Does morphine in hospice speed up death?
The short answer
When morphine is used the way hospice teams prescribe it, with doses adjusted to the person's symptoms, it eases pain and the feeling of not getting enough air. Research in hospice and palliative care has not shown that this kind of careful use shortens life. The timing can feel connected because morphine is often started or increased when someone is already very close to death.
This topic involves medical decisions. It's general information, not advice for your person. Please talk with your hospice nurse or doctor before changing any medicine or care plan.
Why do so many families worry about this?
Many families share this fear. Often, a family sees morphine started, and soon after, their person dies. It is natural to wonder if one caused the other.
But morphine is usually needed most when someone is already very sick. A review of research from palliative care found that people tend to get higher doses as they get closer to death. It found no evidence that starting morphine or raising the dose made death come sooner. The National Cancer Institute also says studies have shown no link between opioid use and early death.
What does morphine do at the end of life?
Morphine is a strong medicine in a group called opioids. Near the end of life, it is used to:
- Relieve pain
- Ease shortness of breath, the frightening feeling of not getting enough air
Easing pain and breathlessness can bring real comfort and rest.
How is the dose decided?
Hospice teams adjust the dose to your person's symptoms and check how it is working. One study of people who died in a palliative care unit found that the typical dose in the last day of life was low. People whose doses went up near the end did not die sooner than people whose doses stayed the same.
If pain or breathlessness is not under control, tell your nurse. The medicine can be changed or increased.
Is addiction a concern?
Experts say that at the end of life, care should focus on relieving pain, not on worries about long-term dependence. The goal is comfort.
What side effects should I watch for?
The National Institute on Aging lists these possible side effects:
- Sleepiness
- Confusion
- Seeing things that are not there
Constipation is also common with strong pain medicines, and other medicines can help prevent or relieve it. Ask your nurse about a plan for this.
What should I ask the hospice nurse?
- What is this medicine for, and what dose is my person getting?
- What changes should I watch for after a dose?
- What should I do if pain or breathlessness comes back?
- Who do I call at night if I have a question?
It is always okay to ask. Your questions help the team keep your person comfortable.
Sources
- National Institute on Aging, Providing care and comfort at the end of life: nia.nih.gov/health/end-life/providing-care-and-comfort-end-life
- National Cancer Institute, Last Days of Life (PDQ), Patient Version: cancer.gov/about-cancer/advanced-cancer/caregivers/planning/last-days-pdq
- Sykes N, Thorns A, The use of opioids and sedatives at the end of life, Lancet Oncology, 2003: pubmed.ncbi.nlm.nih.gov/12732169
- Thorns A, Sykes N, Opioid use in last week of life and implications for end-of-life decision-making, Lancet, 2000: pubmed.ncbi.nlm.nih.gov/10972375
Educational information only. This article is not medical, legal, or financial advice, and it can't account for your person's health or your state's rules. Always talk with your hospice team, doctor, or Medicare (1-800-MEDICARE) about your situation. If you think it's an emergency, call your hospice's 24-hour number or 911.