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Is Dilaudid given to terminally ill patients at end stages when there is no hope left?

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Practicing since : 2009
Answered : 4362 Questions
My daughter was given Dilaudid for extreme pain toward the end of her life (although we didn't know it was near the end) and I heard yesterday that it is generally used when it doesn't matter any more and it is given just to make the patient comfortable. If this is true we would have known more about what was happening than what we were told. We didn't understand....Can you help me with is making me very distressed. We might have done things differently if we had known. She has been gone six months now and we still think we could have helped her more. Thank you
Posted Sun, 22 Dec 2013 in Medicines and Side Effects
Answered by Dr. Rakesh Madhyastha 41 minutes later
Brief Answer: Not true Detailed Answer: Hello Thanks for the query Hydromorphone is a centrally acting analgesic which is used in moderate to severe pain which is not relieved by regular analgesics. There is no such dictum that it is used only in patients who have no further hope. The only parameters which help to know if the patient is reaching the end stage or not are the vital parameters, but I am sure the doctors would have already explained to prognosis in detail. I hope I was of help to you, if you have any further queries please get back to me Regards
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Follow-up: Is Dilaudid given to terminally ill patients at end stages when there is no hope left? 15 minutes later
This really isn't a question but an observation. The doctors essentially pain management group, thinly veiled Hospice group were not sure what to do and we changed the regime so many times over a seventeen day stay at the hospital. One of many over the past four years. My older daughter (an attorney) and I (an International Corporate Executive), left the hospital with my ill daughter and did not have a clue the end was so near. We were shocked as she had been down this path so many times. I understand what you are saying and I have no quarrel with our regular "team" but all these other groups started weighing in and confusion ran supreme. Too late now, if I read between your lines but I am convinced that something went wrong. Thank you for your broader perspective on the uses of Dilaudid but I actually had to force them to stop using it as it rendered her delirious. So much more needs to be done in "end of life" care and advocacy. Thank you XXXX XXXX
Answered by Dr. Rakesh Madhyastha 1 hour later
Brief Answer: I understand Detailed Answer: Hello Thanks for the reply and I am really touched but what you have written. Here in India, what usually happens is terminal care is taken care by people from the 'pain clinic' who are basically anesthetists. It is true that most of their medications make the patients drowsy, just last night I lost a patient, I had given a pain clinic reference for a rare painful skin condition, they gave a drug and he did'nt wake up at all (he died not due to the drug but the primary disease). We primary consultants become answerable to the relatives as to why we think its a better idea to make him completely drowsy but sometimes that is the best option because being drowsy is better than being in severe pain. But the patient's son told me I wanted to say bye to my dad one last time and that just shattered me But what I feel is before putting on such drugs opinion should be sought from the patient attenders as well and the risks have to be explained. I am sorry for your loss Regards
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