Hey guess what? It CAN get worse.
Well, Billy Jo is sure going to remembered at Joliet Area Hospice. No matter what they give her to sedate her, it's not working.
It started off well - she slept the whole night.
Then 9:00am happened. Then the 30mg phenobarbital and haldol decided to become ineffective. She was psychotic, hallucinating, mad, afraid. She wanted her children at her bedside. Fifteen minutes later she wanted "that fucking bitch out of her house" (no one there). Twenty minutes later she was crying that I "needed to turn her around to face the wall because the military police were here and were going to shoot her"
Then it went from 30mg 3x a day to 60 mg 4x per day.
Nothing changed. Called the nurse back. After just two hours they gave her 60mg more.
Nothing changed. Now she wants to get up and dance.
This is the last ditch effort available in a home setting - 90mg every 4 hours. She just got the first application of that. Next one is 1am, next after that 5am. If at any time the psychosis and agitation and trying to get out of bed starts, we make the call and she goes to the hospice home for IV barbiturates I forgot the names of them. Her palliative care doc from before hospice, who adores her, agrees.
I have sworn up and down she will die at home. I promised her so. The problem is, if this doesn't work, there's nothing left to do here. I have to weigh her suffering vs. the promise. The promise loses, every time. I will deal with the consequences of that later, but I won't have the "never forgive myself" issues I thought I would.
If this doesn't work, for her sake and mine, she will die in the hospice home, but at least it will be (hopefully) be in peace.