Dads awful hospice experience

See my original post here: https://www.reddit.com/r/hospice/s/umzJL2JJb3

Now that’s Dad has passed, I’d like to get your thoughts on the full story because it’s so upsetting for us.

Dad was living with heart failure and COPD for years. He went to the hospital on July 4 with a GI bleed. He was prepped for a colonoscopy but just before beginning, the anesthesiologist refused to participate saying the procedure was too risky.

Question 1. Why didn’t the doctors collaborate before he had to go through all the prep of a colonoscopy that he didn’t qualify for?

With the colonoscopy canceled, and the fact that his bleeding had stopped, the GI problem was no longer a focus. But he developed pneumonia and was moved from portable, canister oxygen to High Flow oxygen, along with antibiotics. Since his pneumonia diagnosis, the pulmonologist told us it was time for hospice. His cardiologist thought he would pull through. We were all clinging to hope.

Dad was extremely uncomfortable in the hospital, especially because he lost his strength to stand after the colonoscopy prep and could no longer get to the bathroom.

After he was in the hospital 12 days, both his pulmonologist and his cardiologist said it’s time for hospice because they couldn’t wean him from the oxygen. He ranged from 40-60 liters, and 75%-100%. We talked with Mom about moving to hospice care but she wanted to take her time to be sure she was doing the right thing.

We were told by his pulmonologist that he would need a “contract bed” in the hospital because he wouldn’t survive a transfer to another facility. We met with two hospice providers and went with the one who had a contract bed. They told us call when we were ready. At the initial meeting, they were unsure of what to do about Dads High Flow oxygen needs, but they said they’d find out. That’s when I created my first post.

Fast forward to several days of Dad begging us to let him die. He’d struggle to pull off any equipment attached to him and he stopped eating. For agitation medication, they tried Xanax, sertraline, Ativan, and Seroquel. These meds kept dropping his heart rate too much to successfully control his agitation. Eventually, Mom relented and agreed that it was time to stop his suffering and she signed over to hospice.

That’s when things took a turn for the worse. Hospice sent us home to rest for night assuring us he was in good hands. I was confused about this because I wasn’t sure what they could do for him since the medications to date hadn’t worked, but I was so emotionally and physically tired, and hospice has such a positive reputation that we trusted the process and went home to sleep.

We arrived early the next morning to find Dad wearing gloves, and the additional oxygen mask the hospital added to his regiment was askew, up into his eyes. He was also incredibly weak so it was very hard to hear what he was saying, but he was talking nonstop. He was also missing his breakfast tray.

At first, we thought the medicine they gave him worked because he was no longer combative. We thought he was comfortable. We removed his gloves, and we couldn’t prevent him from taking off the additional oxygen so we could hear him clearly. That’s when he told us the horrors of the night. It’s so painful to write this, but essentially, what they did was put the gloves on him and walk away. I immediately called hospice to find out what was going on and they said they left his care to the nurses. The nurses said they had no such orders. Eventually, hospice arrived on the scene and they said they would transfer him to their facility. I asked how they’d do that with his oxygen needs and they didn’t know. I told them to read his chart and get back to me. A little bit later, they came to me again saying they were going to transport him. At this point, I told her that if she gets approval from his pulmonologist to move him, we’ll move him. The pulmonologist again said he wouldn’t survive a transport, so he’d have to stay put. The hospice nurse, now completely at a loss, walked away talking on her phone and that was our last conversation.

After a few more hours waiting with Dad, who was sleeping peacefully on morphine, we were wondering what exactly was happening. Is hospice coming back? Is he able to survive like this and maybe get better? I asked a nurse what was going on, and she asked us if we wanted to begin to turn down his oxygen. We didn’t know if it was time for that. We didn’t know what to do. We needed care and guidance, and hospice completely failed us.

When Dad’s cardiologist found out what was happening, he came to the room, gave him more morphine and shut off the oxygen. He lived just a few more minutes.

Question 2: Is having High Flow oxygen dependency such a rare occurrence that it makes sense why hospice didn’t know what to do?

Question 3: Is it expected that we lead the steps of a loved one’s passing, especially when we don’t know what the steps are?

Question 4: Why was an invalid left alone in a hospital for the night and not given a breakfast tray as if he had already died?

I know this is a lot to read, and I may have left out pertinent details, so don’t hesitate to ask. Thank you for your kind advice for us. This has been extraordinarily hard.