I only have 4 months of hospice experience, but today I saw something disturbing and asked the nurses I worked with, but no one had ever seen this. I had a pt today that is actively dying. He's diagnosed with lung CA with mets to his brain. I was performing oral care when I saw something black hanging down from the top of his mouth. I looked inside with my flashlight and a large portion of the roof of his mouth had turned black (including his uvula) and was all dried up and hard. The uvula was even hanging at an angle completely stiff. Pt had several doses of atropine and robinul over the past 3 days. I've often wondered if these meds would dry the pt so much it would be uncomfortable for them, but of course they can't tell us. Could these meds possibly do this to his mouth? It was shocking to see and looked incredibly uncomfortable. There was also a large section of clear, hard plastic looking stuff that was firmly stuck to the inside of his cheek.
Also, I've read these increased secretions are not uncomfortable to the pt, but uncomfortable for families to hear, so we give these meds. Do you think it's true it's not uncomfortable for the pt? Not sure what's worse: increased secretions or dried up/cracking mouth.
Thanks in advance for your replys.