End Of Life... Nurse Says Death Is 'imminent'?

[LittleLentils]

Hi everyone,

My relative has advanced COPD and lung cancer. He has been having end of life care for 3 weeks. Today things took a turn though, and the palliative nurse told us 'death is imminent'. He was crying out in pain for morphine and has been sleeping since it was administered.

Does anyone work in end of life care that can help me understand if she means hours/days/weeks? We are all with him now.

Thanks for any help x

Oh @ShowOfHands this is exactly what happened with my beloved gran this Wednesday. She had exactly those drugs. I will be haunted by seeing her in that state for so so long. After she passed I helped the nurse move her into a more dignified position so the undertakers could come and take care of her, and that was a million times easier than the build up to her death.

@Mariposista so sorry for your loss - your gran sounds like a fighter ❤️

The nurses have been brilliant.

I am hoping for a quick passing for him. He has been suffering for a couple of years now, but the last 3 weeks and the lasy 7 days in particular have been horrific. It's horrible to see them in pain isn't it 💔

Just another saying it will probably be overnight. I used to nurse palliative patients and you do get to know when things are more imminent. I presume you have phone numbers, should you require anything for your relative, like breakthrough medication if they become distressed or appear in pain?

Hi Op, I’m a district nurse so sadly come into contact with people like you pretty much every day. I agree with other posters, if I tell a family that a patient is actively dying or death is imminent I am thinking hours but people can really surprise us and stay for days, we had one poor lady on a syringe driver for three weeks.

He may show signs of things changing such as change in breathing, skin changes etc where as some people just simple slip away and no changes are seen.

I am so sorry this is happening to you. Sending hugs

Yes, the my DH's Macmillan nurse told us the evening before, that it wouldn't be long. A Marie Curie nurse sat with him overnight, and when she left in the morning she said it would be hours. He died a couple of hours later, with me and my daughters (and the cat) sitting with him, sharing memories and funny stories. Well me and the girls sharered stories. The cat just sat there on the bed!

It was a wonderful death, really.

Sending lots of hugs to you. My mum died of COPD, we were not told by the medical staff death was imminent, but we knew.

I hope his passing is peaceful.

@LittleLentils I'm sorry, I cross posted with your post about it being horrific for your relative over the last week. I would have worded my post differently if I'd known. I do hope his last hours are more peaceful.

@LittleLentils i am so sorry.

It took my relative about twenty four hours.

Within that time I thought she was unaware that I was there stroking her hair , telling her how loved she was and not to be frightened.

Before she died a few hours later she told someone that I had been.

Im telling you this because I hope you can take comfort that your relative will be find your presence soothing.

With my work hat on as a nurse I also know that hearing is the last sense apart from touch to go .

Hugs to you .

Thank you everyone who's contributed to this, I'm trying to support my mum caring for my dad. Obviously no one can give a time and date and all of the professionals have been professional and protected my parents feelings but I've been trying to work out whether it's months, weeks or days!
May we all take comfort from 'a good death'.

Thinking of you in this long night.

If you don't want to talk then I played some audio stories when my mum died, from the podcast nothing much happens

lile a lot of other posters I deal with death everyday at work.

has his breathing changed? He’ll have a more of a pronounced rattly fast breathing pattern near the end, usually the last one/two hours.

check his feet. Are they cold?

give him permission to leave/die. Sometimes they feel they need permission to leave their loved ones. Let him know he’ll be missed and that you will all support each other once he’s gone.
don’t talk loudly or make loud noises near him, it over stimulates

🌸 🌺 🌷🌼

Sending love and support to you all. I hope it is peaceful in the end 💐

My Gran lasted 5 days. We all got called up to the home on the Monday evening as it was imminent & she wasn't expected to last the night. It was Saturday before she passed away

Sending love and support to you and your family

Sorry you are in this position. In my own experience with both my parents I found the nurse’s predictions to be accurate. It was only a matter of hours after I received the call both times. Stay strong x

It can come suddenly. Breathing stops, then maybe another couple of random breaths. Makes it hard to know which is the last one. Maybe it's different in cancer..but that's what happened with Mum.

Sorry you’re going through this.

when the nurses said this with both my parents in both cases it was two more weeks. With my mum they rang me at 2am once to say come now quickly. She was then unconscious for a week, nil by mouth doing the death rattle thing, then woke up got out of bed and had some mashed potatoes and then lived a further week after that!

sometimes these things can be very unpredictable.

I always feel we initially let my father down. My mother, wrongly in retrospect, chose to let him die in the dementia unit where he was living on the basis that there would be familiar people around. They weren't set up for proper palliative care and were using pain killing drops which he couldn't swallow and the enrolled nurse on duty was not allowed or maybe couldn't set up a morphine pump. One of the staff tipped me the word that he really should have morphine and I finally kicked off and demanded that one way or another he should have morphine. It was amazing how fast they actually could organise a doctor to come in and give morphine injections when somebody was in their face and being quite blunt about their useless care. I felt at least I did right by my dad in the end. The doctor didn't stint on the morphine and I feel relieved that my dad's last hours were peaceful and he wasn't in pain or frightened.

Talk to him. play music if he liked music.

I'm sorry you going through this OP.

Moisten his lips - at this stage he'll be dehydrated and a little dab on the lips may make his feel more comfortable.

A close friend of mine died last August of cancer. I visited him in hospital on what turned out to be his last day. He was drifting in and out of consciousness but I played him some music on my phone of bands we enjoyed together. He certainly seemed to respond to it. Hearing is one of the last senses to go and music always gives pleasure.

I'm sorry you're going through this x

Thanks for all of your replies. He woke up yesterday for a few hours and fell back asleep at 10pm. He's still asleep now. He seems to be hanging on longer than expected. They gave him an injection in his stomach yesterday that calmed him down a lot and he's been sleeping since. He spoke to us yesterday when he woke up and said he doesn't feel any pain. This gave me so much comfort.