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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:
Tiredandtiredagain · 07/07/2025 01:33

I can’t add anything, other than I’m so very sorry.

8853A · 07/07/2025 02:56

Ponderingwindow · 07/07/2025 01:28

I’m confused. Does hospice mean something else in the UK?

Here it is the service that manages your palliative care when you are dying OR the final facility you move into to die.

moving from hospice to a nursing home doesn’t make any sense.

Sometimes people go into hospice for a short stay when on palliative care for different reasons. Pain management, agitation and anxiety, sometimes respite for family or managing mobility. But usually what happens is the doctors think the patient doesn't have long so receiving end of life care but they rally around and realise the end may take longer.

8853A · 07/07/2025 03:36

I've worked many years in palliative and end of life care. I'm so sorry you're all going through this, it's such a difficult and distressing time.
. Ask to speak to the consultant about his urine infection, it can be more difficult to get rid of in men because they have a longer urethra and may need different antibiotics. This is really important as it can present with anxiety, anger and confusion and won't help your fathers fear.
Once the infection is clear, try and talk to your dad about anything he wants to get sort out or talk about before he dies. Is there someone he wants to talk to ? A friend, family member, pastor, priest, rabbi etc. Talk about happier times and childhood stories if appropriate. Does he have some favourite music or books you can read to him? Ask family and friends to come and chat about old times. Death needs to be spoken about including what your dad's wishes are for burial etc but it doesn't have to be miserable and sad every hour or at least it shouldn't be.
The manager and head nurse should be showing you around the nursing home and reassuring you they can provide good palliative and end of life care.
My own mum died of a horrendous disease and I truly understand the need to know how long it's going to take but the truth is they just won't know and that's hard and stressful. I was relieved when my mum died so I understand you want it to be all over.
Do you need to be at the hospice all the time? would working help distract you/ take your mind off death for a bit ? You really need to take care of yourself. That will look different for everyone, so working, hanging out with friends, talking it out or just watching a movie, making use of support at hospice, it doesn't really matter as long as you get a break. 💐

HalfasleepChrisintheMorning · 07/07/2025 04:59

My darling daddy died a year ago today of OC in hospice. I miss him terribly.
It’s horrendous- the hardest thing I have ever experienced- I’m sorry.
It sounds as though he’s deteriorating quickly. If they deteriorate day on day they have days.
My Dad was in hospice 2 weeks and 2 days and went from eating and drinking and being quite cheerful to dying.
It sounds to me as though he’s deteriorating quickly and needs midazolam in a syringe driver.
You absolutely cannot have him home, don’t even consider it. If the hospice want to discharge they will have to find a suitable nursing home and arrange. You’ll probably find that by the time it’s all sorted he’s worse and it isn’t necessary anyway.
sending love

Mischance · 07/07/2025 07:15

I do sympathise with you on this. It is very hard to find what is needed ... somewhere where you feel you can comfortably leave your father and feel confident he will be well cared for. And indeed the best homes do fill up.
The truth is that wherever he goes things will not always feel as you might wish. We know our lived ones so we'll and we have to watch others perhaps doing things not quite as we might feel they should be done.
The warmth and loving approach of the nurses and all the staff is paramount and getting a feel for that is important. And the cleaner can be as important as the manager in terms of how they approach people.
There will be some who fall short ... inevitable in such a setting and sometimes I had a sharp intake of breath when Inlistened to one or two carers ...not because they were unkind but because they did no know my husband as I did.

There will be compromises to be made. It is important though that it is somewhere where you feel welcomed .... I was always welcomed with a cup of my favourite tea .... a small toch that meant a lot. And I slept nights there when he was at the end.
I am wishing you well in this hard search.

Totallybannanas · 07/07/2025 07:49

Thank you everyone. I'm just off to work, but I feel emotionally numb and exhausted. Like I'm just going through the motions and hoping I can make it during the day. Work don't understand, because he isn't actually dying yet. They understand how exhausting just visiting is.

OP posts:
Mischance · 07/07/2025 07:58

Wishing you a good day ...

Rosscameasdoody · 07/07/2025 12:00

Totallybannanas · 06/07/2025 21:54

He has had oramorph. I think they gave him something stronger today oxycodin I think it was, which may have caused the outburst earlier. He wants us with him but he doesn't want to chat. He's not interested in anything really. It's becoming harder to distract him and engage him. He says he is exhausted and having broken sleep. I dread seeing him now he isn't the same person.

OP if the cancer has had an effect on his brain and is producing dementia like effects you need to have a word with whoever is prescribing his pain meds. My mum has advanced dementia and breast cancer. It took a while to settle on the right pain meds for her because opiates tend to have the opposite effect on the brain when there are dementia symptoms, and the pain isn’t properly controlled. If they can get that sorted out - even if it’s a cocktail of different meds - hopefully he may be more at peace.

Totallybannanas · 07/07/2025 12:23

Now some one is ringing to say the funding isn't in place FML. No one seems to co ordinate anything. I'm getting told mixed things by everyone and was told the funding was in place. So I bet they will end up sending him home.

OP posts:
ButteredRadish · 07/07/2025 14:08

Hospices are horrible places to be, in fairness to him. The staff are often intimidating and unable to (or unwilling to) communicate.
They were awful to my grandma, refusing her morphine in her final hours, despite the doctor having prescribed it, based purely on its costs (yes, they actually said this, many times) and she died quite literally screaming. Mid-scream.
My mum still wishes she’d been a bit firmer with them, 26 years later.

So as hard as I’m sure it is, one small grace is that at least he’s still able to advocate for himself and his wishes, even if he isn’t always rational or making sense. Poor man 💔

PeapodMcgee · 07/07/2025 14:18

Totallybannanas · 07/07/2025 12:23

Now some one is ringing to say the funding isn't in place FML. No one seems to co ordinate anything. I'm getting told mixed things by everyone and was told the funding was in place. So I bet they will end up sending him home.

What the fuck is going on?! Please reach out to Macmillan. His nurse will sort it all out with you x

Mischance · 07/07/2025 16:47

They cannot send him home without proper care in place.
If the funding issues continue then please get in touch with Beacon who advise about chc. Look up Beacon chc ... they will give you free advice.

Communication is huge problem in the health services.

Mischance · 07/07/2025 16:48

Beaconchc.co.uk. They helped me ablot.

TooBigForMyBoots · 07/07/2025 23:56

It may be easier to get him a care package than find a place in a nursing home.

@Totallybannanas are you the only family member taking this on? Are there others who could share these responsibilities?Brew

Totallybannanas · 08/07/2025 00:04

TooBigForMyBoots · 07/07/2025 23:56

It may be easier to get him a care package than find a place in a nursing home.

@Totallybannanas are you the only family member taking this on? Are there others who could share these responsibilities?Brew

Yes, I'm on reduced hours with work at the moment. But I can't do this forever. I don't want to lose him but the stress of the last few months and the uncertainty of just not knowing is excruciating. I yearn for it to be over for him and me. That's bloody awful I know. But he isn't living he's just waiting.

OP posts:
PeapodMcgee · 08/07/2025 00:17

It's not awful at all. I've been there. You want control, and certainty, and for him to have a good death so this suffering is over ASAP. That's not wrong.

TooBigForMyBoots · 08/07/2025 00:46

Totallybannanas · 08/07/2025 00:04

Yes, I'm on reduced hours with work at the moment. But I can't do this forever. I don't want to lose him but the stress of the last few months and the uncertainty of just not knowing is excruciating. I yearn for it to be over for him and me. That's bloody awful I know. But he isn't living he's just waiting.

None of that is awful and you are being awesome.❤️

What it is, is a really fucking difficult, confusing, complicated, anger inducing, guilt ridden, logistical nightmare.

Something you really don't need when your dad is dying.

Love, strength and peace to you, your dad and all your loved ones.

