Hello AmyJo,
I am so sorry to hear that you are feeling judged by people for the care you are providing to you husband in his last days. With the opioid crisis happening, people are especially sensitive to the use of opioids in many circumstances as there are significant risks associated to using these medications inappropriately. However, as you know, in palliative care, we use opioids commonly at end-of-life to address symptoms of pain and also shortness of breath. And as your husband is being seen by a hospice nurse and possibly other members of the team, you are in constant communication with health care providers about his needs and insuring his comfort.
As people are close to the end of life, their alertness can be variable, and often declines. This is likely due to overall weakness, the body shutting down and burden of illness that is overwhelming. The side effects of sleepiness for an opioid do exist, but they typically subside within a few days of any appropriate dose adjustments. At the end of life there is a constant balance of managing symptoms and trying to have someone remain as alert as is possible (amidst their decline).
We have some resources on the Canadian Virtual Hospice website that you may find helpful as you navigate discussions about your husband’s medication use and overall decline.
1) When Death is Near - http://www.virtualhospice.ca/en_US/Main+Site+Navigation/Home/Topics/Topics/Final+Days/When+Death+is+Near.aspx
2) Pain - http://www.virtualhospice.ca/en_US/Main+Site+Navigation/Home/Topics/Topics/Symptoms+_+Health+Concerns/Pain.aspx
3) Confusion –http://www.virtualhospice.ca/en_US/Main+Site+Navigation/Home/Topics/Topics/Symptoms+_+Health+Concerns/Confusion.aspx
4) Does morphine make death come sooner? – http://www.virtualhospice.ca/en_US/Main+Site+Navigation/Home/Support/Support/Asked+and+Answered/Medications/Does+morphine+make+death+come+sooner_.aspx
5) What are the side effects of morphine? Does morphine change someone’s physical appearance? - http://www.virtualhospice.ca/en_US/Main+Site+Navigation/Home/Support/Support/Asked+and+Answered/Medications/What+are+the+side+effects+of+morphine_+Does+morphine+change+someone_s+physical+appearance_.aspx
6) What happens if someone has a morphine overdose? Is there a certain amount of morphine that can cause an overdose? - http://www.virtualhospice.ca/en_US/Main+Site+Navigation/Home/Support/Support/Asked+and+Answered/Medications/What+happens+if+someone+has+a+morphine+overdose_+Is+there+a+certain+amount+of+morphine+that+can+cause+an+overdose_.aspx
Hopefully these resources will be useful to you as you care for your husband.
Wishing you much strength,
Simone (CVH Moderator)