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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:
Dymaxion · 06/07/2025 20:47

Is it possible to write down a list of questions and arrange a meeting with the hospice Doctor ?
If he is sent home, you will get 4 care visits a day maximum, do you think you will be able to cope with his symptoms as they currently are ? If not, then you need the Hospice team to come up with better solutions to manage them in a home setting, symptom control is what they are experts in.
It sounds as though your Dad is experiencing a lot of emotional/spiritual distress, has he spent any time talking to the staff about his concerns ?

IggleBiggle · 06/07/2025 20:48

I am so sorry. My DFs partner used to volunteer to sit with people in a hospice and chat with them and from what she said it sounded like it can be very distressing to both go through and to see.

I think the most important things you can do is ensure they are safe and pain and distress are managed.

I think it's a human instinct to feel how you both do. You have my heartfelt sympathies. ♥️

bestbefore · 06/07/2025 20:49

If they want him moved to a nursing home surely they will transport him? You can’t physically take him.

Branleuse · 06/07/2025 20:50

Im sorry youre going through this. It is so difficult. Xx

Totallybannanas · 06/07/2025 20:50

complicated2 · 06/07/2025 20:44

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.

His GP is useless. I'm not sure they will get involved trying to get an appointment is impossible. And will they even do that? I just can't do this anymore. I'm on the verge of losing my job, my marriage is in tatters, my kids are struggling. I just want my life back.

OP posts:
Totallybannanas · 06/07/2025 20:53

bestbefore · 06/07/2025 20:49

If they want him moved to a nursing home surely they will transport him? You can’t physically take him.

I hope so. I don't even want him to go into a home not like this and in this state of mind, but I know I won't cope at home with him at home. Do I just step back? I wish they would just end his suffering. It's distressing for everyone.

OP posts:
Totallybannanas · 06/07/2025 20:55

Dymaxion · 06/07/2025 20:47

Is it possible to write down a list of questions and arrange a meeting with the hospice Doctor ?
If he is sent home, you will get 4 care visits a day maximum, do you think you will be able to cope with his symptoms as they currently are ? If not, then you need the Hospice team to come up with better solutions to manage them in a home setting, symptom control is what they are experts in.
It sounds as though your Dad is experiencing a lot of emotional/spiritual distress, has he spent any time talking to the staff about his concerns ?

Yeah he has had counselling and anti anxiety medication. He's just getting worse, so does this mean he is in the final days or weeks? I just want an explain as to what's going on

OP posts:
uncomfortablydumb60 · 06/07/2025 20:55

Oh gosh that brought tears to my eyes
My DF had stage 4 bowel cancer, which spread to his liver and he died 9 weeks after diagnosis.
it is unusual for a patient to be admitted to a hospice without an imminent terminal prognosis. My DF passed in the hospice .2 days later( personally I think the journey hastened the end)
firstly I would ask for his urine to be (re) tested.. assuming they did
Sounds to me like he still has symptoms and needs repeat or different antibiotics
If clear then I would guess it’s his cancer spreading to his brain and I would mention to the staff he needs sedation, Lorazepam is not enough! Poor man, he must be terrified.
They usually give Midazolam in this situation and a morphine syringe driver

ChaliceinWonderland · 06/07/2025 20:55

Gosh this sounds horrifically stressful. Do you have any support from macmillan? My mum's friend had this and the nurses were brilliant. Please contact carerightsuk.org
Theh have an excellent advice line with trained staff. My step dad is going through same, they gave me some fab advice.
Hugs

Limehawkmoth · 06/07/2025 20:55

Totallybannanas · 06/07/2025 20:26

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.

Does he have delerium? Have they checked for other infections?
delerium is very common in the elderly when they get infections…make sure you’ve ruled that out first , it can sometimes take weeks to recover from infection

the other thing is depression. My dad was massively depressed in 2 years before he died. Going into hospice/care / nursing oh,e just makes that worse. He’s loosing control over his life choices and has lost hope. Whilst end of life care needs to question all meds, it’s possible you might want to discuss that with His GP and get them to do assessment and then consider options . Depression csn make you very very angry.

