I am not having a great 2015, first my dad passed away and now my mother passed away a few weeks back. I have been spending a considerable amount of time in the hospital (in the UK), supporting my mother during this "end of life" care.
Even though the nurses and doctors cared a lot, they had no idea of variation. It was a "professional" gut feel, which was often wrong. I would routinely get called in during this period as they feared my mother was passing. Different doctors/nurses had different opinions, which were always exacerbated at their shift change; they did not have time to be focused on my mother.
To be fair, they did not have a great system in place to assess the variation of my mother's condition (blood pressure, pulse, oxygen level, and breathing rate). They had equipment that could monitor these parameters, but this was not connected up to any type of control chart. They had basic data recording but only assessed against specification limits. The frequency of assessment was once or twice a shift, which for data gathering is pretty much useless given the situation/condition.
I actually ended up constructing a XBarR chart to monitor my mother's breathing cycle every 15 minutes. From this chart I could see my mother declining, and this allowed me to make the decision to stay her final night; it also allowed me to come to terms with what was going on, as I could see the breathing cycle shorten over the period of two days.
In her final moments, I saw a rapid slowing down of the breathing cycle; I held my mother's hand and spoke some special words to her and then watched her pass away within 20 minutes. I will always appreciate that I was with my mother during this period, as I missed my father's passing.
With all the hospital's monitoring technologies, I feel they could do a lot better in managing this "end of life" phase. The doctors were simply doubling the morphine doses; this simple approach meant that I lost the ability to communicate with my mother as the morphine caused her to sleep continuously in the last few days [author's note: oversedation].
I still feel there could have been a better balance between administration of morphine and the ability to communicate with my mother (however, I am not a medical doctor). Also, I believe that these monitoring technologies could be used better and do what I did, which allowed me to make a decision based on data and be there at my mother's passing. I am sure other people in my position would like this also.
Please find attached the spreadsheet and data from monitoring my mother's breathing cycle. Here's my methodology: