Hang in there. We all hyave had those difficult families, and facilities. You may want to consider scheduling a inservice on pain management and commonly used hospice drugs for the facility. Most nursing homes will not comply with the hospice recommendations unless the drugs are on a scheduled dose. PRN ......the patient will never recieve the med. Also you said your patient was not end stage but mid stage. It might be tme for discharge before you and your agency anr both in the hot seat for contining to re sert a inapporiate patient. If you have a lot of these type of patient on your census GET OUT QUICK