Arran2024 · 06/07/2025 20:57

Im so sorry. My dad died earlier this year of esophageal cancer. He was in an NHS end of life care centre. He could barely swallow food, just smoothies, custard, yoghurt, for the 3 months he was there. He was never asked to move. Does the hospice think your dad isn't as near dying as was originally thought?

Totallybannanas · 06/07/2025 21:00

Arran2024 · 06/07/2025 20:57

Im so sorry. My dad died earlier this year of esophageal cancer. He was in an NHS end of life care centre. He could barely swallow food, just smoothies, custard, yoghurt, for the 3 months he was there. He was never asked to move. Does the hospice think your dad isn't as near dying as was originally thought?

I think they took him in to manage his symptoms. He was distressed and agitated before and so was admitted. They tested for UTI so I assumed it was that. Now they say he is scared and and anxious and he needs more stimulation, as he is just waiting for impending doom. I know nothing will snap him out of it now. It will just make it worse. He wants out and that is it.

OP posts:
Totallybannanas · 06/07/2025 21:02

Arran2024 · 06/07/2025 20:57

Im so sorry. My dad died earlier this year of esophageal cancer. He was in an NHS end of life care centre. He could barely swallow food, just smoothies, custard, yoghurt, for the 3 months he was there. He was never asked to move. Does the hospice think your dad isn't as near dying as was originally thought?

I'm sorry you went through this. Dad is still eating and drinking. He was diagnosed 8 weeks ago. Apart from a stent he has had no treatment due to it being so advanced and in a tricky place.

OP posts:
WickWood · 06/07/2025 21:07

I'm so sorry. I also thought delirium was possible. Is the UTI definitely fully resolved?

Arran2024 · 06/07/2025 21:08

Totallybannanas · 06/07/2025 21:02

I'm sorry you went through this. Dad is still eating and drinking. He was diagnosed 8 weeks ago. Apart from a stent he has had no treatment due to it being so advanced and in a tricky place.

My dad had trouble swallowing last Aug but wasnt formally diagnosed til Nov. He had a stent put in in early Dec but he was admitted to hospital for sth else - the cancer was clearly affecting other organs but they didnt do any tests because they knew the osephagal cancer was so advanced.

He never got distressed like your dad. He got a chest infection and recovered.

But he was never asked to move to a nursing home. I'm guessing they think your dad has several months left and they only dovthe last few weeks?

Brizzlerocks · 06/07/2025 21:08

I'm so sorry. I went through this too with my mum and I'm sorry to say that after two weeks the hospice said - you're not dying quick enough you have to leave. Despite her being in a similar state to your father. They tried to discharge her to my home for me to care for her (7 months pregnant!) and then when I refused arranged for her to go to a nursing home near her home 200 miles away. She was distraught. Luckily enough the morning the ambulance arrived to take her one of her mets ate it's way through a major vessel somewhere and she suddenly lost consciousness and died a few days later. I remain appalled at the state of care which is praised for 'excellent end of life care!.' it was a shit show. And this is at a nationally recognised hospice. And I work in the NHS so I know the shit that goes on.
Stand firm - you cannot take him. You are not alone. All of us who have been through this are with you. Xx

KingPrinceCharles · 06/07/2025 21:09

uncomfortablydumb60 · 06/07/2025 20:55

Oh gosh that brought tears to my eyes
My DF had stage 4 bowel cancer, which spread to his liver and he died 9 weeks after diagnosis.
it is unusual for a patient to be admitted to a hospice without an imminent terminal prognosis. My DF passed in the hospice .2 days later( personally I think the journey hastened the end)
firstly I would ask for his urine to be (re) tested.. assuming they did
Sounds to me like he still has symptoms and needs repeat or different antibiotics
If clear then I would guess it’s his cancer spreading to his brain and I would mention to the staff he needs sedation, Lorazepam is not enough! Poor man, he must be terrified.
They usually give Midazolam in this situation and a morphine syringe driver

They usually give Midazolam in this situation and a morphine syringe driver - this was also my experience. OP - please speak to the hospice clinician in charge of your Dad's care and explain your concerns and ask what the next steps are for his care and getting his agitation controlled.

IVbumble · 06/07/2025 21:10

Here's the NICE guidelines relating to palliative & end of life care - healthcare providers are meant to be working to these recommendations & if not please ask.

https://www.nice.org.uk/guidance/csg4

Improving supportive and palliative care for adults with cancer | Guidance | NICE

https://www.nice.org.uk/guidance/csg4

Totallybannanas · 06/07/2025 21:10

WickWood · 06/07/2025 21:07

I'm so sorry. I also thought delirium was possible. Is the UTI definitely fully resolved?

I need to check he was only diagnosed Tuesday. He was also in steroids prior to that. But he's had a particularly bad day today. He even said he wanted to jump off a cliff or cut his throat.

OP posts:
IVbumble · 06/07/2025 21:10

Further info about hospice care.

www.hospiceuk.org/information-and-support/your-guide-hospice-and-end-life-care

Tulipvase · 06/07/2025 21:11

My experience is that my mum was in and out of the hospice as they do also admit to manage pain. She did die in the hospice. 18 months later my dad was dying with bowel cancer. He died at home with me and my sister as we couldn’t get him into a the hospice. He had visits from care staff and nurses and overnight visits from McMillan nurses. We refused to do personal care.

My mum did become quite confused while in the hospice and would ask for ridiculous things. She would flit between states of consciousness.

It is so very hard, I feel for you.

Totallybannanas · 06/07/2025 21:13

KingPrinceCharles · 06/07/2025 21:09

They usually give Midazolam in this situation and a morphine syringe driver - this was also my experience. OP - please speak to the hospice clinician in charge of your Dad's care and explain your concerns and ask what the next steps are for his care and getting his agitation controlled.

He did have that initially, but was finding that stressful carrying it around and kept forgetting it. He was cursing and swearing. So they went back on oral medication. He improved slightly, but now he's declined again massively especially today.

OP posts:
EdgyCrab · 06/07/2025 21:13

Hi OP

I am so sorry for what you and your Dad are going through. Others here have some really good advice on the practical medical side, but I was struck by the fact that your Dad was only diagnosed 8 weeks ago - I know that people can progress very quickly, quicker than your dad even, but that is no time to 'get used' to impending death, inasmuch as someone ever can. You are both really going through it.

My Mum had much more time to get used to the idea she was dying. We talked, spent time together and she was able to have some element of control, which it really sounds like your Dad feels he hasn't got. Your hospice and GP surgery are letting you down, end of life doesn't have to be like this. I am also wondering why the hospice and considering getting him into a nursing home, maybe they think he has more time than you all originally thought? I know it's hard and overwhelming, but be pushy in getting them to make time for a proper conversation. You need to advocate for your Dad, and for you.

I second the poster who suggested calling MacMillan, they were brilliant with me and I hope they can help you find a way through this.

LadyLapsang · 06/07/2025 21:14

We had a lovely family member who died of oesophageal cancer following aggressive treatment and participation in clinical trials to gain more time with their family. It can be scary, but our family member wanted nothing to do with the hospice until the very last days and would have chosen to die at home, but there was a risk he could have had a massive bleed at the end so he went into the hospice so the situation could be managed for the children if this happened (luckily it didn’t). Speak to his doctors and nurses and don’t be afraid to ask questions. Even though it is difficult, try to be there for him. It probably won’t be for long. And, of course, look after yourself.

Totallybannanas · 06/07/2025 21:15

EdgyCrab · 06/07/2025 21:13

Hi OP

I am so sorry for what you and your Dad are going through. Others here have some really good advice on the practical medical side, but I was struck by the fact that your Dad was only diagnosed 8 weeks ago - I know that people can progress very quickly, quicker than your dad even, but that is no time to 'get used' to impending death, inasmuch as someone ever can. You are both really going through it.

My Mum had much more time to get used to the idea she was dying. We talked, spent time together and she was able to have some element of control, which it really sounds like your Dad feels he hasn't got. Your hospice and GP surgery are letting you down, end of life doesn't have to be like this. I am also wondering why the hospice and considering getting him into a nursing home, maybe they think he has more time than you all originally thought? I know it's hard and overwhelming, but be pushy in getting them to make time for a proper conversation. You need to advocate for your Dad, and for you.

I second the poster who suggested calling MacMillan, they were brilliant with me and I hope they can help you find a way through this.

I think they brought him in but he rallied up. He is still eating and drinking, so guessing not end of life.

OP posts: