Mom has been on hospice for the last 3 weeks for CHF and atrial septal deviation. She is in AL on the memory care floor (dementia). The last week or so she has been having major lower back pain enough that she cries when she lays down and moans in pain. The nursing staff has given her a small dose of morphine occasionally when I ask them to. I have asked the hospice nurse to check mom but she told me she left orders to give mom morphine when she is in pain.
I feel like I want to know what is causing this pain but in the end is it really important? Is it a kidney issue, UTI, or part of her CHF? Should I ask hospice to order tests to find out what it is? Any advice would be appreciated.
How often does the hospice nurse visit your mother? You should have a face-to-face talk with her about this. Perhaps you, the hospice nurse, and the director of nursing or the medical manager (or whatever the position is called there) should sit down and come to a clear understanding of who calls the shots.
Does it matter what is causing the pain? Not unless that knowledge is necessary to stopping it.
Mom is enrolled in hospice specifically to minimize pain, anxiety, discomfort, etc. The ALF staff has to be on board with that goal, or it just won't work.
Mom has been even more tired the last week and the nurse noted some aphasia.
Keep you posted.
Actually - is the OP even still with us?
Assuming s/he will check in again, then: have a good look. You may find a bruise or a pressure sore. If you do, and these are not already recorded in your mother's notes, you may then have a pink fit - but do so with a view to making sure that your mother gets improved monitoring and more comfortable positioning.
I did contact the hospice nurse with my concerns and UTI/kidney problem question. She says the pain is in the lower back and not the sides where UTIs normally are. Today when I saw mom she told me it is on her left side below her ribs. I took a look again at her back and nothing is there. No bruising, no red marks, no swelling but if I touch the area she screams out in pain and tells me not to touch her there.
I think I do need to meet with the hospice nurse who comes 2-3 times a week. I have not met her because I work during the day and when I get over to see mom it is just the evening staff who can't answer my questions about how mom was that day. We have texted each other and I expressed my concerns and the hospice nurse said she will be there Monday to check on her. Jeannegibbs I will make an appointment as soon as I can to meet with the hospice nurse and the nursing director per your suggestion. I think we all need to be on the same page with her care. This is a new facility and I think mom is the only one on the floor under hospice. She has a general practitioner who comes to the AL to check on her patients. I am not sure if that doctor or the hospice doctor should be looking into this pain?
Mom is not bedridden and still has her straight posture as she walks. She has to be on oxygen at all times or she can't breathe. She pushes her convertible wheelchair with the tank on the side and then the aides switch her to the concentrator when she is in her room so she is pretty mobile. She was diagnosed with dementia but she remembers many things she is told but just can't think of the words when she talks. She cries and blames us for "dumping" her in this place but she doesn't remember where her home used to be. It is a sad situation.
I will keep you guys posted when I find out what is wrong with her. Thanks.
Why is mom on Hospice? Which doctor certified and and what life limiting condition does she have?
Your mother is in pain. Pain is supposed to be managed by hospice. She's getting small amounts of morphine at the MC unit that is apparently not enough to relieve her pain.
You need to cal the hospice line and tell them that you cannot leave your mom in pain over the holiday weekend. Someone is going to need to examine her and determine if she needs an ER visit or more pain meds.
Is she also getting meds for anxiety and agitation?
Mom is on hospice bc she was 180 lbs a year ago and now she is down to 90 lbs. and she has a hole in her heart that cannot be fixed. She is on oxygen with CHF, she takes Eliquis, Seroquel, and Namzaric.
I was visiting again today and she is not grimacing in pain when she is sitting in her chair though she says it still hurts. When she lays down that is when she cries out in pain. She used to be able to get up from bed without assistance but now she can barely get herself up. She wants to do it herself but asked me yesterday for help. She is not eating but a few bites at each meal. The nurses aide is giving mom morphine at night but like I said, mom doesn't complain about it during the day (at least to them).
I have been searching the internet for information and one site said that lower left side pain could be related to an aortic aneurysm but it is very rare. Her mother died at age 89 from an aortic aneurysm.
I will keep you all posted.
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