Is there pain relief for my niece with late stage cirrhosis ?

I am so sorry for your situation and hers. The only thing I can think of is if you think she is a danger to herself. The social worker, depending upon your state is probably a mandated reporter and if licensed has to report that if she thinks your niece is a harm to herself. I would reach out to the social worker and although she can't tell you what they discuss, you can voice your concern and maybe she can reach out to your niece's doctors. Your niece can also ask for hospice or pain meds. Hospice will come into the home. If your niece allows you in her home, you could be the one that helps her with meds and a hospice nurse might only come once a week or something. That is how it was with my father. On the other hand, you may have to accept that you are powerless over her situation and I know that is extremely painful and difficult. You sound like a caring soul and she is lucky to have you.

@diverdown1
Thank you - my brain says there is nothing I can do but my heart refuses to accept it. I completely understand why the doctor won’t give my niece a pain med prescription while she is still drinking in an uncontrolled environment. My niece flat out refused any hospice involvement. Currently my amazing 75 year old SIL is spending 4-5 days a week getting them groceries and meds, leaving meals in the fridge, doing all the housework, making appts and shuttling my niece and her partner (he is also quite ill) to doc appts. She has approval to go into each appointment and talk with their doctors, and social worker. My understanding is that both their doctors and the social worker have been trying to get them help but since they are still considered mentally competent and refusing help, that is all anyone can do. I am concerned about my SILs health too, as this is wearing her down. Niece and SIL are keeping me somewhat at a distance from all this mess because I just finished 20+years of EOL in home caregiving in 2023- for my parents, sister, and brother and was burned out. I know they are trying to protect me because spring 2025 I was finally diagnosed with lymphoma and Parkinsons (and a couple other things) and have my own stuff to deal with. I do appreciate their intentions, but I learned alot during those 20+ years. I am strong again. My SIL does not really understand medical stuff, but she tries her best. They did let me send a plumber and an electrician over to do some repairs. I was also able to send some washable and disposable bed pads, a walker, wheelchair, and shower chair, over by saying I got them from the Goodwill and they might need them “someday”. On her good moments my niece will call and we’ll have a short chat. She always says she’s fine. She never sounds fine. So far I have been respecting her right to not want to talk about the hard stuff. I always end our conversations with I love you.
Thank you for letting me vent.

Janna:
You sound like a very caring and concerned, wonderful person. Vent at will here.

We hear you and understand; I send you a virtual hug. You are dealing with a lot of challenges in your life.

I have a sister (66) with a husband of 40 years who was diagnosed with Parkinson Disease more than 5 years ago, they live in a remote place with very little support and they are alone. I keep attempting to help but she holds me at a distance. I want to help her so much and it breaks my heart and constantly worries me she will be unable to cope much longer.

What I do is trust that God will let me step in when I am needed. I think the efforts you have made are excellent - the supplies are good for now.

My older sister has some debilitating back issues and copes by withdrawing, she did the same way with breast cancer 25 years ago: withdrew. I think some people are just that way during moments of suffering.

Just be there for her. Send a card in the mail now and then telling her your thoughts, love and prayers are with her...and trust God to do the rest.

If she will not let hospice in yet, that is OK. She may not yet be ready for that stage of reality. She has to learn to accept what they can do for her and they certainly would keep her as pain free as possible once she realizes where she is on her journey. She also may not realize she can go on and off Hospice care, depending on her course of disease. And it does seems to me (as an RN and Gerontologist) she has a good support team.

Perhaps your SIL needs some support - try offering to do something for her if you are worried she is getting overloaded. Your SIL is your niece's mother, correct?

@slarson14
Hugs to you too. I am so sorry about both your sisters situations. There are no easy answers are there? How did our society become so nuclear? What is it that makes so many of us push people away when we really need help? I’ve been pondering that a lot lately. Of course I’m sure we all have some theories, and different people will have different reasons.
My niece is familiar with hospice. She worked in a care facility for about 10 years. She knows how grateful for hospice support in our homes we were as her grandparents, birth mom, her other aunt, and her dad passed. We had an awesome experience with hospice each time. Everyone in my family seems to have a long hard passing. Years of decline followed by 6 months of crisis and misery.
My niece is well aware she is dying. She is angry that it is taking so long. She is also aware her partner is on the last leg of his journey. I am still amazed how the human body can keep going when it seems to be down to just skin covering bone.
I do not understand why she seems to be choosing pain when she knows there are options, but I keep that to myself.
This SIL that my niece is allowing in is actually my nieces step mom. She joined our family when my niece was in her early teens, and there was more than a little drama around that for around 5 years. But she (SIL) is a gem, and eventually won my niece and nephew over by her unwavering support. SIL brought peace, stability, structure, and most importantly kindness into what had been chaos before. All of my family loves/ loved her dearly from the get go. She and I are now the last of our generation. She has been there to help me as I cared for the others, and I was able to help her care for “the love of my life” as my brother passed. I was hoping to be there for her when her time comes, and it distresses me that maybe I won’t be able to. In the meantime we are pretty close, we bring up funny family stories, and can talk about the hard realities of our current situations. I do Costco runs for her, I know all her favorite items. She lets me do things around her house that cause her problems because of her arthritis. I have communication with my SILs remaining friends and great neighbors who are happy to help support her (as she has always done things for them) and get her out to do fun things between my weekly visits, and regular phone calls. This last 6 months we all try to schedule visits around her care for my niece. We drop re-heatable meals in her fridge and freezer, so she does not have to cook after a long day. They (neighbors) keep an eye on her and let me know when she is looking tired or down- not that she would admit it because stubborn seems to run in the family😂🤣.
I am grateful that there are so many caring people in this world.

@janna2 What a difficult situation your family is having but please remember to care for yourself in the meantime. Just as your niece did before she became ill she didn’t consider the negative sides of alcohol abuse or listen to anyone asking her to stop before it was too late. Until she’s found incompetent there is not much that you can do. This might occur soon as the poison circulating in her body becomes overwhelming and affects her brain too. She might consider going to an inpatient hospice since she doesn’t want anyone in her home. Unfortunately as time progresses she will become more easily manageable as she becomes sicker. My brother passed from hepatic cancer and terminal ascites one year ago.