even though he wants us there often, he sleeps through much of the visit or hardly speaks. I took him for a short drive today — he got out of the car, walked a few steps, and then immediately asked to go back. Once inside, he rang the bell repeatedly until he was given more medication.

This experience has been emotionally traumatic. No one has clearly explained what’s happening, and I feel like I’m guessing what's normal and what isn't. He had a UTI earlier this week, and we hoped that might explain some of the behaviours, but his distress and mental state haven't really improved.

We’ve now been told to begin looking for a nursing home. He hasn’t specifically said he doesn’t want to go, but I honestly think he will find it deeply frustrating and depressing. I don’t think he’s safe to live alone, but I also don’t know how he’ll react if the hospice stay ends and he’s moved. I'm also unsure whether his current behaviour is due to the cancer, the medications, or the general decline in his condition. We're not getting updated scans or clear information on prognosis.

I feel emotionally drained and anxious every time I go to see him. Today, he screamed so loudly the nurses thought something terrible had happened — it terrified my brother, who called me afterwards visibly shaken. My dad told the nurses he wanted to put his head through a window. He also asked my brother to help change his pad. His sense of dignity seems to be gone, and it’s heartbreaking to watch.

I don’t know what to do anymore or how to help him through this. Has anyone been through something similar? I feel like I’m watching him slip away and there’s nothing I can do.

OP posts:
Octavia64 · 06/07/2025 20:07

Hospices are usually for very end of life, ie the last few days. The process of dying can be very unpredictable - the dad of a friend of mine was recently moved from a hospice to a nursing home after he was expected to die imminently and then rallied.

the hospice won’t hold onto him indefinitely. Very few people want to go to a nursing home but if that is his level of medical need that is his level of medical need.

Tetchypants · 06/07/2025 20:09

It’s so cruel isn’t it, for both him and his loved ones. I’ve been in your shoes twice and both times I wished for this awful part of life to be as short and painless as possible. There is nothing you can do but wait, and try to cling onto whatever little positives you can. Thoughts with you all 💐

TooBigForMyBoots · 06/07/2025 20:13

Would he be more comfortable at home with carers and a family member?

Totallybannanas · 06/07/2025 20:15

Tetchypants · 06/07/2025 20:09

It’s so cruel isn’t it, for both him and his loved ones. I’ve been in your shoes twice and both times I wished for this awful part of life to be as short and painless as possible. There is nothing you can do but wait, and try to cling onto whatever little positives you can. Thoughts with you all 💐

Did your family members completely change? He just isn't the same person anymore and I'm extremely worried about his mental health and safety. I'm worried he will do something drastic. I don't know if this is the drugs or whether the cancer has spread to his brain! We are being told nothing. He is still mobile, eating and drinking so I just don't know when it will be the end. I just want it over with.

OP posts:
Totallybannanas · 06/07/2025 20:16

I also feel like he just wants them to give him something strong to actually sedate him. He doesn't want to be here.

OP posts:
TonTonMacoute · 06/07/2025 20:18

Oh, OP, I'm so sorry to hear this it sounds incredibly traumatic for all of you.

Im sorry, but why are the hospice expecting you to sort this out? They do all this all the time, this is a first for you. What help and advice are they giving you? Have they explained to you what you should be looking for,and why they want to move him? It's not necessarily that easy to find nursing homes with the appropriate level of nursing care.

You don't need to be rude, but don't be afraid to ask them lots of questions.

ButtSurgery · 06/07/2025 20:20

TooBigForMyBoots · 06/07/2025 20:13

Would he be more comfortable at home with carers and a family member?

That's a huge ask - and a huge cost.

Mumof1andacat · 06/07/2025 20:20

Have a further chat with the doctors at the hospice. Maybe a change to his meds are needed to keep him calmer

Tetchypants · 06/07/2025 20:22

With my father in law he lost his cheerful personality and just wanted to die. We saw the change the day he had to ask a family member to wipe his bottom for him. He was in pain and had lost his dignity. This lasted several days (and we are grateful it was days rather than the weeks or months some people face) and was heartbreaking and frustrating.

I wish they could give end of life patients something to let them sleep forever.

Totallybannanas · 06/07/2025 20:24

TonTonMacoute · 06/07/2025 20:18

Oh, OP, I'm so sorry to hear this it sounds incredibly traumatic for all of you.

Im sorry, but why are the hospice expecting you to sort this out? They do all this all the time, this is a first for you. What help and advice are they giving you? Have they explained to you what you should be looking for,and why they want to move him? It's not necessarily that easy to find nursing homes with the appropriate level of nursing care.

