Morphine Administration

Hi I am new here, I have been attempting to find an answer on your message boards but since there are so many threads I hope it is okay if I just post a new question.

My father was diagnosed with a tumour on his kidney 2 years ago. He was told at that time he had 2-3 months. I live on the opposite side of Australia to him and immediately made a visit to him. 

In the last couple of weeks he has gone downhill fast. It has metasized to his lungs. He is now being given morphine, on a dose of 30mg when neccessary. Prior to the morphine starting he was losing weight rapidly. 7 kgs last week. He is lying down most of the day and not interested in anything. He has fallen a couple of times and not been able to get up. Very negative and says he wants it all to end. He is refusing in-home care.

My question is at what stage do doctors usually start giving morphine? Does this mean he only has weeks to go or months?  My brother sister and myself are 6000 miles away from him and are arranging our affairs to go and be with him. How long do we have? The doctors have not responded to communications and he is being extremely stubborn, telling us not to come etc. At this stage we hope to leave in 3 weeks, will this be too late? Please, I realise all cases are different but any advice will be welcomed.

First, let me say I am very sorry for what you are going through.  We lost my stepfather in April from RCC.  He only lived 8 weeks from the time of his diagnosis.

He was allergic to morphine and so I can't give you a guide with regard to that, but when he was ill, I ran across this website from the Mayo Clinic on the end stages of life and found them to be pretty accurate with regard to my stepfather's course.  I hope they can give you some direction.  Also, do you have hospice care in Australia?  The nurses at hospice told us when it was time to call the rest of the family in.

 http://www.mayoclinic.com/health/cancer/CA00048

 The days ahead are difficult, but use them to say all the things that are important to you.  This is a gift many people do not get.

 Take care-

Trice

Hello Trice

Thankyou for your reply. That website was a good guide. Judging from that I feel we should get there as soon as possible. Which is what I already felt. I just had a feeling that we dont have more than a couple of weeks, if that.

There is much I want to say to him.

Thankyou again

Julia

Hello Again

We do have hospice care here but he is refusing any assistance. I guess deep down he does want us to be there even though he keeps saying dont come.

Julia

I don't think you'll regret that decision.  Also, there is no way he should be by himself.  End-of-life care for my stepfather was EXTREMELY labor intensive.  I had breast cancer last year and he helped to care for me through chemo and surgeries, etc.  For me, it was wonderful to be able to give back to him in this way.  I just wish he had had the outcome I did.  My heart is still broken.  He has left a HUGE void in our lives.  But the fact that we both "shared" cancer, ended up being something that strengthened our already strong bond.  I'm sure you will never second guess your decision about leaving early to be with him and will treasure the spent time with him for the rest of your life.

 Your dad may be a very private person, as was my stepfather.  He accepted that his death was imminent, but had a hard time "letting go" of us.  He told me dying wasn't the hard part...that saying goodbye to the ones you love is the hard part.  His final week was such a struggle.  Hospice even brought in a harpist to try to help him pass over.   We had finally, on what turned out to be his last night, hired a nurse to come sit with him overnight, so we could get some sleep.  He passed away in the first 15 minutes that the nurse was alone with him.  I have a feeling it was easier for him to "let go" once we weren't in the room. 

Good luck to you and your family in the days, weeks and months ahead.

Trice

One more thing.  Once there, you may be able to convince your father to allow hospice to come in.  They are absolutely invaluable.  They will leave emergency meds in your refrigerator and if you are having a problem, they will direct you over the phone what & how much to administer.  You will have a team of people available to you 24 hours a day...although it will be you providing the hands-on care.

Also, I was able to call them on a Sunday afternoon and tell them I felt my stepdad needed a catheter because it was very difficult for us to get him to the bathroom.  They had someone there in a couple of hours.  It was wonderful and made caring for him so much easier for the family.  One of his last best moments was provided by a gentleman from hospice who came by on his final day and bathed and shaved him.

Hospice's services are invaluable for the family....as well as the sick person.