I lost my DF last year to pancreatic cancer. We looked after him at home with the help of the district nurses and Macmillan. There's something which troubles me a little. He was given morphine IV plus patches and was sedated with increasing doses of medazolam after which he couldn't communicate with us. He was very unsettled and restless with uncontrolled twitching especially of his legs. He couldn't speak hardly. It really bothers me that the sedatives stopped him from being able to communicate with us. He was unable to tell us how he was feeling or how much pain he was in. I have since read that the sedative is really only to settle the anxiety of the relatives so that they don't have to witness the stress of dying. This isn't right. All I wanted was my dad to be as comfortable as possible but now I'm haunted by the fact that he may have wanted to speak to us but couldn't because of the drugs. Any thoughts on the appreciated. TIA.
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Life-limiting illness
The diamorphine and midazolam ( and sometimes hyoscine for secretions) is given via a tiny needle subcutaneously gradually infusing over the 24 HR period and is for patient comfort..pain, twitching, pain on turns, nausea, secretions, and general discomfort. Diamorphine and morphine and midazolam don't usually cause twitching, .that may have been his condition, and the sedatives would usually help with the twitching. The reduced conscious level is part of the dying process and although the diamorphine and midazolam are sedative, their introduction and dosing/ titration is done according to the stage of the dying process and how comfortable the person is. It's not like in films when people converse and are normal until the moment of death..death from cancer is usually a process over days and in those last days there is usually coma.
I hope I can reassure you that you acted in his best interests and eased his passing.
All the best OP 
Sorry for your loss my dad passed away from pancreatic cancer too, bastard disease. He didn't have any painkillers at the end apart from a morphine patch, but was still comatose, only stirring occasionally, for the last two days. I think his system was just slowly shutting down. So i would say your experience is part of the process, regardless of whether the person is sedated or not. I hope that helps you feel a bit better about it.
Thank you for taking the time to reply and I do feel somewhat reassured now - thank you. There were times when he showed that he knew what was going on until the last couple of days when he went into a coma. Things go through your mind afterwards but I guess that's natural. I hope we did our best for him.
Sorry for your loss too VimFuego101 Yes it is a bastard disease. I've never come across anything so aggressive and rapid. He lasted 6 months from diagnosis. It was stage 4 with metastasis to the liver and yet a scan 6 months prior was clear!
Thank you all for your advice. I feel much better about it all
My brother was sedated when he died from Lymphoma. He was in a terrible state before that, having panic attacks as his heart was affected, thinking there was someone in the room etc. Once he was sedated everything became much more peaceful. Thank god for sedation.
I'm sorry for your loss OP - it's normal to feel somehow responsible when witnessing a death, I know I did.
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