You don't need to be rude, but don't be afraid to ask them lots of questions.

I think maybe they are giving me a choice before they place him somewhere. He has said previously he wanted to go but he's changing all the time. He just wants to die he doesn't want anything else. I just don't know how he is going to cope. And I don't want to be the one that has to take him there. He's just not well.

OP posts:
Totallybannanas · 06/07/2025 20:26

TooBigForMyBoots · 06/07/2025 20:13

Would he be more comfortable at home with carers and a family member?

I did that before hospice stay. I only only had one carer per day and I went down after lunch until late evening. Those periods alone he was anxious and constantly ringing the nurse and hospice. He is now alot worse. It's like he has dementia.

OP posts:
complicated2 · 06/07/2025 20:27

Have you learned about a "respect form". You can fill one of those in to refuse any kind of treatment or medication that would extend life. That way if something goes wrong then they would give him medication to stop the symptoms and just let him slip away peacefully.

We have been pushing for so long to have this for a family member and the GP just finally agreed about two days ago. It was a relief.

I don't know why they can't sedate people who are in such distress. It seems inhumane and they wouldn't be in that state if the medics didn't keep prolonging life with various interventions. Were they planning to treat the UTI for example? They don't have to do that. They could move him to palliative care if there is an infection.

AluckyEllie · 06/07/2025 20:28

This is why we all should be in favour of assisted dying. It’s horrific. The poor man, knowing he’s dying but he can’t die quick enough. The panic must be unreal. It sounds like he might need more medications to sedate/take the anxiety away. It sounds like anxiety to me, the need to stay close to the hospice, the constant ringing of the bell.

helpfulperson · 06/07/2025 20:30

I'm so sorry you are going through this. Are you the only one involved in dealing with this and do you have POA?

I know this might sound strange but what helped me when dealing with my mums stroke and subsequent dementia etc was what one of the staff said to me which is there is no right decision which is going to make this perfect. There is better choices and less good choices. It may be that a choice is made for all the right reasons and turns out not to be the best so another one is made.

We had something called a 'best interests' meeting which really helped where we met with all the professionals who gave their views and then a social worker explained the options.

Do you have a social worker? if not I would suggest asking to see the hospital social worker?

complicated2 · 06/07/2025 20:30

This is what a respect form looks like
https://www.resus.org.uk/sites/default/files/2020-09/ReSPECT%20v3-1-formSPECIMENFINAL.pdf

It just enables the next of kin or the patient to say that they refuse all further medical interventions to extend life and instead want to prioritise comfort.

It can be filled in by most people who are licenced to prescribe, but definitely by the person's GP.

MigGril · 06/07/2025 20:31

I know my own mum's personality totally changed, it really was like she was a different person. 😩 She was very ill unfortunately for months before she died and I do think that the level of pain she was experiencing (despite a lot of painkillers) had a big effect then of course there are the drugs they are taking as well. It was a very distressing time.

I would be looking at the nursing home option and see if you can find somewhere easy for you to visit regularly.

complicated2 · 06/07/2025 20:32

The hospice or a care home could fill the form in and then act on it to prioritise his comfort (e.g. give anti anxiety medication). Someone needs to make a stand and insist the form is filled in though.

HotAndSweatyButNotBetty · 06/07/2025 20:34

OP I'm so sorry you are going through this experience. (I'm very angry at the naivety of people opposing dignity in dying...this is the awful reality for many). It does sound like he's have a mental health crisis and whether this is mental health (caused by stress/fear) or organic (tumour/dementia) needs evaluation otherwise how can they alleviate these distressing symptoms. I'm surprised the hospice are not more active in doing this.

Sadly not all hospices are the beacons of hope they are made out to be.

Totallybannanas · 06/07/2025 20:34

helpfulperson · 06/07/2025 20:30

I'm so sorry you are going through this. Are you the only one involved in dealing with this and do you have POA?

I know this might sound strange but what helped me when dealing with my mums stroke and subsequent dementia etc was what one of the staff said to me which is there is no right decision which is going to make this perfect. There is better choices and less good choices. It may be that a choice is made for all the right reasons and turns out not to be the best so another one is made.

We had something called a 'best interests' meeting which really helped where we met with all the professionals who gave their views and then a social worker explained the options.

Do you have a social worker? if not I would suggest asking to see the hospital social worker?

I have a social for me that's linked to the hospice. The hospice patient support worker that's for my dad has put in for the funding for the home. I do not want to be the person to take him to the home. I am worried if he says he wants to come home, he can barely cope in the hospice. I keep telling them he isn't the same person but they don't seem to to get how much he has changed and think being in a home will help him get stimulation. I do not have POA.