Francestein · 08/07/2025 01:01

Hi @Totallybannanas i went through this with both of my parents and found it exhausting, overwhelming and totally terrifying. I’m now studying nursing and will probably specialize in palliative care so that I can try and demystify it a bit for families also.
Your father is changing for several reasons.
The cancer has potentially metastasized to his brain. They may have given him prednisone/cortisone which is a steroid medication to reduce the inflammation - it reduces pain from mets and also increases appetite, but can also cause a bit of agitation and restlessness.
If it helps, I can recommend watching Nurse Julie’s videos on YouTube about the processes of dying if you are scared. She helps demystify it for you. She is American and gets a bit religious about it. I don’t know if that’s your thing. It’s not especially mine, but it’s really important to some people. It’s important to speak to the nurses and ask questions if you’re scared. If they don’t have time for you, ask to speak to the social worker or someone on the ward. *BTW, am not in UK so can’t give advice re NHS specific care. Big hugs. X

Totallybannanas · 08/07/2025 08:03

It's is exhausting. I hate seeing him suffer. I feel my mental is totally shit, I feel like I have bi polar as I'm so up and down. The whole system is difficult to navigate which just adds to the stress.

OP posts:
cumbriaisbest · 08/07/2025 08:08

Totallybannanas · 08/07/2025 08:03

It's is exhausting. I hate seeing him suffer. I feel my mental is totally shit, I feel like I have bi polar as I'm so up and down. The whole system is difficult to navigate which just adds to the stress.

Nobody ever tells you this stuff. You are left to deal with it.

I don't want to make this about me but I could write a book on the end of my parents lives. Accused of being a safe guarding risk, manhandled by a nurse,virtually thrown out of a visit ....on and on it went.

Get support, get help.

Mischance · 08/07/2025 08:50

I always find it so sad that the system, which is supposedly there to help people, simply becomes a battle ground because of rigid rules, poor communication, and the fragmentation caused by the privatisation of care and nursing home provision. Also a big factor is the health/social care interface where the patient and their family are caught in the fight between both authorities to avoid paying out. It is frankly cruel. I had hoped that this new government might try and get on top of this but so far they have side-stepped this poisoned chalice.

Many years ago I worked for social services and organising care was simple. The services (the clue's in the name!) were provided by SS - I could walk down the corridor and chat with the person who was organising home care for a client of mine and we could resole any problems - sitto with residential care. It was all joined up and geared towards making everything as easy as possible for the patients.

I am so sorry OP that you are caught up in this whirlpool on top of grieving your father's loss of health and imminent death.

Sending a handhold ......

Dymaxion · 08/07/2025 08:55

He clearly can't be sent anywhere without the funding being in place, this is not your responsibility to organise, so ask them to contact you when it is in place.

You sound like you are living on your last nerve, I hope you have people who can offer you support, whilst you are going through this and afterwards.

Thaawtsom · 08/07/2025 08:57

So sorry you are going through this OP. My dad died of oesophageal cancer and his end of life was hard and messy. He was restless and had end of life hallucinations / dementia. He ended up being heavily sedated to keep him in bed (he was dangerous because trying to get out of bed but unable to stand) and the GP / nursing team / hospice collectively just kept upping his drugs until he died. It was a kindness. I would keep pushing for more medication -- speak about his distress and restlessness and confusion. Sending a hand hold.

cumbriaisbest · 08/07/2025 13:01

@Mischance selling things off which worked perfectly well was criminal.

Dare I say it.....older, kind women with tons of experience and a good dose of common sense and empathy were running the show.

I had to get somebody to unplug a TV so I could say Goodbye to my Mum. This is a place costing thousands per week.

TonTonMacoute · 08/07/2025 19:19

Totallybannanas · 07/07/2025 12:23

Now some one is ringing to say the funding isn't in place FML. No one seems to co ordinate anything. I'm getting told mixed things by everyone and was told the funding was in place. So I bet they will end up sending him home.

Do not, on any account, let them send him home.

I’m so sorry OP, the lack of communication between the different parties sounds so depressingly familiar.

Have you tried looking at the Elderly Parents forum? The person on there have seen everything and done everything. Their advice helped us hugely when we were going through similar.