OP posts:
Totallybannanas · 06/07/2025 20:38

HotAndSweatyButNotBetty · 06/07/2025 20:34

OP I'm so sorry you are going through this experience. (I'm very angry at the naivety of people opposing dignity in dying...this is the awful reality for many). It does sound like he's have a mental health crisis and whether this is mental health (caused by stress/fear) or organic (tumour/dementia) needs evaluation otherwise how can they alleviate these distressing symptoms. I'm surprised the hospice are not more active in doing this.

Sadly not all hospices are the beacons of hope they are made out to be.

They just say he's scared of dying and he is lonely. They seem to think a home would be the best place . They also just keep giving him more an more drugs to help calm him. He has kidney disease so now I'm wondering if this is building up toxins. I just don't know. Trying. To grab a nurse in private is not always and I don't even see the doctors. I just want to stand back if I'm honest. I don't want the pressure and responsibility of finding a home. I don't want to care for him 24/7 I just want his suffering to end.

OP posts:
Messycoo · 06/07/2025 20:38

Sorry to hear of your distressing situation.
ask to speak to the Matron, sister or charge nurse to discuss your concerns.
Ask them what is the usual step by step process . Usually there is a criteria for patients to be end of life, however it does happen that patients rally and then goes to a nursing home to be made as comfortable as possible until such time again his health deteriorates.
like the pp mentioned it’s awful and you and the family have to wait. In the mean time perhaps doctors and nurses will be able to administer a better, steady regime of medication.
sending you a hug and also look after yourself as best you can .

Totallybannanas · 06/07/2025 20:41

complicated2 · 06/07/2025 20:30

This is what a respect form looks like
https://www.resus.org.uk/sites/default/files/2020-09/ReSPECT%20v3-1-formSPECIMENFINAL.pdf

It just enables the next of kin or the patient to say that they refuse all further medical interventions to extend life and instead want to prioritise comfort.

It can be filled in by most people who are licenced to prescribe, but definitely by the person's GP.

Yes we have done that form. They aren't prolonging his life but they aren't reducing it either. It's just palliative care they are giving. But how much longer will this go on for? His mental health is in tatters.

OP posts:
Caramelty · 06/07/2025 20:41

My dad died of the same cancer and he had metastatic cancers of the adrenal gland and the brain; the former caused him to have hormonal imbalances, the latter caused aphasia (inability to speak) - at one stage we thought he had had a stroke.

My dad managed to stay at home until the last week of his life - but he was often agitated and in a lot of physical discomfort and pain. It was very hard to watch him wasting away as he simply couldn’t bring himself to eat or drink much.

It is entirely possible he has a metastatic cancer, but cancer of the oesophagus is a dreadful thing and I suspect it is enough to cause these mood swings and distress.

complicated2 · 06/07/2025 20:44

Totallybannanas · 06/07/2025 20:41

Yes we have done that form. They aren't prolonging his life but they aren't reducing it either. It's just palliative care they are giving. But how much longer will this go on for? His mental health is in tatters.

I think you need to get hold of his GP and say that enough is enough. They can't take action without someone saying it's time, because they don't want to get in trouble.

Can you get hold of his GP somehow? You are doing the right thing.

I had to write a heartfelt letter to them and say that I couldn't bear to visit any more because it was too distressing, that was when they finally agreed to do the right thing.

I really think it's bonkers how medics throw time and money at keeping people going against common sense like this. Nobody would do it to an animal. It's just boggles my mind.

Totallybannanas · 06/07/2025 20:46

Caramelty · 06/07/2025 20:41

My dad died of the same cancer and he had metastatic cancers of the adrenal gland and the brain; the former caused him to have hormonal imbalances, the latter caused aphasia (inability to speak) - at one stage we thought he had had a stroke.

My dad managed to stay at home until the last week of his life - but he was often agitated and in a lot of physical discomfort and pain. It was very hard to watch him wasting away as he simply couldn’t bring himself to eat or drink much.

It is entirely possible he has a metastatic cancer, but cancer of the oesophagus is a dreadful thing and I suspect it is enough to cause these mood swings and distress.

I'm sorry you went through this. My dad lives alone and I just don't think I could cope with him, not on my own. Even with carers coming in. Part of me feels like he is going to do something drastic in a minute. He's just not mentally well. I feel like the hospice just want rid of him. How will the nursing homes manage him? He rings constantly.

OP posts: